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Prevalence of myocardial ischemia as depicted by regional wall motion abnormality in blacks
1Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee 37208, USA.
Insights
Regional wall motion abnormality was observed in 28.1% of patients undergoing two-dimensional echocardiography. This finding highlights the importance of evaluating for this condition in cardiovascular disease assessment.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Coronary artery disease and myocardial ischemia are significant causes of mortality in the U.S.
- Data on the prevalence of these conditions, particularly in Black populations, are limited.
- Regional wall motion abnormality (RWMA) on echocardiography is linked to myocardial ischemia.
Purpose of the Study:
- To examine the prevalence of RWMA using two-dimensional (2-D) echocardiography in patients presenting with cardiovascular disease symptoms.
- To investigate potential racial differences in RWMA prevalence.
Main Methods:
- Retrospective analysis of 601 2-D echocardiographic studies from Metropolitan Nashville General Hospital.
- Inclusion criteria: patients aged >= 45 years (men) or >= 55 years (women).
- Final analysis included 285 patients, assessing for RWMA and its characteristics.
Main Results:
- RWMA was present in 80 (28.1%) of the analyzed patients.
- The septal area was the most commonly affected myocardial segment.
- While Blacks showed a slightly higher prevalence of RWMA (29.2%) compared to Whites (26.2%), the difference was not statistically significant.
Conclusions:
- RWMA is a notable finding in patients undergoing echocardiography for cardiovascular disease.
- The presence of RWMA warrants further investigation and management to prevent coronary artery disease complications.
- Echocardiography is crucial for identifying RWMA, especially in patients with cardiovascular risk factors.
Abstract:
Coronary artery disease with subsequent myocardial ischemia is a common cause of morbidity and mortality in the United States, and data are scarce on the prevalence of the disease in blacks. Regional wall motion abnormality correlates either directly or indirectly with myocardial ischemia. This study examines the two-dimensional (2-D) echocardiography of patients > or = 45 years for men and > or = 55 years at Metropolitan Nashville General Hospital, Nashville, Tennessee. A total of 601 2-D echocardiographic studies were performed on patients who presented with symptoms and signs of cardiovascular disease. Of these, 377 (62.7%) met the age criteria and formed the study group; 92 were excluded for various reasons, leaving 285 (75%) in the analysis group. A total of 80 (28.1%) patients had regional wall motion abnormality while 205 (71.9%) did not. On analysis of the 80 patients with regional wall motion abnormality, the segment of the heart commonly affected was the septal area, although more than one segment of the myocardium was affected in all of the patients. A total of 36 (45%) patients had normal left ventricular size. In relation to race, blacks had a higher prevalence of regional wall motion abnormality compared with whites (29.2% versus 26.2%, respectively), but the difference was not statistically significant. These prevalence rates indicate the importance of looking for this abnormality during echocardiographic evaluation of a patient. The presence of regional wall motion abnormality on 2-D echocardiography in the presence of other cardiovascular risk factors necessitates further investigation and management to minimize later complications of coronary artery disease.