The association between tissue doppler-derived E/(e's') ratio and coronary atherosclerosis severity measured by the SYNTAX score in patients with non-ST elevation-acute coronary syndrome

Maryam Nabati; Samad Golshani; Morteza Taghavi; Abbas Alipour; Homa Parsaee

doi:10.1186/s12872-023-03128-8

The association between tissue doppler-derived E/(e's') ratio and coronary atherosclerosis severity measured by the SYNTAX score in patients with non-ST elevation-acute coronary syndrome

BMC Cardiovasc Disord. 2023 Feb 22;23(1):98. doi: 10.1186/s12872-023-03128-8.

Authors

Maryam Nabati¹, Samad Golshani², Morteza Taghavi³, Abbas Alipour⁴, Homa Parsaee⁵

Affiliations

¹ Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Dr.mr.nabati@gmail.com.
² Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
³ Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
⁴ Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran.
⁵ Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: The prognosis of patients hospitalized with non-ST elevation-acute coronary syndrome (NSTE-ACS) is typically determined by the existence and severity of myocardial necrosis and left ventricular (LV) remodeling.

Aim: The present study was to assess the association between the E/(e's') ratio and the coronary atherosclerosis severity, measured by the SYNTAX score, in patients with NSTE-ACS.

Methods: Utilizing a descriptive correlational research design, this study was prospectively conducted on 252 patients with NSTE-ACS, undergoing an echocardiography to determine the left ventricular ejection fraction (LVEF), the left atrial (LA) volume, the pulsed-wave (PW) Doppler-derived transmitral early (E) and late (A) diastolic velocities, and the tissue Doppler (TD)-derived mitral annular early diastolic (e') and peak systolic (s') velocities. After that, a coronary angiography (CAG) was performed, and the SYNTAX score was calculated.

Results: The patients were divided into two groups, viz., those with the E/(e's') ratio < 1.63 and the cases with the ratio ≥ 1.63. The results revealed that the patients with a high ratio were older, had a higher prevalence of females, a SYNTAX score ≥ 22, and a lower glomerular filtration rate than those with a low ratio (p-value < 0.001). Besides, these patients had larger indexed LA volume and lower LVEF than others (p-value: 0.028 and 0.023, respectively). Furthermore, the multiple linear regression outcomes established a positive independent association between the E/(e's') ratio ≥ 1.63 (B = 5.609, 95% CI 2.324-8.894, p-value = 0.001) and the SYNTAX score.

Conclusion: The study results demonstrated that the patients hospitalized with NSTE-ACS and the E/(e's') ratio ≥ 1.63 had worse demographic, echocardiographic, and laboratory profiles and a higher prevalence of a SYNTAX score ≥ 22 than those with a lower ratio.

Keywords: Diastolic dysfunction; Mitral annulus velocity; Non-ST elevation acute coronary syndrome; Systolic dysfunction; Tissue Doppler imaging.

MeSH terms

Acute Coronary Syndrome*
Coronary Artery Disease*
Female
Humans
Male
Myocardial Infarction*
Stroke Volume
Ventricular Dysfunction, Left*
Ventricular Function, Left