Background: The relationship between diastolic function parameters and the severity of coronary artery disease (CAD) is controversial. This study aimed to determine the relationship between left ventricular diastolic function and the severity of CAD. Methods: This cross-sectional study included 63 patients with Ischemic heart disease (IHD) or those suspected of having IHD, who underwent angiography. The study was conducted in Shafa Hospital, Kerman, Iran, from 2021 to 2022. Two-dimensional (2D) strain echocardiography was used to assess left ventricular (LV) function parameters, followed by coronary angiography. Based on the severity of the disease, patients with significant CAD were placed in the case group, and patients with insignificant CAD were placed in the control group. The correlation between the CAD severity and the severity of LV diastolic dysfunction was computed. Descriptive tests, independent t tests, and Spearman correlation coefficients were used. P<0.05 was considered statistically significant. Results: The results indicated that there was no correlation between E/e′ (P=0.103), left atrial volume index (LAVI) (P=0.168), tricuspid regurgitation velocity (TRV) (P=0.217), myocardial performance index (MPI) (P=0.106), E wave deceleration time (dt) (P=0.644), and late diastolic strain rate (P=0.502) with CAD severity based on SYNTAX score. However, there was a correlation between left atrial (LA) strain (P=0.017), global longitudinal strain (GLS) (P<0.001), early diastolic strain rate (P<0.001), and systolic strain rate (P=0.047) with SYNTAX score. Besides, there was a correlation between LA strain (P=0.017), GLS (P<0.001), early diastolic strain rate (P<0.001), and late diastolic strain rate (P=0.035) with numbers of epicardial coronary arteries with significant lesions. Conclusion: In contrast with 2D strain echocardiography, this study showed that conventional echocardiography parameters had no significant relationship with CAD severity. GLS had the strongest correlation with CAD severity, and diastolic strain rates had a weaker correlation with CAD severity. |
- Organization WH [Internet]. Cardiovascular diseases (cvds). c2009. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/index html
- Jang JJ, Bhapkar M, Coles A, Vemulapalli S, Fordyce CB, Lee KL, et al. Predictive Model for High-Risk Coronary Artery Disease. Circ Cardiovasc Imaging. 2019;12:e007940. doi: 10.1161/CIRCIMAGING.118.007940. PubMed PMID: 30712364; PubMed Central PMCID: PMCPMC6368397.
- Tayyareci Y, Yildirimturk O, Yurdakul S, Aytekin V, Demiroglu IC, Aytekin S. Evaluation of left ventricular regional systolic functions in patients with coronary artery disease by two-dimensional strain imaging: a velocity vector imaging study. Turk Kardiyol Dern Ars. 2011;39:93-104. doi: 10.5543/tkda.2011.01065. PubMed PMID: 21430414.
- Mukhopadhyay T, Gupta A, Biswas U, Majumdar B. Severity of coronary artery disease and echocardiographic parameters of ventricular diastolic function in patients with non-ST-elevation acute coronary syndrome. Int J Med Sci Public Health. 2019;8:86-90.
- Fukuta H, Ohte N, Wakami K, Goto T, Tani T, Kimura G. Prognostic value of left ventricular diastolic dysfunction in patients undergoing cardiac catheterization for coronary artery disease. Cardiol Res Pract. 2012;2012:243735. doi: 10.1155/2012/243735. PubMed PMID: 22567531; PubMed Central PMCID: PMCPMC3332169.
- Nagueh SF. Left Ventricular Diastolic Function: Understanding Pathophysiology, Diagnosis, and Prognosis With Echocardiography. JACC Cardiovasc Imaging. 2020;13:228-44. doi: 10.1016/j.jcmg.2018.10.038. PubMed PMID: 30982669.
- Ma L, Li Y, Wu Z, Mu Y. A New Potential Predictor of Coronary Artery Disease: The Ratio of Mitral Peak Filling Velocity to Mitral Annular Velocity in Early Diastole. Med Sci Monit. 2017;23:1180-9. doi: 10.12659/msm.901704. PubMed PMID: 28267707; PubMed Central PMCID: PMCPMC5352015.
- Afifi S, Abtahi F, Yoosefi A, Rezaian GR. Could Mitral Valve and Mitral Annular Velocities, Left Atrial and Left Ventricular Wall Strain Predict the Presence of Coronary Artery Disease? A Case-Control Echocardiographic Study. International Cardiovascular Research Journal. 2019;13:39-44.
- Toufan M, Ashouri D, Mohammadi B, Golmohammadi Z. Prediction of Severity of Coronary Stenosis in the Absence of Infarction by Tissue Doppler Imaging and Conventional Echocardiography at Rest. Journal of Cardiovascular and Thoracic Research. 2013;3:11-5.
- Page HL, Jr. The Judkin’s technique. Cathet Cardiovasc Diagn. 1979;5:187-9. doi: 10.1002/ccd.1810050214. PubMed PMID: 487422.
- Yuda S, Fang ZY, Marwick TH. Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction. J Am Soc Echocardiogr. 2003;16:1163-70. doi: 10.1067/S0894-7317(03)00647-3. PubMed PMID: 14608288.
- Bonow RO, Vitale DF, Bacharach SL, Frederick TM, Kent KM, Green MV. Asynchronous left ventricular regional function and impaired global diastolic filling in patients with coronary artery disease: reversal after coronary angioplasty. Circulation. 1985;71:297-307. doi: 10.1161/01.cir.71.2.297. PubMed PMID: 3155499.
- Nakajima Y, Kane GC, McCully RB, Ommen SR, Pellikka PA. Left ventricular diastolic filling pressures during dobutamine stress echocardiography: relationship to symptoms and ischemia. J Am Soc Echocardiogr. 2009;22:947-53. doi: 10.1016/j.echo.2009.04.030. PubMed PMID: 19524401.
- Lin FY, Zemedkun M, Dunning A, Gomez M, Labounty TM, Asim M, et al. Extent and severity of coronary artery disease by coronary CT angiography is associated with elevated left ventricular diastolic pressures and worsening diastolic function. J Cardiovasc Comput Tomogr. 2013;7:289-96. doi: 10.1016/j.jcct.2013.08.008. PubMed PMID: 24268115.
- Maragiannis D, Schutt RC, Gramze NL, Chaikriangkrai K, McGregor K, Chin K, et al. Association of Left Ventricular Diastolic Dysfunction with Subclinical Coronary Atherosclerotic Disease Burden Using Coronary Artery Calcium Scoring. J Atheroscler Thromb. 2015;22:1278-86. doi: 10.5551/jat.29454. PubMed PMID: 26269148.
- Jamiel A, Ahmed AM, Farah I, Al-Mallah MH. Correlation Between Diastolic Dysfunction and Coronary Artery Disease on Coronary Computed Tomography Angiography. Heart Views. 2016;17:13-8. doi: 10.4103/1995-705X.182649. PubMed PMID: 27293524; PubMed Central PMCID: PMCPMC4879799.
- Abali G, Akpinar O, Nisanoglu V, Ilgenli TF. Severity of coronary artery disease and echocardiographic parameters of ventricular diastolic function. Echocardiography. 2014;31:809-13. doi: 10.1111/echo.12479. PubMed PMID: 24341841.
- Biering-Sorensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, et al. Myocardial strain analysis by 2-dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imaging. 2014;7:58-65. doi: 10.1161/CIRCIMAGING.113.000989. PubMed PMID: 24186963.
- Radwan H, Hussein E. Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity. Egypt Heart J. 2017;69:95-101. doi: 10.1016/j.ehj.2016.08.001. PubMed PMID: 29622962; PubMed Central PMCID: PMCPMC5839366.
- Said KM, Nassar AI, Fouad A, Ramzy AA, Abd Allah MFF. Left atrial deformation analysis as a predictor of severity of coronary artery disease. Egypt Heart J. 2018;70:353-9. doi: 10.1016/j.ehj.2018.09.004. PubMed PMID: 30591754; PubMed Central PMCID: PMCPMC6303351.
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