Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation

Research output: Contribution to journalArticle

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{d51fb200b45548339d7f879260f54270,
title = "Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation",
abstract = "BACKGROUND: Pulsed tissue Doppler imaging (TDI) allows direct measurement of systolic and diastolic function of the left ventricle. In patients with coronary artery disease (CAD), myocardial ischemia-related impaired diastolic function may be linked to systemic endothelial damage/dysfunction and increased thrombogenesis. We hypothesized relationships between TDI-defined diastolic dysfunction and plasma von Willebrand factor (vWf, marking endothelial damage/dysfunction), soluble P-selectin (sP-sel, reflecting platelet activation), fibrin D dimer (an index of fibrin turnover and thrombogenesis), fibrinogen, and plasma viscosity (PV) in CAD. METHODS: Conventional 2-dimensional Doppler echocardiography and TDI were performed in 75 stable CAD patients (55 men, 59 +/- 11 years) and 40 age- and sex-matched healthy controls. Peak systolic (Sm), peak early (Em), and late (Am) diastolic mitral annular velocities measured at 4 sites (septal, lateral, inferior, and anterior) were averaged as global systolic and diastolic left ventricular function, respectively. The mean TDI velocities were dichotomized into low and high (below/above median) groups. Plasma vWf, sP-sel, D dimer (enzyme-linked immunosorbent assay), fibrinogen (modified Clauss), and PV levels were measured. RESULTS: CAD patients had significantly lower Sm, Em, Em/Am ratio, and a higher ratio of early transmitral flow E-velocity over Em (E/Em) when compared with controls (all P <.05). On multivariate analysis, adjusted for age, ejection fraction, and clinical variables, the differences in the group means of vWf, sP-sel, and fibrinogen remained significantly different between the low and high TDI indexes. D-dimer levels were unrelated to any TDI indexes. None of the transmitral flow indexes were independently related to the research indexes. CONCLUSIONS: In patients with CAD, diastolic dysfunction was closely associated with increased platelet activation and endothelial damage/dysfunction independent of systolic function. TDI-derived indexes are more sensitively related to plasma hemostatic markers than transmitral indexes in middle-aged patients with CAD.",
author = "KW Lee and Andrew Blann and Gregory Lip",
year = "2005",
month = oct,
day = "1",
doi = "10.1016/j.ahj.2004.11.019",
language = "English",
volume = "150",
pages = "756--66",
journal = "Thrombosis and Haemostasis",
issn = "0340-6245",
publisher = "Schattauer",
number = "4",

}

RIS

TY - JOUR

T1 - Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation

AU - Lee, KW

AU - Blann, Andrew

AU - Lip, Gregory

PY - 2005/10/1

Y1 - 2005/10/1

N2 - BACKGROUND: Pulsed tissue Doppler imaging (TDI) allows direct measurement of systolic and diastolic function of the left ventricle. In patients with coronary artery disease (CAD), myocardial ischemia-related impaired diastolic function may be linked to systemic endothelial damage/dysfunction and increased thrombogenesis. We hypothesized relationships between TDI-defined diastolic dysfunction and plasma von Willebrand factor (vWf, marking endothelial damage/dysfunction), soluble P-selectin (sP-sel, reflecting platelet activation), fibrin D dimer (an index of fibrin turnover and thrombogenesis), fibrinogen, and plasma viscosity (PV) in CAD. METHODS: Conventional 2-dimensional Doppler echocardiography and TDI were performed in 75 stable CAD patients (55 men, 59 +/- 11 years) and 40 age- and sex-matched healthy controls. Peak systolic (Sm), peak early (Em), and late (Am) diastolic mitral annular velocities measured at 4 sites (septal, lateral, inferior, and anterior) were averaged as global systolic and diastolic left ventricular function, respectively. The mean TDI velocities were dichotomized into low and high (below/above median) groups. Plasma vWf, sP-sel, D dimer (enzyme-linked immunosorbent assay), fibrinogen (modified Clauss), and PV levels were measured. RESULTS: CAD patients had significantly lower Sm, Em, Em/Am ratio, and a higher ratio of early transmitral flow E-velocity over Em (E/Em) when compared with controls (all P <.05). On multivariate analysis, adjusted for age, ejection fraction, and clinical variables, the differences in the group means of vWf, sP-sel, and fibrinogen remained significantly different between the low and high TDI indexes. D-dimer levels were unrelated to any TDI indexes. None of the transmitral flow indexes were independently related to the research indexes. CONCLUSIONS: In patients with CAD, diastolic dysfunction was closely associated with increased platelet activation and endothelial damage/dysfunction independent of systolic function. TDI-derived indexes are more sensitively related to plasma hemostatic markers than transmitral indexes in middle-aged patients with CAD.

AB - BACKGROUND: Pulsed tissue Doppler imaging (TDI) allows direct measurement of systolic and diastolic function of the left ventricle. In patients with coronary artery disease (CAD), myocardial ischemia-related impaired diastolic function may be linked to systemic endothelial damage/dysfunction and increased thrombogenesis. We hypothesized relationships between TDI-defined diastolic dysfunction and plasma von Willebrand factor (vWf, marking endothelial damage/dysfunction), soluble P-selectin (sP-sel, reflecting platelet activation), fibrin D dimer (an index of fibrin turnover and thrombogenesis), fibrinogen, and plasma viscosity (PV) in CAD. METHODS: Conventional 2-dimensional Doppler echocardiography and TDI were performed in 75 stable CAD patients (55 men, 59 +/- 11 years) and 40 age- and sex-matched healthy controls. Peak systolic (Sm), peak early (Em), and late (Am) diastolic mitral annular velocities measured at 4 sites (septal, lateral, inferior, and anterior) were averaged as global systolic and diastolic left ventricular function, respectively. The mean TDI velocities were dichotomized into low and high (below/above median) groups. Plasma vWf, sP-sel, D dimer (enzyme-linked immunosorbent assay), fibrinogen (modified Clauss), and PV levels were measured. RESULTS: CAD patients had significantly lower Sm, Em, Em/Am ratio, and a higher ratio of early transmitral flow E-velocity over Em (E/Em) when compared with controls (all P <.05). On multivariate analysis, adjusted for age, ejection fraction, and clinical variables, the differences in the group means of vWf, sP-sel, and fibrinogen remained significantly different between the low and high TDI indexes. D-dimer levels were unrelated to any TDI indexes. None of the transmitral flow indexes were independently related to the research indexes. CONCLUSIONS: In patients with CAD, diastolic dysfunction was closely associated with increased platelet activation and endothelial damage/dysfunction independent of systolic function. TDI-derived indexes are more sensitively related to plasma hemostatic markers than transmitral indexes in middle-aged patients with CAD.

U2 - 10.1016/j.ahj.2004.11.019

DO - 10.1016/j.ahj.2004.11.019

M3 - Article

C2 - 16209979

VL - 150

SP - 756

EP - 766

JO - Thrombosis and Haemostasis

JF - Thrombosis and Haemostasis

SN - 0340-6245

IS - 4

ER -