Abstract
Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination; ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities; TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups; there was statisticallysignificant difference between Group I and Group II (P value ; patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.
Highlights
Ischemic heart disease (IHD) is a major cause of death in developed countries
We aimed to examine the value of the S'-wave dispersion of tissue Doppler imaging (TDI) across mitral valve annular velocities to predict angiographically significant coronary artery obstruction
Tissue Doppler imaging (TDI) is an echocardiographic modality that uses Doppler principles to measure myocardial motion velocity, Doppler echocardiography relies on changes in frequency of US signals reflected from moving structure [10] [11]
Summary
Ischemic heart disease (IHD) is a major cause of death in developed countries. IHD mortality rates worldwide have declined over the past four decades, coronary artery disease (CAD) is still responsible for around 35% of the overall mortality among individuals over age 35 [1]-[6].It has been appraised that about 50% of middle-aged men and 1/3 of middle-aged women in the USA will develop some manifestations of CAD [7].Non-invasive imaging modalities as stress echocardiography and myocardial perfusion imaging are important and useful tools in everyday practice for early detection, evaluation, and risk stratification of CAD [8]. Tissue Doppler imaging (TDI) is an echocardiographic modality that uses Doppler principles to measure myocardial motion velocity, Doppler echocardiography relies on changes in frequency of US signals reflected from moving structure [10] [11]. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. All patients had undergone full history taken and clinical examination; ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities; TDI with measuring of S'-wave and coronary angiography. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups; there was statistically significant difference between Group I and Group II (P value < 0.0001); patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease
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