Examination of probable distinction between cardiac or non- cardiac thoracal disorder via echocardiographic myocardial strain analysis

Patients with cardiac disorder have to undergo time- consuming and expensive examinations such as laboratory of cardiac biomarkers or ischemic diagnostic. To save time and money in this observational registry the probable distinction between cardiac and non- cardiac disorder in patients with vague thoracal disorder and the probability for coronary artery disease (determined via Grace Score) is examined via echographic myocardial strain analysis in 300 patients retrospectively to establish a cut off value corresponding to acute coronary disease also to prevent coronary angiography. Therefore patients undergo echography routinely with consecutive evaluation of systolic, diastolic and strain analysis to elevate exact statements with reference to deformation of the myocard and its velocity. Several study have shown that these strain parameters (circumferential and radial strain) enable vitality and ischemic diagnosis and therefore could be eligible for this purpose.

Inclusion Criteria:

• thoracal cardiac or non cardiac disorder
• signed informed consent

Exclusion Criteria:

• glomerular filtration rate (GFR) < 60 ml/min
• angina pectoris
• acute myocardial infarction within 3 months prior inclusion
• pregnancy

300 patients with vague thoracal disorder -cardiac or non cardiac- are enrolled prospectively to undergo routinely echography as well as routine examinations such as anamnetic, hemodynamic examinations and laboratory. The distinction between non cardiac disorder or acute coronary disease (ACS) is offen difficult so that time- consuming and expensive ischemic diagnostics or coronary artery angiography will follow. To prevent these time consuming or expensive diagnostics retrospectively a cut off value will be determined of systolic, diastolic and additionally of circumferential and radial echographic strain data analysis corresponding to acute coronary disease.