Title: Correlation between Transient Ischemic Left Ventricular Dilation and Severity of Coronary Artery Disease
Authors: Wala Abdelaziz Farid (MD), Ahmed Abdelaziz Emara (MD) , Mie Mohammed Abdalraouf (MD) , Mohamed Abd Al-Magid Mahmod, (MSc)
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.83
Abstract
Background: Left ventricular (LV) transient ischemic dilatation (TID) during stress echocardiography is considered a marker of extensive coronary artery disease.
Objectives: To assess the relationship between (TID) ratio assessed by DSE and severity of CAD assessed by coronary angiography.
Methods: This study included 100 patients referred to stress echocardiography laboratory. All patients were subjected to detailed history, full cardiac examination, dobutamine stress echocardiography; The TID ratio was defined as the ratio of LV end-diastolic volume or end-systolic volume at post-stress to rest. MAPSE, was measured in (mm) by M. mode echocardiography from four different annuli in apical 4- and apical 2-chamber views . (Group I) (20) patients with normal findings, (group II) comprised (40) patients with abnormal ischemic stress echocardiography. These patients findings were further divided into two subgroups: Group (IIA): 40 patients with abnormal ischemic DSE without TID of the LV. Group (IIB): (40) patients with abnormal ischemic DSE with TID of the LV.
Results: A significant difference between group (IIA) and group (IIB) regarding ESV stress (P= 0.048) , EDV stress (P= 0.002). A highly significant difference between group (IIA) and group (IIB) regarding both the ESV ratio (P<0.001) and the EDV ratio (P<0.001). Also EDV ratio was statistically significant in group (IIB) regarding MAPSE at rest (P= 0.010) and stress (P=0.003). Also ESV ratio was statistically significant in group (IIB) regarding MAPSE at rest (P= 0.014) and stress (P=0.007).
Conclusion: Patients with TID have more sever and extensive ischemic defects and higher peak WMSI.
Keywords: Dobutamine stress echocardiography (DSE), Transient ischemic Dilation (TID), Mitral Annular Plane Systolic Excursion (MAPSE), Coronary artery disease (CAD).
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