Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions
The aim. To analyze the structure of ischemic heart disease and the prevalence of myocardial ischemia with no ob-structive coronary arteries among patients who underwent elective coronary angiography. Materials and methods. We examined 1,200 patients with a clinical diagnosis of ischemic heart di...
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| Format: | Article |
| Language: | English |
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Professional Edition Eastern Europe
2023-12-01
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| Series: | Український журнал серцево-судинної хірургії |
| Subjects: | |
| Online Access: | http://cvs.org.ua/index.php/ujcvs/article/view/603 |
| _version_ | 1797371780560584704 |
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| author | Yevhen Yu. Marushko Nadiya M. Rudenko Yana Yu. Dzhun |
| author_facet | Yevhen Yu. Marushko Nadiya M. Rudenko Yana Yu. Dzhun |
| author_sort | Yevhen Yu. Marushko |
| collection | DOAJ |
| description | The aim. To analyze the structure of ischemic heart disease and the prevalence of myocardial ischemia with no ob-structive coronary arteries among patients who underwent elective coronary angiography.
Materials and methods. We examined 1,200 patients with a clinical diagnosis of ischemic heart disease. After coro-nary angiography all the patients with non-stenotic coronary arteries underwent hyperventilation challenge test to ex-clude vasospastic angina and echocardiographic study with intravenous administration of dipyridamole to assess the index of coronary reserve and longitudinal strain.
Results. The mean age of the study participants was 59.1 ± 4.2 years. The number of male and female subjects was comparable, amounting to 493 (48.8%) and 517 (51.2%), respectively. Stenotic coronary arteries were detected in 699 patients (74.1%). The number of women without hemodynamically significant lesions was twice as large than that of men (210 [67.5%] vs. 101 [32.5%]). Among the examined patients with non-stenotic atherosclerosis of the coronary arteries, 241 patients (77.4%) were diagnosed with coronary microvascular dysfunction, 19 (6.1%) with vasospasm of the coronary arteries, and 2 patients (0.6%) were diagnosed with a combination of vasospastic and microvascular angina. In 36 (73.5%) of 49 patients, a segmental decrease in longitudinal strain of the apex/individual apical segments of the left ventricle was found. In patients without obvious micro- and macrovascular pathology, the interventricular septum was significant enlarged. In 9 (18.4%) of 49 patients, a diagnosis of hypertrophic cardiomyopathy was established.
Conclusion. Patients with ischemia with no obstructive coronary arteries require careful examination and compari-son of clinical signs with the results of objective tests. Understanding the prevalence and mechanisms of the problem is a key to improving the diagnosis and treatment of cardiovascular complications in this group. |
| first_indexed | 2024-03-08T18:25:50Z |
| format | Article |
| id | doaj.art-9428acf89b9b4472b417cffb632539a1 |
| institution | Directory Open Access Journal |
| issn | 2664-5963 2664-5971 |
| language | English |
| last_indexed | 2024-03-08T18:25:50Z |
| publishDate | 2023-12-01 |
| publisher | Professional Edition Eastern Europe |
| record_format | Article |
| series | Український журнал серцево-судинної хірургії |
| spelling | doaj.art-9428acf89b9b4472b417cffb632539a12023-12-30T12:05:43ZengProfessional Edition Eastern EuropeУкраїнський журнал серцево-судинної хірургії2664-59632664-59712023-12-01314343910.30702/ujcvs/23.31(04)/MR055-3439603Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery LesionsYevhen Yu. Marushko0https://orcid.org/0000-0002-0696-9926Nadiya M. Rudenko1https://orcid.org/0000-0002-1681-598XYana Yu. Dzhun2https://orcid.org/0000-0003-0343-5002Clinic for Adults, Ukrainian Children’s Cardiac Center, Kyiv, UkraineClinic for Adults, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine; Shupyk National Healthcare University of Ukraine, Kyiv, UkraineClinic for Adults, Ukrainian Children’s Cardiac Center, Kyiv, UkraineThe aim. To analyze the structure of ischemic heart disease and the prevalence of myocardial ischemia with no ob-structive coronary arteries among patients who underwent elective coronary angiography. Materials and methods. We examined 1,200 patients with a clinical diagnosis of ischemic heart disease. After coro-nary angiography all the patients with non-stenotic coronary arteries underwent hyperventilation challenge test to ex-clude vasospastic angina and echocardiographic study with intravenous administration of dipyridamole to assess the index of coronary reserve and longitudinal strain. Results. The mean age of the study participants was 59.1 ± 4.2 years. The number of male and female subjects was comparable, amounting to 493 (48.8%) and 517 (51.2%), respectively. Stenotic coronary arteries were detected in 699 patients (74.1%). The number of women without hemodynamically significant lesions was twice as large than that of men (210 [67.5%] vs. 101 [32.5%]). Among the examined patients with non-stenotic atherosclerosis of the coronary arteries, 241 patients (77.4%) were diagnosed with coronary microvascular dysfunction, 19 (6.1%) with vasospasm of the coronary arteries, and 2 patients (0.6%) were diagnosed with a combination of vasospastic and microvascular angina. In 36 (73.5%) of 49 patients, a segmental decrease in longitudinal strain of the apex/individual apical segments of the left ventricle was found. In patients without obvious micro- and macrovascular pathology, the interventricular septum was significant enlarged. In 9 (18.4%) of 49 patients, a diagnosis of hypertrophic cardiomyopathy was established. Conclusion. Patients with ischemia with no obstructive coronary arteries require careful examination and compari-son of clinical signs with the results of objective tests. Understanding the prevalence and mechanisms of the problem is a key to improving the diagnosis and treatment of cardiovascular complications in this group.http://cvs.org.ua/index.php/ujcvs/article/view/603coronary heart diseasecoronary angiographycoronary microvascular dysfunctionvasospastic anginamyocardial ischemia with no obstructive coronary arteries |
| spellingShingle | Yevhen Yu. Marushko Nadiya M. Rudenko Yana Yu. Dzhun Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions Український журнал серцево-судинної хірургії coronary heart disease coronary angiography coronary microvascular dysfunction vasospastic angina myocardial ischemia with no obstructive coronary arteries |
| title | Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions |
| title_full | Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions |
| title_fullStr | Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions |
| title_full_unstemmed | Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions |
| title_short | Algorithm for Diagnosis of Patients with Ischemic Heart Disease Depending on the Presence of Significant Coronary Artery Lesions |
| title_sort | algorithm for diagnosis of patients with ischemic heart disease depending on the presence of significant coronary artery lesions |
| topic | coronary heart disease coronary angiography coronary microvascular dysfunction vasospastic angina myocardial ischemia with no obstructive coronary arteries |
| url | http://cvs.org.ua/index.php/ujcvs/article/view/603 |
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