Background:
Left ventricular (LV) diastolic dysfunction occurs before LV systolic dysfunction and electrocardiographic changes in ischemic cascade. Diastolic wall strain (DWS) has been proposed as a marker of LV diastolic stiffness. Therefore, the objectives of this study were to defined the relationship between DWS and percutaneous coronary intervention (PCI) and see other echocardiographic parameters in patients who undergoing coronary angiography (CAG).
Methods:
254 patients (mean age: 61 ± 10, 136 (54%) men) undergoing CAG and normal left ventricular systolic function without regional wall motion abnormalities were enrolled, and among them, 68 (27%) patients performed PCI. All patients performed echocardiography before CAG and DWS defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS =[PWT(systole)-PWTdiastole)]/PWT(systole)).
Results:
Patients who performed PCI showed significantly lower DWS (0.27 ± 0.09 vs. 0.39 ± 0.08, p < 0.001). Age did not differ between the two groups (61.6 ± 10.6 vs. 60.9 ± 10.4, p = 0.623), and LV ejection fraction was also similar (62.8 ± 4.6 vs. 63.5 ± 5.2%, p = 0.380). Other echocardiographic parameters did not show significance differences but E/E’ ratio was slightly but significantly elevated in patients performed PCI (10.9 ± 4.8 vs 9.2 ± 3.3, p = 0.011). In multiple regression analysis, lower DWS was an independent predictor for PCI (Cut-off value: 0.34, sensitivity: 89%, AUC: 0.870, SE: 0.025, p < 0.001).
Conclusion:
DWS, a simple parameter that can be calculated from routine 2D echocardiography, is inversely associated with presence of coronary artery disease and PCI.
Pulmonary hypertension in thalassaemia major patients with normal left ventricular systolic function
