الفهرس 
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Abstract
The diagnosis of coronary artery disease using echocardio-graphy mostly depends on the detection of left ventricle abnormal wall motion and the assessment of left ventricle ejection fraction. However, there are no abnormal left ventricle wall motions at rest in coronary artery disease patients without a history of myocardial infarction.
Significant coronary artery stenosis might cause persistently impaired longitudinal left ventricle function at rest, so 2D speckle tracking echocardiography is more accurate than conventional 2D echocardiography in evaluating the regional and global myocardial function and assessing infarct size, the viability of the infarcted myocardium, and mild changes of myocardial ischemia
The current study included 60 individuals who were recruited from Ain Shams university hospitals in the period from March 2020 to December 2020. All patients were recruited from the catheter laboratory suspected to have coronary artery disease indicated for a coronary angiogram and underwent echocardiographic assessment before elective coronary angiography
The objective of the study was to assess the correlation between the severity of coronary artery disease as assessed by angiographically derived SYNTAX score and the Global longitudinal and Circumferential peak systolic strain in patients without regional wall motion abnormality and with normal systolic function.
All patients were subjected to history taking, clinical examination, ECG recording, full echocardiographic assessment, measurement of Global longitudinal and Circumferential peak systolic strain then coronary angiography was done.
2D loops used for speckle tracking echocardiography to assess the left ventricle from apical 4,3 and 2 chamber views for the longitudinal strain and short axis at the basal, mid, and apical levels of the heart for the circumferential strain.
According to the results of the current study, we concluded:
● Speckle-tracking echocardiography helps early detection of sub-clinical left ventricular dysfunction and presence, extent, and severity of coronary artery disease and thus helps in the prevention of development of complications and progression of ischemia and facilitate the application of the preventive measures.
● Global longitudinal and circumferential peak systolic strain declined incrementally with the increasing severity of coronary artery disease defined by the increasing number of stenotic coronary vessels. So the risk of multi-vessels disease increases with decreasing strain.
Through those data, we recommend applying 2D speckle tracking echocardiography in the routine assessment of patients presenting with stable coronary artery disease which can detect early impairment of left ventricular function and subclinical ischemia.