Predictive value of left ventricular diastolic parameters on type and severity of acute coronary syndrome

OBJECTİVE Cardiovascular system diseases are leading causes of death in developed countries. Coronary artery disease is also the most common cardiovascular disease and is associated with high rates of mortality and morbidity. In some studies, coronary artery disease was found to be seen in patients below 75 years of age and the mean age for first heart attack was 65.8 in males and 70.4 in females. The first impaired echocardiographic parameter in acute ischemia is diastolic function and systolic dysfunction occurs later. Echocardiography reveals segmental wall motion abnormalities. Diastolic functions were classified into 4 groups as normal, impaired relaxation, pseudonormal and restrictive pattern by using standard diagnostic criteria. In our study, we aimed to evaluate predictive value of left ventricular diastolic parameters on type and severity of acute coronary syndromes. MATERIAL AND METHOD After receiving approval from the local ethics committee, the study has been started at Abant İzzet Baysal University Faculty of Medicine between April 2016 and January 2017. The study was prospectively performed by including 60 patients, who applied to our hospital by complaining of chest pain. Laboratory tests including cardiac enzymes were obtained for all patients who applied due to chest pain. Besides, 12 –lead ECG was performed for all patients. In order to make diastolic function staging, echocardiography was performed by a cardiologist. After receiving a diagnosis, patients were assessed with statistical analyses regarding their echocardiographic results. RESULTS According to echocardiography results of patients included in the study, normal function was observed in 25 patients; impaired relaxation in 21; pseudonormal pattern in 7 and restrictive pattern in 7. Of these patients, 35 were males and 25 were females. The mean age was 59.9 (± 13.4) years. According to the diagnosis of the patients, 26 patients were diagnosed with nonspecific chest pain. 27 patients were diagnosed as having NSTEMI and 7 patients were diagnosed as having STEMI. There was no correlation between the echocardiographic results of our patients and the diagnoses they have been received. CONCLUSIONS Although diastolic parameters have many uses to evaluate diagnosis, prognosis and mortality of acute coronary syndromes, there was no significant difference between the groups in our study. The most likely reason for this is the inadequate number of patients in some groups. Keywords: Acute coronary syndrome, diastolic function, echocardiography