Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction

Yuda, S., Fang, Z. Y. and Marwick, T. H. (2003) Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction. Journal of The American Society of Echocardiography, 16 11: 1163-1170. doi:10.1067/S0894-7317(03)00647-3


Author Yuda, S.
Fang, Z. Y.
Marwick, T. H.
Title Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction
Journal name Journal of The American Society of Echocardiography   Check publisher's open access policy
ISSN 0894-7317
Publication date 2003-01-01
Sub-type Article (original research)
DOI 10.1067/S0894-7317(03)00647-3
Volume 16
Issue 11
Start page 1163
End page 1170
Total pages 8
Editor Dr Harvey Feigenbaum
Place of publication USA
Publisher Mosby Inc
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Abstract Background. Regional left ventricular (LV) dysfunction may occur in patients with coronary artery disease (CAD) in the absence of infarction, but the causes of this phenomenon are unclear. We sought to identify whether changes in regional LV function were related to stenosis severity, using sensitive new ultrasound markers of function. Methods: We studied 67 individuals with no history of infarction and with normal LV systolic function: 49 patients with CAD and 18 control subjects without CAD. All patients underwent color Doppler tissue imaging, integrated backscatter (IB), anatomic M-mode echocardiography, and strain rate imaging to detect changes in structure and function. Peak early and late diastolic myocardial velocity, cyclic variation of IB, wall thickness, and percent wall thickening were measured in each basal and mid segment. Strain rate and peak systolic strain were calculated in each wall. CAD was defined as greater than or equal to 50% diameter stenosis. Normokinetic segments (n = 354) subtended by CAD were divided according to stenosis severity into 3 groups: group 1 (subtended by 50%-69% stenosis); group 2 (subtended by 70%-98% stenosis); and group 3 (subtended by greater than or equal to99% stenosis). Each parameter in each group was compared with that in 216 segments from control subjects. Results: Segments subtended by significant CAD showed lower peak early and late diastolic myocardial velocity compared with control segments. Group 3 showed significantly lower myocardial velocities than group 2 for both peak early (4.8 +/- 1.8 vs 6.0 +/- 2.0 cm/s, P <.05) and late (4-5 +/- 2.1 vs 5.6 +/- 2.1 cm/s, P <.05) diastolic myocardial velocity. Group 3 also showed a significantly lower cyclic variation IB than did control segments (6.7 +/- 2.3 vs 7.9 +/- 2.6 dB, P <.05), but there was no difference in calibrated IB, wall thickness, strain parameters, or percent wall thickening. These differences were not attributable to the distribution of segments for patients with severe CAD, nor were they explained on the basis of collaterals. Conclusion: Although the absolute values show overlap between groups, the results of this study indicate that subtle changes of regional LV function may occur in the absence of infarction, in association with severe coronary stenoses.
Keyword Cardiac & Cardiovascular Systems
Regional Diastolic Function
Ultrasonic Tissue Characterization
Ischemic-heart-disease
Dobutamine Echocardiography
Stress Echocardiography
Myocardial-ischemia
Doppler Velocity
Unstable Angina
Artery Disease
Wall-motion
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 11:23:32 EST