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[Diagnostic value of left ventricular diastolic function using pulsed Doppler echocardiography in patients with
Insights
Transesophageal atrial pacing effectively diagnoses coronary heart disease (CHD). Post-pacing Doppler analysis reveals left ventricular diastolic dysfunction, a sensitive marker for myocardial ischemia in CHD patients.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Coronary heart disease (CHD) diagnosis remains critical.
- Assessing left ventricular diastolic function aids in understanding cardiac health.
Purpose of the Study:
- To evaluate transesophageal atrial pacing combined with echocardiography for diagnosing CHD.
- To identify markers of myocardial ischemia using Doppler parameters.
Main Methods:
- Transesophageal atrial pacing in 54 patients.
- 12-lead ECG and echocardiography for assessing contractile disorders.
- Pulsed Doppler echocardiography to examine left ventricular diastolic function post-pacing.
Main Results:
- 38 patients showed altered Doppler parameters post-pacing compared to rest.
- 16 patients without CHD had no changes in diastolic function.
- Two types of transmitral blood flow disorders identified in CHD patients, with 'pseudonormal' flow indicating severe impairment.
Conclusions:
- Transesophageal atrial pacing with Doppler echocardiography is a sensitive method for diagnosing CHD.
- Left ventricular diastolic dysfunction and local contractility abnormalities are sensitive markers for myocardial ischemia.
Abstract:
Transesophageal atrial pacing was performed in 54 patients (mean age 50.0 +/- 6.8 years) to diagnose coronary heart disease (CHD). ECG was recorded in 12 leads during the test. Echocardiography was used to assess local contractile disorders. The diastolic function of the left ventricle was examined by pulsed Doppler echocardiography in the postpacing period. Thirty eight patients were found to have altered Doppler parameters for transmitral blood flow in the postpacing period as compared to the resting period. Sixteen patients without CHD displayed no changes in the left ventricular diastolic function in the postpacing period. Two types of transmitral blood flow disorders were identified in CHD patients in the postpacing period. The so-called "pseudonormal" type of transmitral blood flow was typical of patients with the most severe contractile impairments and grave course. Abnormalities in local contractility and signs of left ventricular diastolic dysfunction were ascertained to be a sensitive marker for myocardial ischemia.