scholarly journals Impaired right ventricular filling in patients with a chronic coronary syndrome

2021 ◽  
Author(s):  
Alexey N Sumin ◽  
Ekaterina V Korok ◽  
Tat'ana Yu Sergeeva

Aim: The prognostic value of right ventricle (RV) systolic dysfunction is known but the RV diastolic dysfunction (RVDD) is less investigated, thus the purpose of this study was to assess the incidence of RVDD in patients with coronary artery disease (CAD) and to identify factors associated with its presence. Material and methods: We examined 200 patients with stable CAD (153 men). RV diastolic parameters were studied by echocardiography: peak velocity of early (Et) and late (At) RV fill-ing and their ratio, velocities at the tricuspid annulus (et’, a’t, s’t). Patients were divided into 2 groups: with (n=92) and without RVDD (n=108). Results: Old myocardial infarction (MI) (p=0.007), anterior MI (p=0.001), congestive heart failure (p=0.030) and peripheral arterial disease (p=0.030) were more prevalent in patients with RVDD. The end-systolic dimensions were higher (p=0.010), while left ventricular (LV) ejection fraction (EF) (p=0.044) and the mitral E/A ratio (p<0.001) were lower in this group. No significant differences were found between the groups in the coronary artery stenosis. Independent predictors of the RVDD presence were increased age, old MI, hyperlipidemia, moderate chronic heart failure, peripheral arterial disease, and decreased LVEF. Conclusions: The RV diastolic dysfunction is much more common than systolic dysfunction in patients with stable CAD (46% and 7.5%, respectively). The RVDD presence was predominantly associated with an increase in age and LV systolic dysfunction, but not with coronary artery lesions. The predictive value of RVDD requires further research.

2017 ◽  
Vol 4 (5) ◽  
pp. 1276
Author(s):  
Somnath Mukherjee ◽  
Prashant Kumar ◽  
D. P. Sinha

Background: To determine the frequency of peripheral arterial disease (PAD) in patients presenting with acute coronary syndrome (ACS) and association of PAD with different risk factors of coronary artery disease (CAD) and to look for in hospital outcome of ACS patients with or without PAD.Methods: This cross-sectional observation study was undertaken in the department of cardiology, IPGME&R Hospital, Kolkata from June 2015 to August 2016 to recruit 199 consecutive patients admitted with ACS and were evaluated with detailed clinical history, physical examination, ABI (Ankle Brachial Index) measurement, echocardiography and appropriate blood investigations.Results: Among 199 total ACS patients, STEMI was the predominant mode of presentation (71.86%) and majorities were male. PAD was seen in 26 patients and mean age was 56.68±8.84 years. Factors independently related with PAD in acute coronary syndromes are hypertension (OR- 1.49; 95% CI: 0.615-3.232), diabetes (OR- 2.55;95% CI : 0.9762-6.6665), smoking (OR-2.55; 95% CI: 1.055-6.19), past history of CVA (OR-11.15;95% CI: 1.77-70.32), LV systolic dysfunction (OR-1.388; 95% CI:0.607-3.1742). 2 and 13 patients died within 7 days of admission among 26 ACS-PAD group (7.69%) and 173 ACS-non-PAD group (7.5%) respectively and most of them had STEMI.Conclusions: Significant numbers of ACS patients are having PAD and older age, male sex, diabetes, hypertension, smoking and LV systolic dysfunction were found to be independent predictors for PAD in ACS patients. Early in hospital mortality was seem to be dependent on clinical presentation, not on presence or absence of PAD.


2017 ◽  
Vol 11 (2) ◽  
pp. 79-84
Author(s):  
Syed Dawood Md Taimur ◽  
Mashhud Zia Chowdhury ◽  
Md Enamul Hakim

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84


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