Author + information
- Mahmoud A. Abdelsamad,
- Hatem Abdelrahman,
- Amal Soliman and
- Yehia Kishk
Despite a decline in mortality attributed to coronary artery disease (CAD), its burden remains high and is the leading cause of heart failure. Early detection of CAD severity is essential to initiate treatment and improve prognosis.
To determine how LV wall motion assessed by echocardiographic Tissue Doppler Imaging (TDI) is affected by increasing severity of CAD among patients with stable angina pectoris and preserved ejection fraction (EF).
Fifty five patients with chronic stable angina and normal EF who were referred to our hospital to do TDI after performing coronary angiography are included. Patients without significant stenosis constituted the control group and patients with significant stenosis were divided into three groups according to number of vessel affected. Regional longitudinal peak systolic, early, and late diastolic myocardial velocities were measured at six mitral annular sites and averaged to provide global estimates.
Patients with significant coronary disease were matched with the control group. In patients with one-, two- and three-vessel disease, the global systolic function decreased with increased severity of CAD (p-value 0.033, 0.005, 0.000 respectively). In one- and two-vessel disease, global early diastolic velocity decreased significantly (p-value 0.034, 0.006 respectively), but only in patients with one-vessel disease, the global late diastolic performance increased with a significant reduction of eˋ/aˋ ratio (p-value 0.002).
Color TDI performed at rest in patients with stable angina and preserved EF reveals both diastolic and systolic dysfunction and the nature of the dysfunction depends on the extent of the CAD.