Objective: We aimed to evaluate effect of termination property of left anterior descending (LAD) on tissue Doppler echocardiography (TDE) parameters in patients experiencing their first anterior myocardial infarction (AMI) who had undergone successful primary percutaneous coronary intervention (PCI).
Methods: A prospective, cross-sectional observational study was performed. Eighty-four patients were enrolled in the study. Echocardiography was performed during the first three days of AMI. Conventional TDE measurements were obtained from right ventricular (RV) and four left ventricular (LV) walls: for the systolic function - mitral annular TDE systolic velocity - Sm, for diastolic function - mitral annular TDE early and late diastolic velocities - Em, Am, transmitral early and late diastolic velocities ratio - E/A, and combined systolic and diastolic function - myocardial performance index (MPI). Coronary arteries were evaluated and patients were divided into two groups (non-wrapped LAD and wrapped LAD) according to the termination properties. Student-t, Mann-Whitney U and Chi-square tests, bivariate Pearson and Spearman correlation analyses were used for statistical analysis.
Results: Baseline characteristics and conventional echocardiographic parameters of the patients were similar. There was a statistically significant difference for the anterior wall Sm parameter, whereas there was no substantial difference for Em, Am and MPI values. The anterior wall Sm was more affected in patients with non wrapped LAD than in patients with wrapped LAD (6.70 ± 1.66 and 7.44 ± 1.66 cm/s; p=0.036,).The anterior Sm parameter was uniquely correlated with LAD termination status when compared with other independent parameters (r=0.236, p=0.036).
Conclusion: We showed that termination of LAD is important for the anterior wall systolic functions in the early stage of AMI treated successfully.
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http://dx.doi.org/10.5152/akd.2012.152 | DOI Listing |
J Cardiothorac Surg
November 2021
Department of Cardiology, Tianjin Chest Hospital, Tianjin University, Chest Clinical Medical College of Tianjin Medical University, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China.
Background: It is difficult to choose correctly interventional strategy for coronary intermediate lesions combined with myocardial bridge. Endovascular imaging is advocated to guide treatment, but flow reserve fraction (FFR) is not recommended to guide the interventional treatment of myocardial bridge disease because of the inaccurate judgment misled by myocardial bridge.
Case Presentation: In this study, we reported a case of a 56-year-old male patient with unstable angina pectoris (UAP).
Cureus
February 2021
Department of Cardiology, Saint Louis University Hospital, St. Louis, USA.
Acute occlusion of the left anterior descending (LAD) coronary artery generally results in ST-segment elevation in the anterior leads of the electrocardiogram and reciprocal ST-segment depression in the inferior leads. We present a case of LAD occlusion presenting as inferior wall ST-segment elevation myocardial infarction.
View Article and Find Full Text PDFBMJ Case Rep
January 2021
Department of Cardiology and Vascular Medicine, Airlangga University, Surabaya, East Java, Indonesia.
We report three cases of acute myocardial infarction caused by left anterior descending (LAD) artery occlusion presenting as ST elevation in the inferior. Therefore, coronary angiography showed an occlusion of the LAD coronary artery. Our cases show the rare occurrence of left coronary circulation dominance affecting inferior leads.
View Article and Find Full Text PDFCase Rep Cardiol
October 2020
Department of Cardiology, Clinic of Internal Medicine, "Sveti Duh" University Hospital, Zagreb, Croatia.
Changes of the ST segment are commonly used as predictors of the culprit vessel during an acute myocardial infarction. In case of combined ST elevation in both inferior and anterior leads, these changes can be due to a distal occlusion of a "wrapped" left anterior descending artery (LAD) or a two-vessel disease. Our case of anterior wall myocardial infarction with inferior ST elevation and anterior ST depression shows that electrocardiographic changes during acute myocardial infarction cannot always be explained by logical sequelae of the injury current, vessel anatomy, and their irrigation territory.
View Article and Find Full Text PDFEgypt Heart J
June 2020
Menoufia University, P.O box 34, 55-El Gish street, Tanta, Egypt.
Background: We examined the impact of left anterior descending (LAD) wrapping on left ventricular (LV) mechanics in patients with normal coronary angiography. Seventy-one patients with evidence of normal coronary angiography (LAD wrapping: n = 52, 73%) and LAD non-wrapping (n = 19, 27%) were included in the study. Using 2D-strain imaging, we measured LV longitudinal and circumferential (circ) strain (ε), systolic strain rate (SR), early (SR) and atrial (SR) diastolic SR, LV electromechanical dyssynchrony (TTP-SD), and LV twist and torsion in study groups.
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