The impact of coronary sinus narrowing on diastolic function in patients with refractory angina.
Coronary sinus Reducer
Coronary sinus narrowing
Diastolic function
Refractory angina
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 09 2019
15 09 2019
Historique:
received:
08
12
2018
revised:
10
03
2019
accepted:
19
03
2019
pubmed:
14
4
2019
medline:
15
5
2020
entrez:
14
4
2019
Statut:
ppublish
Résumé
Evaluating the impact of Coronary sinus (CS) narrowing on diastolic function. Narrowing of the CS is an emerging therapy for refractory angina pectoris, improving perfusion to the ischemic subendocardium and relieving ischemia and angina. It was speculated that increased CS pressure might cause interstitial myocardial edema and diastolic dysfunction. Prospective assessment of diastolic function was performed at baseline and 6 months following CS Reducer implantation in consecutive patients treated for refractory angina. Diastolic function assessment included left atrial volume, early transmitral filling peak velocity (E wave), E wave deceleration time (DT), transmitral atrial wave velocity (A wave), and early diastolic velocity of the septal (e' septal) and lateral (e' lateral) aspects of the mitral annulus. Twenty-four patients with chronic refractory angina and proven myocardial ischemia (mean age 69.3 ± 10.9 years) were included in the analysis. A wave velocity, E/A ratio, E wave DT and left atrial volume did not significantly change 6 months following Reducer implantation (p > 0.1 for all comparisons). A non-significant decrease in E wave velocity (80.5 ± 22.3 cm/s vs. 75.7 ± 17.5 cm/s, p = 0.19) and non significant increase in e' septal and lateral (5.28 ± 1.54 cm/s vs. 5.30 ± 1.71 cm/s, p = 0.95 and 8.26 ± 1.85 cm/s vs. 8.46 ± 2.07 cm/s, p = 0.69, respectively) led to a non-significant decrease in E/e' average ratio (12.6 ± 5.7 vs. 11.4 ± 3.3, p = 0.24). Mean diastolic function class significantly decreased following Reducer implantation from 1.5 ± 0.66 to 1.17 ± 0.76 (p = 0.008). Coronary sinus narrowing in patients with myocardial ischemia and refractory angina does not adversely affect diastolic function and may actually improve it.
Sections du résumé
OBJECTIVE
Evaluating the impact of Coronary sinus (CS) narrowing on diastolic function.
BACKGROUND
Narrowing of the CS is an emerging therapy for refractory angina pectoris, improving perfusion to the ischemic subendocardium and relieving ischemia and angina. It was speculated that increased CS pressure might cause interstitial myocardial edema and diastolic dysfunction.
METHODS
Prospective assessment of diastolic function was performed at baseline and 6 months following CS Reducer implantation in consecutive patients treated for refractory angina. Diastolic function assessment included left atrial volume, early transmitral filling peak velocity (E wave), E wave deceleration time (DT), transmitral atrial wave velocity (A wave), and early diastolic velocity of the septal (e' septal) and lateral (e' lateral) aspects of the mitral annulus.
RESULTS
Twenty-four patients with chronic refractory angina and proven myocardial ischemia (mean age 69.3 ± 10.9 years) were included in the analysis. A wave velocity, E/A ratio, E wave DT and left atrial volume did not significantly change 6 months following Reducer implantation (p > 0.1 for all comparisons). A non-significant decrease in E wave velocity (80.5 ± 22.3 cm/s vs. 75.7 ± 17.5 cm/s, p = 0.19) and non significant increase in e' septal and lateral (5.28 ± 1.54 cm/s vs. 5.30 ± 1.71 cm/s, p = 0.95 and 8.26 ± 1.85 cm/s vs. 8.46 ± 2.07 cm/s, p = 0.69, respectively) led to a non-significant decrease in E/e' average ratio (12.6 ± 5.7 vs. 11.4 ± 3.3, p = 0.24). Mean diastolic function class significantly decreased following Reducer implantation from 1.5 ± 0.66 to 1.17 ± 0.76 (p = 0.008).
CONCLUSION
Coronary sinus narrowing in patients with myocardial ischemia and refractory angina does not adversely affect diastolic function and may actually improve it.
Identifiants
pubmed: 30979603
pii: S0167-5273(18)37111-0
doi: 10.1016/j.ijcard.2019.03.041
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8-12Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019. Published by Elsevier B.V.