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Severity of coronary artery disease and echocardiographic parameters of ventricular diastolic function in patients with non‑ST‑elevation acute coronary syndrome

Tanmay Mukhopadhyay, Ashish Gupta, Uttam Biswas, Biswakes Majumdar.




Abstract

Background: Ischemic heart disease results in systolic and diastolic dysfunction (DD), but diastolic function seems to be more susceptible to ischemia than systolic function. Hence, we investigate the relationship between the extent and severity of coronary lesions and left ventricular (LV) diastolic function in patients with coronary heart disease.

Objective: The objective of this study was to determine the relationship between the severity of the coronary artery disease (CAD) and LV diastolic function in patient with non‑ST‑elevation acute coronary syndrome (NSTE‑ACS).

Materials and Methods: A total of 109 patients with NSTE‑ACS (NSTI myocardial infarction and unstable angina) were included in the study. All angiographic variables pertinent to SYNTAX score (SS) calculation were computed using online SS calculator. All patients underwent echocardiographic examination.

Results: Echocardiographic parameters E/e’, left atrial volume index (LAVI), and mitral inflow velocity (E/A) were measured in all patients and were found that an overall significant difference (P < 0.0001) in the SS between normal, Grade 1, Grade 2, and Grade 3 DD was seen. The significance of other parameters for determining DD, E/e’, and LAVI was calculated using Spearman’s correlation which also showed significant positive correlation with SS. 45.8% and 27.5% variation in the SS is accounted for E/e’ and LAVI alone, respectively.

Conclusion: The study shows a positive correlation between severity of CAD assessed using SS and E/A, E/e’, and LAVI which are various determinants of DD.

Key words: Diastolic Dysfunction; Coronary Artery Disease; SYNTAX Score






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