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Diastolic function in patients with coronary artery disease: effect of angina and heart failure functional class
D F Kesler1, A A Galyanov, K G Zhukov
1Research Institute of Working Ability for Invalids, St. Petersburg, Russia.
Insights
Coronary artery disease patients exhibit impaired heart diastolic function, particularly with advanced heart failure. Mechanocardiography reveals prolonged relaxation and reduced filling, indicating significant cardiac abnormalities.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Coronary artery disease (CAD) and myocardial infarction (MI) can lead to significant cardiac dysfunction.
- Assessing diastolic function is crucial for understanding heart health post-MI and in heart failure (HF).
Purpose of the Study:
- To investigate diastolic function in male CAD patients with prior MI using mechanocardiography.
- To correlate diastolic function abnormalities with angina severity and heart failure classification.
Main Methods:
- Utilized left and right mechanocardiography (MCG) to assess diastolic function.
- Compared 69 male CAD patients (post-MI) with 18 healthy controls.
- Analyzed isometric relaxation time, atrium wave duration, and rapid filling wave duration.
Main Results:
- Patients post-MI showed prolonged isometric relaxation and atrium wave duration, with reduced rapid filling wave duration compared to controls.
- Diastolic abnormalities were more pronounced in heart failure class III than class II, affecting both left and right MCG.
- Right ventricle diastolic abnormalities were detected even in patients without overt right ventricle failure symptoms.
Conclusions:
- Diastolic dysfunction is prevalent in CAD patients post-MI, correlating more strongly with heart failure severity than angina.
- Mechanocardiography is a valuable tool for detecting subclinical diastolic abnormalities, even in the right ventricle.
Abstract:
The diastolic function of left and right parts of the heart using left and right mechanocardiogram method was investigated in 69 male patients with coronary artery disease and preceding myocardial infarction and in 18 normal patients. Nine patients were in angina class I, 28 were in class II, 32 were in class III. Forty-seven patients were in heart failure class II and 22 were in class III. The duration of isometric relaxation and atrium wave in left and right mechanocardiograms was more, and rapid filling wave was less in patients after myocardial infarction than in the control group. The duration of isometric relaxation and of atrium wave in left mechanocardiogram was more, and the duration of rapid filling wave was less in patients with heart failure class III than in patients in class II. The duration of isometric relaxation was more and the duration of rapid filling wave was less in right mechanocardiogram in patients with heart failure class III than in patients in class II. The diastolic abnormalities correlate more with the severity of heart failure than the angina severity. The diastolic abnormalities in right mechanocardiogram were found in patients without clinical manifestations of right ventricle failure.