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Left ventricular performance in patients with normal coronary arteries: hemodynamic characteristics and clinical
1Department of Cardiology, Soroka University Hospital, Soroka Medical Center, Beer-Sheva, Israel.
Insights
Patients with normal coronary angiograms but elevated left-ventricular end-diastolic pressure and low-normal ejection fraction showed higher rates of cardiovascular risk factors and ischemic events. This suggests potential diastolic dysfunction in this subgroup.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Coronary angiography is crucial for diagnosing coronary artery disease.
- Left-ventricular end-diastolic pressure (LVEDP) and ejection fraction (EF) are key indicators of cardiac function.
- Subtle abnormalities in cardiac function may exist even with normal coronary angiograms.
Purpose of the Study:
- To investigate cardiac function differences in patients with normal coronary angiograms.
- To explore the relationship between LVEDP, EF, and cardiovascular risk factors.
- To identify potential indicators of increased ischemic events in specific patient subgroups.
Main Methods:
- Retrospective analysis of 111 patients with normal coronary angiograms.
- Classification into two groups based on LVEDP and EF: Group I (elevated LVEDP, low-normal EF) and Group II (normal LVEDP, high-normal EF).
- Comparison of cardiovascular risk factors (diabetes mellitus, hypertension, hypercholesterolemia, smoking) and clinical events (angina, ischemic events) between groups.
Main Results:
- Group I patients (n=68) exhibited elevated LVEDP and low-normal EF.
- Group II patients (n=43) had normal LVEDP and high-normal EF.
- Group I showed a systematically higher prevalence of diabetes mellitus, hypertension, hypercholesterolemia, and smoking history.
- Group I patients tended to experience more angina and ischemic events compared to Group II.
Conclusions:
- Elevated LVEDP with low-normal EF in patients with normal coronary angiograms may indicate underlying diastolic dysfunction.
- This subgroup is associated with a higher burden of cardiovascular risk factors.
- These findings suggest a potential increased risk for angina and ischemic events in this population.
Abstract:
Of 111 patients with normal coronary angiograms, 68 patients had elevated left-ventricular end diastolic pressure and 'low-normal' ejection fraction (Group I) while the other 43 patients had normal left ventricular end diastolic pressure and 'high normal' ejection fractions (Group II). Although the number of patients was too small for meaningful statistical analysis, systematically a higher percentage of patients with diabetes mellitus, hypertension, hypercholesterolemia and smoking history was found in Group I. In contrast to the patients in Group II, patients in Group I tended to have more angina and ischemic events.