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Abstract: Poster Presentations |

PREVALENCE OF MODERATE OR SEVERE LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PERSONS WITH SUSPECTED MYOCARDIAL ISCHEMIA WITH AND WITHOUT AN ABNORMAL ADENOSINE OR EXERCISE SESTAMIBI STRESS TEST OR PRIOR CORONARY REVASCULARIZATION FREE TO VIEW

Gautham Ravipati, MD*; Wilbert S. Aronow, MD; Albert J. De Luca, MD; Tamana Walia, MD; John A. McClung, MD; Robert N. Belkin, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest


Chest. 2005;128(4_MeetingAbstracts):279S-b-280S. doi:10.1378/chest.128.4_MeetingAbstracts.279S-b
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Abstract

PURPOSE:  To determine the prevalence of moderate or severe left ventricular diastolic dysfunction (LVDD) in patients with suspected myocardial ischemia with and without an abnormal adenosine or exercise sestamibi stress test (SST) or prior coronary revascularization.

METHODS:  The patients included 171 men and 164 women, mean age 63 years, with suspected myocardial ischemia who underwent a SST and Doppler and tissue Doppler interrogation of the mitral inflow and mitral annulus, respectively. Moderate LVDD was diagnosed if the peak early diastolic transmitral flow velocity (E)/peak late diastolic transmitral flow velocity (A) was 0.75-1.50 and one or both of the following were present: the E/peak early diastolic myocardial velocity (Ea) was ≥10 or the peak systolic pulmonary vein flow velocity (S)/ peak diastolic pulmonary vein flow velocity (D) was <1. Severe LVDD was diagnosed if the E/A was >1.5 and one or both of the following were present: the E/Ea was ≥10 or the S/D was <1. LVDD was evaluated blindly by a single experienced echocardiographer without knowledge of the clinical characteristics or whether the SST was normal or abnormal. A left ventricular ejection fraction (LVEF) of <50% was considered abnormal.

RESULTS:  Moderate or severe LVDD was present in 117 of 142 patients (82%) with an abnormal SST or prior coronary revascularization and in 11 of 193 patients (58%) with a normal SST and no prior coronary revascularization (p<0.001). Moderate or severe LVDD was present in 34 of 38 patients (89%) with an abnormal SST or prior coronary revascularization and an abnormal LVEF and in 4 of 8 patients (50%) with a normal SST and no prior coronary revascularization and an abnormal LVEF (p<0.01).

CONCLUSION:  There is a very high prevalence of moderate or severe LVDD in patients with suspected myocardial ischemia, especially if there is an abnormal SST or prior coronary revascularization.

CLINICAL IMPLICATIONS:  There is a very high prevalence of moderate or severe LVDD in patients with ischemic heart disease, especially in those with an abnormal LVEF.

DISCLOSURE:  Gautham Ravipati, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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