Introduction .– The 2D strain echocardiography is a new technique to analyze ventricular function in all dimensions. The objective of our study is to emphasize the value of 2D strain in detecting infra clinical myocardial ischemia in acute coronary syndrome without ST elevation.

Patients and methods .– This is a prospective study from October 2011 to June 2012 included 30 patients admitted for acute coronary syndrome without ST elevation. All of them have had clinical examination, ECG, cardiac enzyme dosage, echocardiography with analysis of longitudinal left ventricular function by 2D strain and coronary angiography.

Results .– The average age of patients was 62.2 ± 8.08 years, [26 men and four women], they had more than three cardiovascular risk factors dominated by hypertension [63%], smoking [55.6%] and diabetes [45.6%], previous history of ischemic heart disease was found in 39.3% of cases.

The typical chest pain was the mode of revelation in 95% of cases, with ST segment elevation in 36% of cases, negative T waves in 61% of cases, troponin was positive in all cases. Concerning echocardiography, the left ventricle was not dilated in majority of cases with preserved systolic function [EF = 57.78 ± 6.89%], but the two-dimensional longitudinal strain was altered [−14.41 ± 3.34%], a very strong linear correlation between the conventional and new parameters was observed [OR = 2.75, P = 0.02]. In coronary angiography, 25.9% of patients had single vessel lesions, 37% had two vessels lesions and 35,1% had three vessels lesions, a strong linear correlation between two-dimensional strain and severity of coronary lesions [OR = 3.15, P = 0.01]. Besides medical treatment, 32.3% have undergone angioplasty and 34.6% were undergoing surgery.

Conclusion .– These results suggest a considerable usefulness of two dimensional longitudinal strain, a new method of echocardiography in the estimation of global and regional LV function in patients with acute coronary syndrome without ST elevation and its agreement with conventional parameters such as LVEF.