Presystolic Wave Research Articles

Independent Relationship between Ankylosing Spondylitis and Presystolic Wave Detected on Echocardiography.

Ankylosing spondylitis (AS) is a persistent inflammatory disease affecting the axial skeleton which may lead to cardiovascular involvement. We examined the relationship between the presystolic wave (PW), which is frequently encountered in the evaluation of the left ventricular (LV) outflow tract, and AS. The study included 117 consecutive patients with 73 of them being male. Demographic and clinical characteristics of the participants were recorded and echocardiographic examination was performed. Patients were categorized into two groups: patients diagnosed with AS (n = 64) and patients without AS (n = 53). LV ejection fraction (P = 0.014), LV mass index (P < 0.001), mitral E wave velocity (P = 0.002), and PW (P = 0.014) were independently linked with AS. A substantial correlation was found between PW and AS.

Presystolic wave as a predictor of interatrial block in patients with supraventricular tachycardia.

The identification of interatrial block (IAB) through electrocardiography (ECG) has been correlated with an elevated likelihood of developing atrial fibrillation (AF) and stroke. IAB is diagnosed by evaluating P-wave prolongation on a surface ECG. The presystolic wave (PSW) is an echocardiographic marker determined by pulse-wave examination of the aortic root during late diastole. As IAB and PSW share similar pathophysiological mechanisms, we speculated that PSW, as a component of the P wave, might be useful in predicting IAB. In the present study, we aimed to determine the relationship between PSW and IAB. Patients with pre-diagnosis of supraventricular tachycardia (SVT) on electrocardiography or rhythm Holter monitoring between January 2021 and December 2022 were included in the study. Surface 12-lead ECG and transthoracic echocardiography (TTE) were performed for the diagnosis of IAB and PSW. Patients were divided into two groups based on the presence of IAB, and PSW was compared between the groups. In total, 104 patients were enrolled in this study. IAB was diagnosed in 16 patients (15.3%) and PSW was detected in 33 patients (31.7%). The PSW was higher in the IAB ( +) group than in the IAB ( -) group (10 patients (71.4%) vs. 23 patients (32.4%), p = 0.008). PSW may be a useful tool for predicting IAB in patients with SVT. Further studies are needed to determine the clinical utility of PSW in the diagnosis and management of IAB.

Relationship between presystolic wave and subclinical left ventricular dysfunction as assessed by myocardial performance index in patients with metabolic syndrome.

The myocardial performance index (MPI) is an index that shows both systolic and diastolic functions of the ventricle. Presystolic wave (PSW) is a late diastolic wave encountered in the left ventricular outflow tract (LVOT) and is associated with increased left ventricular stiffness and decreased left ventricular compliance. In our study, MPI was compared between patients with metabolic syndrome and normal patients, and we also investigated whether PSW could predict subclinical left ventricular dysfunction (SCLVD) in patients with metabolic syndrome. A total of 119 patients, 59 with metabolic syndrome and 60 healthy volunteers, were included in our study. Our study is a two-center prospective study. The patient groups were compared in terms of demographic, laboratory and echocardiographic parameters. Univariate and multivariate regression analyzes were performed to detect predictors of SCLVD. Higher MPI and PSW were found in patients with metabolic syndrome compared to the normal population (0.56 ± 0.11 vs. 0.46 ± 0.07, p < 0.001, 34 (57.6%) vs. 19 (31.7%), p = 0.004, respectively). MPI was found to be higher in patients with metabolic syndrome with PSW ( +) (0.59 ± 0.13 vs. 0.52 ± 0.05, p = 0.005). Smoking and PSW were found as Independent Predictors of Subclinical Left Ventricular Dysfunction in the Multivariate Logistic Regression Analysis Model (OR 0.146, 95%CI 0.028-0.767, p = 0.023 and OR 10.689, 95%CI 2.176-52.515, p = 0.004, respectively). Higher MPI and SCLVD were detected in patients with metabolic syndrome compared to the normal population. In addition, PSW positivity was associated with SCLVD in this patient group.

The impact of radioactive iodine treatment on subclinical left ventricular dysfunction in patients treated for differentiated thyroid cancer: assessing the predictive value of presystolic wave

Objectives: Despite strong evidence regarding the impact of radioactive iodine (RAI) on the hematopoietic, genitourinary, and gastrointestinal systems, its role in the cardiovascular system needs to be clarified. We hypothesized that the presence of a presystolic wave could be predictive for cardiovascular dysfunction in subjects receiving RAI. Thus, we investigated presystolic wave presence in differentiated thyroid cancer (DTC) patients with and without RAI therapy after undergoing total thyroidectomy. Methods: Patients were included in the study within 1-5 years after thyroidectomy or thyroidectomy and RAI treatment. Participants were divided into three groups as follows: the first group included patients with DTC who received RAI following total thyroidectomy (Group 1; n = 33), the second group included patients with DTC who did not receive RAI following total thyroidectomy (Group 2; n = 34). The third group of age-matched subjects who underwent total thyroidectomy with suspicion of DTC and resulted in benign pathologies was also selected (Group 3; n = 37). All subjects underwent transthoracic echocardiography. The presence of a presystolic wave was assessed with Doppler imaging of the left ventricular outflow tract. Results: Presystolic wave was more common in subjects receiving RAI (Group 1) compared to Group 2 (those without RAI) (90.9% vs. 61.8% respectively, p = 0.003), and its prevalence in Group 3 was 54.1%. Multiple logistic regression analysis revealed that receiving RAI (OR: 4.922, 95% CI: 1.640 – 20.022, p = 0.004) was independently associated with a 5-fold higher risk for the presence of a presystolic wave. Conclusions: RAI following total thyroidectomy in patients with DTC is associated with a five-fold increase in the presence of the presystolic wave, as a proxy marker for subclinical left ventricular dysfunction.

The relationship of left ventricular outflow tract presystolic wave and 24-h ambulatory blood pressure measurements.

Left ventricular outflow tract (LVOT) presystolic wave is a novel marker for several cardiac conditions. It is shown to be related to several cardiac conditions. The aim of this study is to investigate the relationship between LVOT presystolic wave and 24-h ambulatory blood pressure measurements. A total of 194 patients who came to the cardiology outpatient clinic were prospectively enrolled in the study. After demographic and clinical inquiry, blood biochemistry and hemogram tests were performed. Each patient was evaluated with echocardiography and 24-h ambulatory blood pressure measurement. The patients were divided into hypertensive and nonhypertensive groups regarding their ambulatory blood pressure measurements and the LVOT presystolic wave of the groups on echocardiography was compared. The hypertensive group was significantly older (59.34 ± 11.15 vs. 49.89 ± 15.43; P < 0.001). Presystolic wave presence (96.2 vs. 29.5%; P < 0.001) and velocity (62.23 vs. 29.42; P < 0.001) were higher in patients with hypertension. Blood pressure values and LVOT amplitudes showed a positive correlation ( P < 0.001; r = 0.326). In multivariable logistic regression analysis; age, BMI and the presystolic wave were independently associated with hypertension (odds ratio: 8.09; P < 0.001). LVOT presystolic wave is associated with systemic hypertension and it could be used as a predictor for systemic hypertensive patients.

Relationship between non-dipper hypertension with presystolic wave and left atrial functions

Amaç: Bu çalışmanın amacı presistolik dalga (PSD) varlığı ve non-dipper hipertansiyon arasındaki ilişkiyi araştırmaktır. Ayrıca PSD oluşumuna sol atriyum fonksiyonlarındaki değişimin etkisi olup olmadığı araştırılması amaçlanmıştır. &#x0D; Gereç ve Yöntem: Bu kesitsel çalışmaya 77 dipper ve 43 non-dipper hipertansiyonu olan 120 hasta dahil edildi. Dipper ve non-dipper hipertansiyon grupları, PSD varlığı ve sol atriyum fonksiyon ekokardiyografik parametreleri açısından birbirleriyle karşılaştırıldı.&#x0D; Bulgular: Sol atriyum aktif boşalma fraksiyonu (SAABF) (38.6 ± 2.8’ e karşı 35.1 ± 3.3) ve PSD insidansı (%69.8’ e karşı %37.7) non-dipper hipertansiyon grubunda dipper hipertansiyon grubuna göre anlamlı olarak daha yüksekti. Yaş, miyokardiyal pik erken diyastolik hız (Em), sol atriyum minimum hacmi, SAABF (odds oranı = 1.719, 95% güven aralığı = 1.367–2.162) ve PSD (odds oranı = 7.116, 95% güven aralığı = 2.063–24.548) non-dipper hipertansiyonun bağımsız öngördürücüleri olarak bulundu. Presistolik dalgası olan ve olmayanlar içinde non-dipper hipertansiyon ve dipper hipertansiyonu olan gruplar SAABF’ sine göre karşılaştırıldığında non-dipper hipertansiyon grubunda SAABF anlamlı olarak daha yüksek izlendi.&#x0D; Sonuç: PSD'nin varlığı hipertansiyonu hastalarında daha yüksek riskli olan non-dipper grubun kolayca saptanmasında fayda sağlayabilir. Bu hasta grubunda PSD' nin daha sıklıkla oluşumu diyastolik dolumu korumak için artmış sol atriyum kasılmasından bağımsızdır.

A presystolic wave could easily detect subclinical left ventricular dysfunction in prediabetic patients with no history of hypertension.

Prediabetes is associated with left ventricular (LV) systolic and diastolic dysfunction. A presystolic wave (PSW) is detected on late diastole from the Doppler examination of the LV outflow tract and is related to LV dysfunction. LV dysfunction could be detected with different echocardiographic methods, including conventional Doppler and Tissue Doppler imaging (TDI), 2D speckle tracking echocardiography, and myocardial performance index (MPI). In this study, we aimed to investigate the association of the presence of PSW with LV dysfunction assessed by different echocardiographic methods. A total of 137 prediabetic normotensive patients were enrolled in this study. Eighty-one (59.1%) patients had a PSW and 36 (40.9%) patients had not PSW on the Doppler examinations. Echocardiographic features were compared between these groups. LV dysfunction was determined based on MPI, LV global longitudinal strain (LVGLS), and conventional Doppler and TDI measurements. There were no differences between groups regarding clinical and laboratory parameters, except LDL, which was significantly higher in the PSW-positive group. The PSW-positive group had lower E, Em, Ea, E/A, Em/Am, Ea/Aa, LVGLS and higher A, Am, Aa, E/e', isovolumetric relaxation time, and MPI than PSW-negatives. PSW velocity was moderately correlated with MPI (R=.33, p=.003) and LVGLS (R=.35, p=.001). The presence of PSW was independently associated with LV dysfunction assessed by MPI (OR=3.87, p<.001), LVGLS (OR=10.29, p<.001), and conventional Doppler and TDI parameters (OR=8.87, p<.001). PSW was significantly associated with subclinical LV dysfunction in prediabetic normotensive patients assessed with three echocardiographic methods.

The association of presystolic wave with subclinical left-ventricular dysfunction in patients with subclinical hypothyroidism.

Subclinical hypothyroidism (SCH) patients develop left-ventricular dysfunction (LVD) in an earlier stage. LVD could be detected with myocardial performance index (MPI), left -ventricular global longitudinal strain (LVGLS), and conventional and tissue-Doppler imaging (TDI). A presystolic wave (PSW) detected on late diastole is associated with LVD. We aimed to determine whether there is an association between PSW and subclinical LVD assessed by different echocardiographic methods in SCH patients. We prospectively enrolled 105 patients diagnosed with SCH in this study. Patients were divided into two groups based on the presence of PSW. Both groups were compared with respect to demographic, clinical, and echocardiographic properties. Multivariable regression analysis was performed to detect predictors of subclinical LVD. The study included 70 PSW-positive patients (66%, mean age: 50.2) and 35 PSW-negative patients (34%, mean age: 46.5). PSW-positive patients had a lower platelet and a higher RDW level compared to PSW-negative patients. PSW-positive patients had more frequent subclinical LVD, which was assessed by MPI, by conventional and TDI parameters, and by LVGLS. PSW velocity was significantly correlated with MPI velocity (r = 0.31, p = 0.009), TSH level (r = 0.44, p < 0.001), and with LVGLS (r = 0.33, p = 0.005). The presence of PSW was an independent predictor of subclinical LVD in multivariable logistic regression analysis detected with MPI, LVGLS, and TDI parameters (OR = 5.409, p = 0.03; OR = 4.872, p = 0.005; OR = 5.632, p = 0.014, respectively). PSW prevalence was 66% in SCH patients. PSW velocity was significantly correlated with MPI and LVGLS. The presence of PSW was independently associated with subclinical LVD in SCH patients.

The relationship between presystolic wave and subclinical left ventricular dysfunction assessed by myocardial performance ındex in patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) patients have left ventricular dysfunction (LVD) in an earlier stage. Myocardial performance index (MPI) reflects both systolic and diastolic dysfunction. A presystolic wave (PSW) detected on late diastole has been found to be associated with LVD. We sought to determine whether there is an association between PSW and subclinical LVD assessed by MPI in PCOS patients. We prospectively enrolled 106 patients diagnosed with PCOS in this study. Patients were divided into two groups based on the presence of PSW. Both groups were compared with respect to demographic, clinical, and echocardiographic properties. Univariable and multivariable regression analyses were performed to detect predictors of subclinical LVD. The study included 58 patients with PSW-positive (54.7%, mean age: 23) and 48 patients with PSW-negative (45.3%, mean age: 25). PSW-positive patients had a higher waist-to-hip ratio, fasting insulin, and HOMA-IR compared to PSW-negative patients. Higher MPI velocities and more frequent subclinical LVD were observed in PSW-positive group than in PSW-negatives (p<0.001, p=0.0031, respectively). PSW velocity was significantly correlated with MPI velocity (r:.404, p=0.0016). The presence of PSW, HOMA-IR, and waist-to-hip ratio>85 were predictors of subclinical LVD in univariate logistic regression analysis. Only the presence of PSW was an independent predictor of subclinical LVD in multivariable logistic regression analysis (OR:3.257, p=0.028). PSW prevalence was 54.7% in PCOS patients. PSW velocity was significantly correlated with MPI velocity. The presence of PSW was independently associated with subclinical LVD in PCOS women.

Prevalence of the presystolic wave in echocardiography and its association with the extent of coronary artery disease in patients with chronic stable angina.

Since mortality and morbidity of coronary artery disease are high, there is a need for non-invasive diagnostic methods for early diagnosis and prediction of ischemic heart disease (IHD) outcome. This study aimed to assess the relationship between angiographic findings, the Presystolic wave (PSW) and some of the ischemic related parameters in echocardiography of the patients with chronic stable angina. This cross-sectional study was conducted on the patients with chronic angina pectoris who referred to a tertiary hospital for coronary angiography in Mashhad, Iran. Demographic and medical history of the patients, as well as echocardiography findings, including ejection fraction (EF), regional wall motion abnormalities (RWMA), PSW and diastolic function were recorded. Angiographic findings, including SYNTAX score were also assessed. A total of 220 patients (132 males and 88 females) with the mean age of 62.43±11.40years old participated in this study. The prevalence of PSW was 49.1%. The absence of the PSW was related to more RWMA (P=.002), and higher stages of left ventricular diastolic dysfunction (LVDD) (P=.029) and higher SYNTAX score (P=.001). There was a significant association between the absence of the PSW and EF categories, especially in severe LV systolic dysfunction (LVEF<30%) (P=.001). The findings of this study revealed that PSW is strongly associated with the SYNTAX score. The absence of the PSW may indicate patients at high-risk clinical status (higher SYNTAX score, severe systolic dysfunction, more RWMA, and higher stages of LVDD).

Relation of p - wave dispersion with presystolic a - wave and aortic valve sclerosis in asymptomatic subjects.

P-wave duration and P-wave dispersion (PWD) are thought to be the surrogate marker of devoloping atrial fibrillation (AF). The main purpose of present study was to investigate the association between presystolic wave (PSW), aortic valve sclerosis, and PWD. Patients with sinus rhythm admitted to the cardiology outpatient clinic were consecutively enrolled. Maximum (Pmax) and minimum (Pmin) P-wave duration and PWD were measured. Echocardiography was used to assess the aortic valve morphology and presence of PSW. The patients were divided into two groups according to presence or absence of AVSc and PSW. A total of 100 patients were enrolled consecutively. Patients with both PSW and AVSc had higher PWD values compared with those without PSW (42±15 vs 65±20) and AVSc (52±21 vs 69±19). The patients were categorized on the basis of median PWD values. According to univariate analysis, there was significant association between PWD and presence of PSW (P: .004), presence of AVS (P: .011), hypertension (P: .01) interventricular septal thickness (IVST) (P: .026), and posterior wall thickness (PWT) (P: .022). Multivariate logistic regression analyses demonstrated presence of PSW (95% confidence interval (1.058-6.505, P: .037) as an independent determinant of PWD. Assessment of presystolic A-wave on echocardiography examination may provide important information regarding the atrial conduction velocities that is a electrophysiological cause of AF. While there was a significant association between AVSc and PWD in univariate analysis, this significance disappeared in multivariate analysis.

Left Ventricular Myocardial Performance Index and Its Relationship with Presystolic Wave in Prediabetic Patients

Introduction: In this study, we aimed to investigate the effect of prediabetes on the cardiovascular system and the relationship between MPI and PSW by using myocardial performance index (MPI) and presystolic wave (PSW) and the usability of both parameters as a screening test. Methods: A total of 113 participants, that is, 59 prediabetic patients and 54 healthy volunteers, aged 18–79 years, who applied to cardiology and endocrinology polyclinics between March 2020 and September 2020, were included in the present study. The groups were compared in demographic and clinical data, left ventricular functions, left ventricular MPI, PSW, and laboratory results. Results: Left ventricular diastolic dysfunction (p=0.001), MPI (p<0.001), and PSW (p=0.003) were higher in the prediabetic group. A positive correlation was observed between fasting blood glucose and MPI index (r=0.509, p<0.001) and between PSW and MPI (r=0.405, p=0.001). Discussion and Conclusion: This study is the first in the literature to examine the effects of prediabetes on the cardiovascular system using MPI and PSW. We think that these parameters may be associated with left ventricular diastolic dysfunction in prediabetics.

Left ventricular outflow tract presystolic wave in a dog.

Left ventricular outflow tract presystolic wave in a dog.

Presistolik dalga ankilozan spondilitte subklinik sol ventrikül diyastolik disfonksiyonu için bir belirteç olabilir mi?

Purpose: The aim of this study was to evaluate the clinical significance of presystolic wave in the detection of diastolic dysfunction in ankylosing spondylitis patients. Materials and Methods: In this cross-sectional study, 59 patients and 65 healthy controls were included in the study. Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Metrology Index, Maastricht Ankylosing Spondylitis Enthesitis Score and Bath Ankylosing Spondylitis Functional Index was eveluated. The Doppler tissue-imaging and presystolic wave measurements were performed by same cardiologist who was blinded to study details. Results: Presystolic wave was detected in 26.6% of the whole study population; in 37.3% of patients and 16.9% of the control group. When the patient and control groups were divided into two subgroups according to the presence or absence of presystolic wave; myocardial performance index, transmitral E wave velocity, E/A ratio, left ventricular outflow tract velocity and septal e’ wave velocity were statistically significant in subjects with presence presystolic wave in both groups. In the univariate model, high c-reactive protein level, increased BASMI and BASFI scores and elevated myocardial performance index were determined as risk factors for the presence of presystolic wave in ankylosing spondylitis patients. Conclusion: The assessment of presystolic wave on echocardiography examination may provide important information about the left ventricul diastolic function, which has a prognostic impact for ankylosing spondylitis patients.

The relationship between presystolic wave and nondipper hypertension.

A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), and the possible mechanism for PSW is considered to be left ventricular stiffness and impaired LV compliance. We aimed to compare the relationship between PSW and dipper, nondipper hypertension. A total of 83 patients were included in the study. The participating patients were divided into two groups as 42 patients with dipper hypertension and 41 patients with nondipper hypertension based on the results of ambulatory blood pressure monitoring. Left ventricular mass index (91.6 ± 12.9 vs. 106.1 ± 7.9, P < 0.001) and E/Em (7.4 [6.6-8.3] vs. 10 [8-12], P < 0.001) were significantly higher, and Em (9.9 ± 2.7 vs. 7.9 ± 3.4, P = 0.004) was significantly lower in the nondipper group compared with dipper group. And also, the PSW was found to be higher in the nondipper group. The nondipper group had markedly increased frequencies of PSW compared with the dipper group (68 vs. 38%, respectively, P = 0.008). In the multivariate logistic regression test, E/Em [odds ratio (OR) 1.464, 95% confidence interval (CI): 1.113-1.926, P = 0.006] and the presence of PSW (OR 3.115, 95% CI: 1.061-9.143, P = 0.039) were determined as independent predictive parameters for nondipper hypertension. The presence of PSW on transthoracic echocardiography suggests that we may come across nondipper hypertension and a high risk of end-organ damage. PSW may be used as a useful parameter in risk stratification in hypertensive patients.

The presystolic wave was not sufficient for diagnosing subclinical left ventricular diastolic dysfunction in hemodialysis patients

Purpose: In hemodialysis patients, detection of left ventricul diastolic dysfunction as early as possible is critically important. The presystolic wave occurs in the left ventricul outflow tract and it’s associated with left ventricul stiffness and compliance. The aim of this study was to evaluate the clinical significance of presystolic wave in the detection of diastolic dysfunction in hemodialysis patients. Materials and Methods: In this cross-sectional study, eighty hemodialysis patients and 88 healthy controls were included in the study. The laboratory parameters were tested before the dialysis. The conventional B-mode, pulsed doppler parameters, doppler tissue-imaging, and presystolic wave measurements were performed at echocardiography. Results: Presystolic wave was detected in 46.0% of patients and 18.1% of the control group. There was no statistically significant difference between patients in terms of MPI, mitral E and A wave velocity, E/A and e’/a’ ratio, deceleration time, septal a’ and e’ wave velocity, and Sao in either presence or absence of presystolic wave. In the univariate model, higher Eao velocity and septal E/e’ ratio, and reduced duration of hemodialysis were determined as risk factors for the presence of presystolic wave.Conclusion: The assessment of presystolic wave on echocardiography examination may provide important information about the left ventricul diastolic function. But we have demonstrated in this study that presystolic wave is not entirely associated with left ventricul diastolic dysfunction in hemodialysis patients.

Presystolic Wave is Associated with Subclinical Left Ventricular Dysfunction Assessed by Myocardial Performance Index in Type 2 Diabetes Mellitus.

BackgroundMyocardial performance index (MPI), demonstrates both systolic and diastolic functions of the left ventricle. Presystolic wave (PSW) is frequently detected on Doppler examination of the left ventricular outflow tract and possible mechanism of PSW is impaired LV compliance and left ventricular stiffness.ObjectiveTo investigate the relationship between PSW and MPI in type 2 diabetic patients.MethodA total of 129 type 2 diabetic patients were included in this study. Patients were divided into two groups according to the presence of PSW on Doppler echocardiography. There were 90 patients (38 male, mean age 57.77 ± 10.91 years) in the PSW-positive group and 39 patients (13 male; mean age: 55.31 ± 11.29 years) in the PSW-negative group. The p values of < 0.05 were considered statistically significant.ResultsMPI was higher in PSW- positive group (0.63 ± 0.17vs 0.52 ± 0.13, p < 0.001). In addition, subclinical left ventricle dysfunction (LVD) was higher in the PSW- positive group (p = 0.029). Univariate analysis showed that the presence of PSW associated with abnormal MPI (p = 0.031). Pearson correlation analysis showed that PSW velocity correlated with MPI (r: 0.286, p = 0.006).ConclusionPresence of the PSW on Doppler examination was associated with subclinical LV dysfunction in patients with DM type 2. This easy-to-perform echocardiographic parameter may be related to subclinical LVD among patients with type 2 DM.

Presystolic wave is associated with carotid intima media thickness.

Carotid intima media thickness (CIMT), a direct marker of atherosclerosis, has emerged as a promising means for cardiovascular risk evaluation. Presystolic wave (PSW) is commonly detected by the Doppler interrogation of the left ventricular outflow tract (LVOT). It is thought to be a result of a stiff left ventricle and impaired LV compliance. Herein, we aimed to investigate a possible association between carotid intima media thickness, an atherosclerotic marker, and PSW. We prospectively enrolled 282 patients divided into two groups based on the presence of PSW: 221 (89F; mean age: 49.3±11.5years) had PSW on Doppler examination while 61 patients (32F; mean age: 46.4±10.3years) did not. Both groups were compared with respect to demographic, clinical properties, and CIMT. Both groups had comparable age, body mass index, and diabetes mellitus, hypertension, dyslipidemia, smoking, and family history for coronary heart disease. PSW-positive group had significantly higher CIMT (PSW-positive: 0.59±0.22mm vs PSW-negative: 0.42±0.11mm; P<0.001) than PSW-negative group. Multivariate analysis showed that the independent predictors of increased CIMT were age (95% CI; 1.044-1.101, P<0.001), dyslipidemia (95% CI; 0.147-0.664, P=0.002), and the presence of PSW (95% CI; 2.168-7.836, P<0.001).Correlation analysis showed that PSW velocity is correlated with increased CIMT in PSW-positive group (r: 0.418, P<0.001). Assessment of PSW on TTE is easy and feasible method. Presence of PSW and increased PSW velocity on TTE might provide information that we should be careful in terms of subclinical atherosclerosis.

OP-447 - Presence of Presystolic Wave and Increased Velocity are Associated with Epicardial Fat Thickness

OP-447 - Presence of Presystolic Wave and Increased Velocity are Associated with Epicardial Fat Thickness

Relation of presystolic wave on doppler examination to syntax score in patients with acute myocardial infarction.

There are few reports demonstrating a relationship between presystolic wave (PSW) and left ventricular function. The aim of the present study was to investigate the associations between PSW and angiographic and echocardiographic characteristics of patients with acute myocardial infarction (AMI). We studied 348 consecutive patients with AMI. Pulsed Doppler-echocardiography was used to assess the both diastolic functions and presence of PSW from left ventricular outflow tract. Patients were divided into two groups by the presence or absence of PSW. The Syntax score (SXscore) was calculated from baseline angiograms to assess the complexity and severity of coronary artery disease. The overall prevalence of PSW was 51.1%. Compared to patients without PSW, patients with PSW presence had greater left ventricular ejection fraction (LVEF), greater septal a' velocity, lower mitral E and septal e' velocity and lower E/A and e'/a' ratios. Also, median SXscore were significantly lower in the PSW presence group compared to PSW absence group [1 (6-14) vs. 12 (7-18), P = 0.013]. In addition, the number of patients with high-SXscore (> 16) was significantly lower in PSW presence group (24 vs. 42), (P = 0.006). In multiple logistic regression analysis, absence of PSW found independent predictor of high-SXscore (OR 2.297 95% CI 1.235-4.272; P = 0.009). We found that the presence of PSW was related with higher LVEF, lower SXscore and lower stage diastolic dysfunction in patients with AMI. PSW may be used in prediction of the coronary artery disease complexity and it could help risk stratification in patients with AMI.