Left ventricular dyssynchrony in coronary artery disease patients without regional wall-motion abnormality:
Miao Li1, Lin Li1, Wenfang Wu1
1Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Insights
Three-dimensional echocardiography detects left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall-motion abnormality. The 16-region systolic dyssynchrony index (16R-SDI) correlates with CAD severity and predicts high Gensini scores.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Left ventricular dyssynchrony (LVD) is increasingly recognized in coronary artery disease (CAD) patients.
- Assessing LVD in CAD patients without regional wall-motion abnormality (RWMA) is crucial for understanding disease progression.
Purpose of the Study:
- To investigate LVD in CAD patients without RWMA using three-dimensional echocardiography (3-DE).
- To explore the relationship between LVD parameters and the severity of CAD, quantified by the Gensini score (GS).
Main Methods:
- Sixty-one CAD patients underwent 3-DE to quantify LVD parameters, including TmsvSD and systolic dyssynchrony index (SDI) across 16, 12, and 6 regions.
- Coronary artery disease severity was assessed using the Gensini score (GS) based on coronary angiography.
- Patients were stratified into low, mid, and high GS groups to compare LVD values.
Main Results:
- CAD patients exhibited elevated LVD parameters compared to controls.
- The 16-region systolic dyssynchrony index (16R-SDI) was significantly prolonged in the high-GS group.
- 16R-SDI showed a positive correlation with GS and was identified as an independent predictor of GS.
Conclusions:
- Three-dimensional echocardiography is a valuable noninvasive tool for detecting LVD in CAD patients without RWMA.
- The 16R-SDI parameter demonstrates a significant correlation with CAD severity and can help identify patients with higher disease burden.
Objectives:
Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall-motion abnormality (RWMA) by three-dimensional echocardiography (3-DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS).
Methods:
Sixty-one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD-16, TmsvSD-12, and TmsvSD-6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R-SDI, 12R-SDI, 6R-SDI) using 3-DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low-GS ≤20, mid-GS >20 and ≤48, and high-GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed.
Results:
Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R-SDI, and 6R-SDI were prolonged in the high-GS group compared with the low- and mid-GS groups. 16R-SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R-SDI was an independent predictor of the GS. 16R-SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high-GS.
Conclusion:
Three-dimensional echocardiography is a noninvasive technique to detect LVD in non-RWMA CAD patients, and the parameter 16R-SDI was significantly correlated with CAD severity.
More Related Videos
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:30Peripheral Artery Disease I: Introduction