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[Left ventricular diastolic function evaluated by Doppler echocardiography in coronary artery disease in relation to
A Kowalska1, K Loboz-Grudzień, T Hirnle
1Oddział Kardiologiczny Dolnoślaskiego, Szpitala Specjalistycznego, T. Marciniaka we Wrocławiu.
Insights
In coronary artery disease (CAD), Doppler mitral flow indices reveal diastolic dysfunction often precedes systolic dysfunction. Left ventricular ejection fraction and wall motion score independently impact diastolic function indicators.
Area of Science:
- Cardiology
- Cardiovascular Research
- Echocardiography
Background:
- Coronary artery disease (CAD) can lead to left ventricular (LV) dysfunction.
- Assessing LV diastolic and systolic performance is crucial for managing CAD patients.
- Doppler mitral flow indices (D.m.f.i.) offer insights into diastolic function.
Purpose of the Study:
- To investigate the relationship between LV diastolic dysfunction, measured by D.m.f.i., and LV systolic performance in patients with CAD.
- To identify specific D.m.f.i. parameters indicative of diastolic dysfunction in CAD.
- To explore the correlation between LV systolic function parameters and D.m.f.i.
Main Methods:
- 107 patients with confirmed CAD were analyzed.
- Patients were grouped based on left ventricular ejection fraction (EF) ≥ 55%.
- 13 Doppler mitral flow indices were calculated, including time, velocity, and flow volume parameters.
Main Results:
- In CAD patients with normal EF, diastolic dysfunction presented as impaired relaxation.
- Prolonged isovolumic relaxation time (IVRT) and deceleration time (DT) were observed.
- Positive correlation found between EF and DT (r=0.35); inverse correlation between wall motion score index (WMSI) and DT (r=-0.33).
- EF and WMSI were identified as independent factors influencing DT.
Conclusions:
- Diastolic dysfunction appears to precede systolic dysfunction in coronary artery disease.
- Significant correlations exist between D.m.f.i. and LV systolic function parameters.
- LV systolic function should be considered in the analysis of Doppler mitral flow data.
Abstract:
The aim of the study was to assess the relationship between left ventricular (LV) diastolic dysfunction measured by Doppler mitral flow indices (D.m.f.i.) and LV systolic performance in coronary artery disease (CAD). 107 pts with confirmed CAD without or after MI in I, II NYHA class was divided into 2 groups according to ejection fraction (EF) value = 55%. 13 D.m.f.i. regarding to the time, velocity, flow volume and derivates were calculated. In the patient with CAD with normal EF, the diastolic dysfunction was characterised by the impaired relaxation. There were prolonged isovolumic relaxation time IVRT and deceleration time of early filling flow DT, reduced early filling fraction EFF and increased the atrial filling fraction AFF, decreased E/A ratio and E/A-VTI. The regression analysis revealed the positive correlation between EF and DT r = 0.35 and inverse correlation between wall motion score index WMSI and DT r = DT r = -0.33. The stepwise regression analysis revealed that EF and WMSI are independent factors influencing on DT. Our results confirm that diastolic dysfunction precedes the systolic dysfunction in CAD. The correlation between D.m.f.i. and LV systolic function parameters were obtained. The results suggest that the LV systolic function should be take to account in the Doppler mitral flow analysis.