[Clinical aspects of the left ventricular diastolic dysfunction at patients with coronary heart disease].
Is is known that, besides the systolic disfunction, the presence of diastolic disfunction influences the prognosis of patients with coronary heart disease. The aim of the paper is to study the influence of the presence of diastolic disfunction upon the clinical profile and the functional capacity of the patients with coronary heart disease.


METHODS
189 patients with ischemic heart disease (chronic myocardial infarction, stable angina, ischemic cardiomiopathy) underwent an echocardiographic examination. The diastolic disfunction was assessed at the Doppler examination, by the the ratio of the E and A velocities. Consequently, 138 patients had a E/A ratio under 1 or above 2 and were considered with diastolic disfunction (group A); the other 47 with E/A ratio between 1-2 were included in group B. After the clinical evaluation, 80 patients underwent an exercise testing (47 of group A and 33 of group B).


RESULTS
Group A had a greater mean age (62.8 +/- 11.7 vs 51.5 +/- 11.6 years, p = 0.00006) and more females (72.5% vs 46.8%, p = 0.001); dyspnoea was more frequent and severe (NYHA II-IV), the arterial pressure higher (146/85 +/- 25/13 mmHg vs 136/79 +/- 26/15 mmHg, p = 0.004) and cardiac rate higher (82 +/- 18 vs 69 +/- 11/min, p = 0.0003). The echocardiographic assessment revealed a more severe systolic disfunction and a lower ejection fraction (50.3 +/- 10.6% vs 55.7 +/- 10.6%, p = 0.003). At the exercise testing, the maximum level and the duration of exercise were lower at group A than group B (5.41 +/- 2.07 MET vs 7.23 +/- 2.78 MET, p = 0.001 respectively 8.4 +/- 4.5 min vs 11.4 +/- 4.9 min, p = 0.01).


CONCLUSIONS
The presence of diastolic disfunction is higher at older patients and at those with associated arterial hypertension. Dyspnoea correlates with the presence and severity of diastolic disfunction and the exercise capacity is lower at these patients.
Mitu
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F
Facultatea de Medicină, Clinica a VI-a Medicală, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi.
Mitu
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M
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D005080:Exercise Test / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology