Left ventricular dyssynchrony in coronary artery disease patients without regional wall‐motion abnormality: Correlation with Gensini score

Abstract

Objectives Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall‐motion abnormality (RWMA) by three‐dimensional echocardiography (3‐DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS). Methods Sixty‐one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD‐16, TmsvSD‐12, and TmsvSD‐6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R‐SDI, 12R‐SDI, 6R‐SDI) using 3‐DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low‐GS ≤20, mid‐GS >20 and ≤48, and high‐GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed. Results Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R‐SDI, and 6R‐SDI were prolonged in the high‐GS group compared with the low‐ and mid‐GS groups. 16R‐SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R‐SDI was an independent predictor of the GS. 16R‐SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high‐GS. Conclusion Three‐dimensional echocardiography is a noninvasive technique to detect LVD in non‐RWMA CAD patients, and the parameter 16R‐SDI was significantly correlated with CAD severity.

Myocardial ischemia and previous infarction contribute to left ventricular dyssynchrony in patients with coronary artery disease

“…Another study used 3-dimensional echocardiography to quantify LVMD in CAD patients without regional wall motion abnormality and found out that CAD patients still demonstrated increased LVMD compared with healthy controls. 10 Logistic regression analysis of this study showed that significant predictors of LVMD were myocardial ischemia, infarction scar extent and QRS duration. In additional analysis, when EF was included in the model, significant predictors of LVMD were male sex, ischemia, larger end-diastolic volume, low ejection fraction and longer QRS duration, but not infarct scar extent.…”

“…Another study used 3-dimensional echocardiography to quantify LVMD in CAD patients without regional wall motion abnormality and found out that CAD patients still demonstrated increased LVMD compared with healthy controls. 10 …”

“…7,8 The increase in LVMD may be related to multivessel CAD and the severity of coronary artery stenosis. [8][9][10] LVMD have been seen on the first day after acute myocardial infarction and it has been reported to be present only in the infarcted myocardium or both the infarcted and non-infarcted areas. 11,12 The association between LVMD, myocardial infarct scars and ischemia have earlier been studied with different methods, but there is still versatility between the studies in the determinants of LVMD in patients with CAD.…”

Relationship of Gensini score with retinal vessel diameter and arteriovenous ratio in senile CHD

“…In the past, many studies explored the methods of predicting and evaluating the lesions, mainly including the determination of many biomarkers such as vascular-related inflammatory factors, growth differentiation factors, and angiopoietin-like proteins in the body, and imaging techniques such as coronary angiography [ 8 , 9 , 10 ]. However, there are some disadvantages such as high cost and trauma to the body of these methods [ 11 ]. Therefore, it is of great clinical significance to find a simple, noninvasive, convenient, economic, and repeatable detection index for an early and accurate evaluation of the degree of lesions to prevent senile CHD.…”

Value of early detection of left ventricular mechanical dyssynchrony for assessing long‐term outcomes

“…LVD may have higher predictive value for events compared to electrical dyssynchrony. In the article by Li M et al, the LVD as assessed by 3‐Dimensional echocardiography (3DE) correlated well with Gensini score in patients with CAD but without regional wall‐motion abnormalities. Gated single photon emission computerized tomography myocardial perfusion imaging (SPECT‐MPI) also has shown similar correlation of LVD with the severity of CAD .…”