E/e` ratio is superior to speckle tracking for detecting elevated left ventricular end-diastolic pressure in patients with coronary artery disease and preserved ejection fraction

2019 ◽  
Vol 36 (7) ◽  
pp. 1263-1272 ◽  
Author(s):  
Antonio Amador Calvilho Júnior ◽  
Jorge Eduardo Assef ◽  
David Le Bihan ◽  
Rodrigo Bellio de Mattos Barretto ◽  
Antonio Tito Paladino Filho ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Artery Disease

scholarly journals Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with coronary artery disease and preserved left ventricular ejection faction

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Y Ohara ◽  
Y Yoshimura ◽  
Y Fukuoka ◽  
K Tanioka ◽  
K Yamamoto
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Ejection ◽  
Lv Ejection Fraction ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Elevated left ventricular (LV) filling pressures are the main physiologic consequence of LV diastolic dysfunction. Left atrial (LA) strain was recently found useful to predict elevated LV filling pressures noninvasively. However, there are few reports on the role of LA strain when predicting LV filling pressure in patients with coronary artery disease (CAD). The aim of this study was to explore the correlation between LA strain and LV end-diastolic pressure (LVEDP) in patients with CAD and preserved LV ejection fraction. Methods Fifty-four patients with stable CAD were enrolled. Global atrial longitudinal strain was measured by averaging all atrial segments. Resorvoir (S-LAs), conduit (S-LAe), and contractile (S-LAa) phase strain were obtained. LVEDP was invasively obtained by left heart catheterization. Results Patients were divided into two groups: elevated LVEDP group (LVEDP > 15mmHg group: n = 23) and normal LVEDP group (LVEDP ≤ 15mmHg group: n = 31). Elevated LVEDP group showed significantly decreased S-LAs and S-LAa (S-LAs: 21.3 ± 7.2% vs. 27.5 ± 7.8%, p < 0.005; S-LAa: 9.7 ± 3.3% vs. 14.6 ± 3.4%, p < 0.0001). However, E/Ea and S-LAe were not significantly different between the two groups. LVEDP significantly correlated with S-LAa (r=-0.596, p < 0.0001) and S-LAs (r=-0.431, p < 0.001). Receiver operating characteristics curve analysis showed that S-LAa could predict elevated LVEDP (AUC = 0.84) and a cut-off value of S-LAa < 11.6% was able to most accurately identify patients with elevated LVEDP. Conclusions LA strain, especially S-LAa, provided additional diagnostic value for the noninvasive assessment of LV filling pressure in CAD patients with preserved LV ejection fraction.

scholarly journals Elevated heart rate in hypertension and coronary artery disease: risk factor or risk marker in patients with preserved left ventricular ejection fraction

2019 ◽  
Vol 25 (4) ◽  
pp. 389-406 ◽  
Author(s):  
E. V. Kokhan ◽  
G. K. Kiyakbaev ◽  
Z. D. Kobalava
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Positive Effects ◽  
Artery Disease

Numerous studies have demonstrated the negative prognostic value of tachycardia, both in the general population and in specific subgroups, including patients with coronary artery disease (CAD), arterial hypertension (HTN) and heart failure with preserved ejection fraction (HFpEF). In the latest edition of the European guidlines for the treatment of HTN the level of heart rate (HR) exceeding 80 beats per minute is highlighted as a separate independent predictor of adverse outcomes. However, the feasibility of pharmacological reduction of HR in patients with sinus rhythm is unclear. Unlike patients with reduced ejection fraction, in whom the positive effects of HR reduction are well established, the data on the effect of pharmacological HR reduction on the prognosis of patients with HTN, CAD and/or HFpEF are not so unambiguous. Some adverse effects of pharmacological correction of HR in such patients, which may be caused by a change in the aortic pressure waveform with its increase in late systole in the presence of left ventricular diastolic dysfunction, are discussed. The reviewed data underline the complexity of the problem of clinical and prognostic significance of increased HR and its correction in patients with HTN, stable CAD and/or HFpEF.

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