AI Article Synopsis
- Coronary microvascular dysfunction (CMD) is a prevalent condition mimicking symptoms of obstructive coronary artery disease, prompting a study to assess if left ventricular (LV) diastolic function and hypertrophy can help predict CMD.
- The research involved analyzing data from 378 patients who underwent coronary angiography and echocardiography, identifying that CMD was present in 77.5% of them, with the CMD group being older, having fewer males, and higher blood pressure.
- The study found that LV ejection time is significantly associated with CMD presence, while other echocardiographic parameters showed weaker or non-significant associations, suggesting a need for further exploration in CMD diagnosis.
Article Abstract
Background: Coronary microvascular dysfunction (CMD) is a common disorder, leading to symptoms similar to obstructive coronary artery disease. We aimed to determine whether measures of left ventricular (LV) diastolic function and hypertrophy may predict presence of CMD.
Methods: We retrospectively included patients undergoing diagnostic coronary angiography and transthoracic echocardiography, excluding patients with obstructive coronary artery disease, previous revascularization therapy, moderate or severe mitral valve disease, or atrial fibrillation. The following markers of LV diastolic function and hypertrophy were assessed: E- and A-wave velocity, E-wave deceleration time, E/A- and E/E'-ratio, left atrial area, left LV mass index, LV ejection time (LVET) and mitral valve closure to opening time. Logistic regression analysis was used to determine the association of echocardiographic parameters with presence of CMD.
Results: From 378 patients (mean age ± SD 59.7 ± 13.6 years, 45.6% male) included, the majority had CMD (n = 293, 77.5%). Patients with CMD were older (60.5 ± 13.4 years vs. 56.9 ± 14.3 years, p = 0.03), were less frequent male (42.3% vs. 57.0%, p = 0.02), and had higher systolic blood pressure (137.9 ± 25.7 mmHg vs. 124.7 ± 25.6 mmHg, p < 0.0001). LVET was significantly associated with CMD (1.42 [1.02-1.96], p = 0.04), while a non-statistically significant link was observed for A-wave velocity and E/E'-ratio (1.39 [0.96-2.00], p = 0.08 and 1.40 [0.92-2.13], p = 0.1, respectively). For all other echocardiography-derived measures, odds ratio for the association with CMD was <1.3 per each SD increase.
Conclusions: In this cross-sectional single-center cohort study, CMD was a frequent finding in patients undergoing coronary angiography for suspected obstructive coronary artery disease. LVET from transthoracic echocardiography is associated with the presence of CMD.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052509 | PMC |
| http://dx.doi.org/10.1016/j.ijcha.2020.100493 | DOI Listing |
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