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Yahia M, Emara A, Abdou W, Ewis MF. Impact of Coronary Microvascular Dysfunction on Myocardial Strain in Patients with Heart Failure and Preserved Ejection Fraction. J Cardiovasc Echogr 2023; 33:133-138. [PMID: 38161778 PMCID: PMC10756320 DOI: 10.4103/jcecho.jcecho_28_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/21/2023] [Accepted: 08/29/2023] [Indexed: 01/03/2024] Open
Abstract
Background This research aimed to evaluate the role of coronary microvascular dysfunction in alteration of left ventricular (LV) myocardial deformation. Materials and Methods This observational study involved 50 patients with LV ejection fraction (LVEF) >50% and coronary microvascular dysfunction (diagnosed by coronary angiography). TIMI frame count (TFC) was calculated for each patient. They were classified into 2 groups: 30 patients with heart failure and preserved ejection fraction (HFpEF) (cases group) and 20 patients without HF (control group). Speckle tracking echocardiography was used to evaluate LV deformation. Results The mean age of the studied patients was 58.8 ± 8 years. The frequency of diabetes mellitus, hypertension, and dyslipidemia were significantly higher in cases than controls. Cases had significant higher BMI (30 ± 4.48 vs. 27.3 ± 3.94 kg/m2, P=0.029). The total TFC in cases was 97.1 ± 22.9 and in controls was 79 ± 18.5, and this difference was statistically significant (P=0.005). Significantly decreased LV global strain was observed in HFpEF cases than in controls (-17.6 ± 2.14 % versus -19.5 ± 1.98%, P < 0.001). In cases with a higher TFC, the LV global strain decrease was more pronounced. There was a significant correlation between the LV global strain and total TFC (r=-0.470 and P=0.009). Conclusion Patients with HFpEF exhibited higher total TFC reflecting more affected coronary microvasculature. Those patients had reduced LV global strain. Coronary microvascular dysfunction probably leads to alteration of myocardial performance.
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Affiliation(s)
- Mohamed Yahia
- Department of Cardiology, Faculty of Medicine, University of Menoufia, Shebin Elkom, Egypt
| | - Ahmed Emara
- Department of Cardiology, Faculty of Medicine, University of Menoufia, Shebin Elkom, Egypt
| | - Waleed Abdou
- Department of Cardiology, Faculty of Medicine, University of Menoufia, Shebin Elkom, Egypt
| | - Mohamed Fouad Ewis
- Department of Cardiology, Faculty of Medicine, University of Menoufia, Shebin Elkom, Egypt
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Xing X, Li D, Chen S, Wang L, Li Z, He L. Evaluation of left ventricular systolic function in patients with different types of ischemic heart disease by two-dimensional speckle tracking imaging. J Cardiothorac Surg 2020; 15:325. [PMID: 33148298 PMCID: PMC7640713 DOI: 10.1186/s13019-020-01345-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate left ventricular systolic function in patients with different types of ischemic heart disease using two-dimensional speckle tracking imaging (2D-STI). Methods We retrospectively studied patients who were admitted to Peking University Third Hospital from January 2011 to December 2017 due to chest tightness and chest pain. Two hundred forty-two patients were divided into control group, CMD group and obstructive CAD group. The main coronary artery stenosis was confirmed by coronary angiography or coronary computed tomography and coronary flow reserve (CFR) in patients was measured by transthoracic Doppler echocardiography. Left ventricular strain and strain rate (SR) measured by 2D-STI. Cardiac structure and function were measured by conventional echocardiography. Results Conventional echocardiography showed that there was no significant difference in cardiac structure and function among the three groups (P > 0.05). Moreover, the longitudinal strain (LS) of each ventricular wall in CMD group was notably lower than that in control group (P < 0.01). In addition, global longitudinal SR and longitudinal SR in CMD group and obstructive CAD group were obviously lower than those in control group (P < 0.01). GLS, endocardial LS and epicardial LS were negatively correlated with CFR (P < 0.01). Conclusions Early left ventricular systolic dysfunction was found in patients with CMD and patients with obstructive CAD, with similar degree. CFR is an independent influencing factor of GLS. GLS and stratified LS have certain diagnostic value for CMD.
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Affiliation(s)
- Xing Xing
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Dan Li
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Shaomin Chen
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Lingli Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Zhaoping Li
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
| | - Liyun He
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
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Kibel A, Selthofer-Relatic K, Drenjancevic I, Bacun T, Bosnjak I, Kibel D, Gros M. Coronary microvascular dysfunction in diabetes mellitus. J Int Med Res 2017; 45:1901-1929. [PMID: 28643578 PMCID: PMC5805190 DOI: 10.1177/0300060516675504] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/30/2016] [Indexed: 12/16/2022] Open
Abstract
The significance, mechanisms and consequences of coronary microvascular dysfunction associated with diabetes mellitus are topics into which we have insufficient insight at this time. It is widely recognized that endothelial dysfunction that is caused by diabetes in various vascular beds contributes to a wide range of complications and exerts unfavorable effects on microcirculatory regulation. The coronary microcirculation is precisely regulated through a number of interconnected physiological processes with the purpose of matching local blood flow to myocardial metabolic demands. Dysregulation of this network might contribute to varying degrees of pathological consequences. This review discusses the most important findings regarding coronary microvascular dysfunction in diabetes from pre-clinical and clinical perspectives.
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Affiliation(s)
- Aleksandar Kibel
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
| | - Kristina Selthofer-Relatic
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
- Department of Internal Medicine, Faculty
of Medicine, University of Osijek, Osijek, Croatia
| | - Ines Drenjancevic
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
| | - Tatjana Bacun
- Department of Internal Medicine, Faculty
of Medicine, University of Osijek, Osijek, Croatia
- Department of Endocrinology, Clinic of
Internal Medicine, Osijek University Hospital, Osijek, Croatia
| | - Ivica Bosnjak
- Department for Heart and Vascular
Diseases, Clinic of Internal Medicine, Osijek University Hospital, Osijek,
Croatia
| | - Dijana Kibel
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
- Department of Diagnostic and
Interventional Radiology, Osijek University Hospital, Osijek, Croatia
| | - Mario Gros
- Department of Physiology and Immunology,
Faculty of Medicine, University of Osijek, Croatia
- Department of Diagnostic and
Interventional Radiology, Osijek University Hospital, Osijek, Croatia
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