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[Nuclear medical determination of left ventricular diastolic function in coronary heart disease]
Insights
Resting diastolic function, assessed by Peak Filling Rate (PFR) and Time to Peak Filling Rate (TPFR), is more sensitive than ejection fraction (EF) in detecting left ventricular dysfunction in coronary artery disease patients.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Cardiac Imaging
Background:
- Coronary artery disease (CAD) significantly impacts left ventricular function.
- Assessing diastolic and systolic function is crucial for patient management.
- Nuclear cardiology offers methods to evaluate cardiac mechanics.
Purpose of the Study:
- To compare the sensitivity of left ventricular diastolic function parameters (PFR, TPFR) versus ejection fraction (EF) in patients with CAD.
- To evaluate diastolic dysfunction in patients with and without a history of myocardial infarction.
Main Methods:
- Utilized the Nuclear Stethoscope to measure Peak Filling Rate (PFR) and Time to Peak Filling Rate (TPFR) in 191 CAD patients.
- Measured resting ejection fraction (EF).
- Categorized patients based on infarction history (anterior, inferior, or none).
Main Results:
- Diastolic dysfunction (abnormal PFR/TPFR) was prevalent: 87% post-anterior MI, 81% post-inferior MI.
- Reduced EF was observed in 66% post-anterior MI and 61% post-inferior MI.
- Patients with CAD without MI history also showed impaired diastolic function.
Conclusions:
- Resting diastolic function (PFR, TPFR) is a more sensitive indicator of left ventricular dysfunction in CAD patients than resting systolic function (EF).
- Diastolic dysfunction is common even in CAD patients without a history of myocardial infarction.
Abstract:
In 191 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 123 patients had already suffered a myocardial infarction, of these 59 an anterior wall infarction and 64 an inferior wall infarction. The remaining 68 patients had a CAD without a history of myocardial infarction. The PFR was 2.20 +/- 0.64 EDV/sec in the 59 patients after anterior wall infarction and 2.64 +/- 0.82 EDV/sec in the 64 patients after inferior wall infarction and 2.83 +/- 0.84 EDV/sec in 68 patients with coronary artery disease without a history of myocardial infarction. The TPFR was 178 +/- 36.7 msec after anterior and 157 +/- 49.2 msec after inferior wall infarction and 156 +/- 47 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 87% after anterior wall infarction and in 81% after inferior wall infarction. In comparison with this the ejection fraction was reduced in 66% in anterior and in 61% after inferior wall infarction at rest. These results indicate that the resting diastolic function appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest.