CORONARY ARTERY DISEASE AND SEGMENTAL ISOVOLUMIC RELAXATION PATTERNS- WHAT IS THE RELATION?

Abstract

Background: Some segments relax with the early diastolic peak velocity lying in the isovolumic relaxation period. Its significance for prediction of coronary artery disease has not been fully elucidated. So we aimed to elucidate if the presence of abnormal isovolumic relaxation velocities can add a value to predict presence of significant coronary artery disease.
Methods: This study included 100consecutive subjects; 60 subjects with coronary artery disease (CAD), 40 normal subjects as a control group. Echocardiographic evaluation of: wall motion abnormalities, transmitral; E and A-velocities & E/A ratio. Tissue-Doppler study of the isovolumic relaxation velocities detected in the four basal segments. Patients with CAD were divided into; group I with significant CAD, group II with non significant CAD, the control group represents group III. Collected data underwent statistical analysis.
Result: post systolic shortening (PSS) was more frequent in the ischemic myocardium; with high specificity (92.5%) and good positive predictive value (86.6%) in detecting segments with significant coronary stenosis. The incidence of occurrence of peak early diastolic velocity (PVIVR) is more in patients with non significant CAD; it has good specificity (86.2%) for detection of any degree of coronary stenosis.
Conclusion: The presence of abnormal isovolumic relaxation velocities could be considered as a good positive test for prediction of CAD.
Key wards: Isovolumic relaxation velocity, Post systolic shortening (PSS), peak early diastolic velocity (PVIVR).