The correlation between speckle-tracking echocardiography and coronary angiography in suspected coronary artery disease with normal left ventricular function.

Introduction: Our study objects to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography (2DSTE) in predicting presence and severity of coronary artery disease (CAD). Methods: Patients with stable angina pectoris with normal left ventricular function (>50%) undergoing coronary angiography were enrolled and subjected to speckle tracking echocardiography. Global longitudinal peak systolic strain was measured and correlated to the results of coronary angiography for each patient. Results: Number of male (P=0.001), diabetes (P=0.01) and smoking (P=0.01) patients were significantly higher in the CAD group compared to non-CAD patients. Global longitudinal peak systolic strain (GLPSS) was significantly (P=0.0001) lower in CAD patients in comparison to non- CAD patients. GLPSS showed significantly lower in patients with Syntax score (SS)≥22 in comparison to SS<22. Cut-off value -19 for GLPSS could be used to predict the presence of significant CAD with 80.6% sensitivity and 76.5% specificity (area under curve (AUC) -0.83, P=0.0001). The mean GLPSS value decreased as the number of diseased coronary vessels increased (P=0.0001). The optimal cut-off value of -16 GLPSS with a sensitivity of 76.7% and specificity of 83.3% [AUC 0.84, P<0.0001] was found significant to predict CAD severity. Multivariate regression of GLPSS and another risk factor for predicting significant CAD, GLPSS showed OR=1.55 (CI-1.36-1.76) P=0.0001 for predicting the presence of CAD. Conclusion: 2DSTE can be used as a non-invasive screening test in predicting presence, extent and severity of significant CAD patients with suspected stable angina pectoris.

Unusual presentation of extramedullary haematopoiesis in a young boy.

Acute transverse myelopathy in a young person may be due to infection, postinfective or inflammatory demyelination, or vascular causes. Rarely, a completely reversible cause of acute transverse myelopathy may be seen, as described here in our case of transverse myelopathy due to extramedullary haematopoiesis (EMH). An 18-year-old man who had a history of a lone blood transfusion at age of 7 years presented with paraplegia. MRI showed multiple epidural space masses of EMH compressing the spinal cord. He was detected to have thalassaemia intermedia and was treated with blood transfusions, steroids and radiotherapy to the involved paraspinal areas. He recovered fully over 15 days and remained symptom free at 6 months.