scholarly journals Prognostic Value of Diastolic Dysfunction Derived From D-SPECT in Coronary Artery Disease Patients With Normal Ejection Fraction

2021 ◽  
Vol 8 ◽  
Author(s):  
Bin Xu ◽  
Lu Liu ◽  
Fuad A. Abdu ◽  
Guoqing Yin ◽  
Abdul-Quddus Mohammed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Prognostic Value ◽  
Systolic Function ◽  
Normal Ejection Fraction ◽  
Normal Systolic Function ◽  
Artery Disease

Diastolic dysfunction (DD) with normal systolic function has been elucidated to be associated with heart failure and worse prognosis. The recently introduced single photon emission computed tomography (SPECT) with dedicated cardiac cadmium-zinc-telluride (CZT) cameras (D-SPECT) is a novel method to quantitate left ventricular functional parameters. We aimed to evaluate the prognostic value of DD derived from D-SPECT in coronary artery disease (CAD) patients with normal ejection fraction. All CAD patients who underwent D-SPECT and invasive coronary angiography within 3 months were considered. DD was defined as peak filling rate (PFR) <2.1 end diastolic volume (EDV, ml)/s according to the D-SPECT results. Patients were divided into three groups: group 1 (n = 226)—normal PFR; group 2 (n = 67)—ischemia-related DD (abnormal stress PFR and normal rest PFR); and group 3 (n = 106)—rest DD (abnormal rest PFR). The primary clinical endpoint of the present study was a composite of heart failure events (HFE). A total of 399 consecutive CAD patients with normal systolic function undergoing stress D-SPECT were analyzed. The incidence rates of HFE among the three groups were 4.0, 7.5, and 11.3%, respectively. Cox regression analysis showed that the multivariate predictors of HFE were rest PFR, diabetes mellitus, obesity, and old age. DD derived from D-SPECT in CAD patients with normal ejection fraction is predictive of HFE.

scholarly journals Echocardiographic evaluation of diastolic dysfunction in type 2 diabetes mellitus with normal systolic function and correlation with duration of diabetes mellitus and HbA1C

2018 ◽  
Vol 6 (10) ◽  
pp. 3235
Author(s):  
Uttam Kumar Sarkar ◽  
Mayank Jain ◽  
Priyanka Kiyawat
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diabetic Patients ◽  
Diabetic Mellitus ◽  
Duration Of Diabetes ◽  
Normal Systolic Function ◽  
Artery Disease

Background: The incidence of heart failure in diabetic subjects is high even in absence of hypertension and coronary artery disease. Studies have reported a high prevalence of preclinical diastolic dysfunction among subjects with diabetes mellitus. The aim of this study was to assess relationship of diastolic dysfunction with duration of diabetes mellitus and HbA1c level.Methods: This cross-sectional observational study was conducted in 200 consenting patients with diabetes mellitus without history of hypertension and established coronary artery disease with normal systolic function from the period of February 2013 to October 2014. All diabetic patients were studied for HbA1c level, time period since 1st diabetes was diagnosed, and echocardiography was performed and, diastolic function parameters were measured.Results: In this study, out of 32 subjects with HbA1c 7.1-8.0%, 25 (78.12%); out of 80 subjects with HbA1c 8.1-10.0%, 69 (86.25%); and out of 24 subjects with HbA1c >10%, 24 (100.0%) had diastolic dysfunction. Out of 88 subjects with duration of diabetic mellitus 0-5 years, 34 patients (38.63%); out of 64 subjects with duration of diabetic mellitus of 6-10 years, 53 patients (82.81%); out of 42 subjects with duration of diabetic mellitus 11-15 years, 38 patients (90.47%); and out of 6 subjects with duration of diabetic mellitus >15 years, 6 patients (100.0%) had diastolic dysfunction.Conclusions: Diastolic dysfunction is significantly associated with duration of disease and glycemic control assessed by HbA1c.

scholarly journals New biochemical predictor of the ventricular tachyarrhythmias in patients with ischemic cardiomyopathy

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Atabekov ◽  
R Batalov ◽  
S Sazonova ◽  
S Gusakova ◽  
S Krivolapov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Ischemic Cardiomyopathy ◽  
Roc Analysis ◽  
Ventricular Tachyarrhythmias ◽  
Icd Implantation ◽  
Galectin 3 ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. The cardioverter-defibrillator (ICD) implantation is the most effective method for the sudden cardiac death (SCD) prevention. However, about 25% patients did not receive an ICD therapy during the first 5-years follow-up. At the same time ICD does not register ventricular tachyarrhythmias (VTA) events in patients with ICD implanted for the primary prevention of SCD. So, it’s necessary to find out new prognostic markers of the VTA incidence, which will help to optimize the selection of patients who really need an ICD implantation. Currently, ST-2 and galectin-3 are actively studied in patients with coronary artery disease (CAD) and chronic heart failure due to their high potential prognostic value. Moreover, their role in the development of life-threatening arrhythmias is still poorly understood. In this regard, the study of the level of biomarkers of inflammation and myocardial fibrosis is relevant. Aim. To evaluate the prognostic value of the ST-2 and galectin-3 in VTA predicting in patients with coronary artery disease and left ventricular ejection fraction less than 35 %. Material and methods. The study included 40 patients (males – 36, median age – 64,5 [57,5; 68,5] years) with CAD, II and III functional class of chronic heart failure, left ventricle ejection fraction less than 35 % and ICD implantation indications (primary prevention of the SCD). ST-2 and galectin-3 blood concentration were determined before ICD implantation. All patients were followed-up during 18 months. There were assessed arrhythmological events recorded in ICD memory and ICD-lead parameters. Results. The 1st group consisted of 10 (25,0 %) patients with VTA events terminated with ICD antitachycardia pacing or shock, the 2nd group – 30 (75,0 %) patients without VTA events. The univariate ROC-analysis showed that the high values of the ST-2 (p = 0,003) and galectin-3 (p = 0,045) were associated with frequent VTA events. Kaplan-Meier analysis showed that the ST-2 > 22,48 ng/ml (p = 0,02) and galectin-3 > 10,95 ng/ml (p = 0,009) significantly increase the risk of the VTA events. The multivariate ROC-analysis showed that only ST-2 increase (OR = 1,1053; CI 95 %: 1,0134-1,2056; р = 0,023) leaded to frequent VTA events. Conclusion. An increase of ST-2 more than 22,48 ng/ml and galectin-3 more than 10,95 ng/ml has predictive value in VTA assessing risk in patients with ischemic cardiomyopathy. In multivariate analysis, an independent predictor of VTA is the ST-2 increase more than 22,48 ng/ml.

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