KMID : 0828520060100040256
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Journal of the Korean Geriatrics Society 2006 Volume.10 No. 4 p.256 ~ p.261
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The Most Feasible Doppler Left Ventricular Diastolic function Measurements in the Elderly with 3 Vessel Coronary Artery Disease
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Shin Young-Woo
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Abstract
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Background: Normal aging causes a decrease in left ventricular diastolic function and so it expected to be a limitation in the diagnosis of ischemia-related impaired diastolic function in the elderly. This study was designed to find out the feasibility of the assessment at the left ventricular diastolic function and a useful diastolic index in the elderly with coronary artery disease.
Methods: The elderly patients (61¡79 years old) who underwent coronary angiography for suspected coronary artery disease (CAD) were divided into 40 (23 women, 17 men) normal subjects and 42 (24 women, 18 men) patients with 3 vessel CAD, defined as 50% or more diameter stenosis of 3 major epicardial arteries were evaluated by conventional and tissue Doppler imaging. The following diastolic pulse wave and tissue Doppler imaging parameters were obtained: The peak early mitral inflow velocity (E), the peak late mitral inflow velocity (A), the ratio of E/A, the deceleration time of E (DT), the isovolumetric relaxation time (IRT), the peak early diastolic mitral annular velocity (Ea), the peak late diastolic mitral annular velocity (Aa), the ratio of Ea/Aa, and the ratio of E/Ea.
Results: The elderly patients with 3 vessel CAD had significantly higher E/Ea ratio, validated to be a good estimate of the left ventricular filling pressure, in the diastolic Doppler parameters when compared with normal controls (p=0.04), and could assess the left ventricular diastolic dysfunction. And E/Ea >12 showed the case of 3 vessel CAD with higher frequency, especially in men with Ea <5 cm/sec.
Conclusion: Left ventricular diastolic dysfunction at rest can be identified in the patients with 3 vessel CAD as compared with normal control in the elderly. The E/Ea ratio in the most useful diastolic index in the such cases.
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KEYWORD
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Diastole, Coronary artery disease
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