Analysis of the Predictive Efficacy of Conventional Echocardiography Combined with Quantitative Parameters of Myocardial Contractile Function for Coronary Artery Stenosis Lesions

Objective: To evaluate whether combining conventional echocardiography with non-invasive myocardial work (MW) parameters improves prediction of coronary artery stenosis in patients with preserved left ventricular ejection fraction (LVEF). Methods: We retrospectively enrolled 180 patients undergoing coronary angiography (CAG); 72 had ≥50% stenosis (lesion group) and 108 had <50% or no stenosis (non-lesion group). Conventional parameters (LVEF, E/e′) and MW indices—global longitudinal strain (GLS), global work index (GWI) and global work efficiency (GWE)—were derived by two-dimensional speckle tracking and pressure–strain loop analysis. Results: Absolute GLS, GWI, GWE, LVEF and E/e′ were independent predictors (all p < 0.05). GWI was the best single predictor (AUC 0.761). The combined conventional+MW model achieved the highest AUC (0.887; 95% CI 0.831–0.929), outperforming the conventional-only (0.725) and MW-only (0.832) models (both p < 0.05), with 93.52% specificity. Conclusion: Adding MW parameters to conventional echocardiography substantially improves non-invasive prediction of coronary artery stenosis, providing a useful confirmatory risk-stratification tool before CAG.