Predictive value of percutaneous peripheral arterial compliance T in left ventricular diastolic function with coronary artery disease

Wenhao Zhang; Guoliang Liang; Liang Lv; Xinxin Gu; Qiong Zhang; Ankang Liu; Jiangwei Ma

doi:10.3389/fcvm.2024.1366072

November 8, 2024Frontiers in Cardiovascular MedicineOpen Access

Predictive value of percutaneous peripheral arterial compliance T in left ventricular diastolic function with coronary artery disease

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Why the study?

Diastolic dysfunction emerges early and is prevalent in cardiac insufficiency, making early detection via convenient measurement of peripheral arterial sclerosis clinically relevant to prevent heart failure.

Does peripheral arterial compliance correlate with left ventricular diastolic function in patients with suspected ACS and varying degrees of coronary artery stenosis?

Structured PICO

Does peripheral arterial compliance correlate with left ventricular diastolic function in patients with suspected ACS and varying degrees of coronary artery stenosis?

P

Population

556 patients suspected of Acute Coronary Syndrome (ACS) undergoing coronary arteriography, mean age 59, 47% male, single-center (China). Key exclusions: NYHA class III-IV, LVEF < 50%, prior MI, cardiomyopathy, significant valvular disease, and renal insufficiency.

I

Intervention

Measurement of peripheral arterial compliance (relaxation time constant, T value) via invasive catheterization and ultrasound

C

Comparator

Stratification by coronary artery stenosis severity (Group A: no stenosis, Group B: <50%, Group C: 51-75%, Group D: >75%)

O

Outcome

Correlation between peripheral arterial compliance (T values) and left ventricular diastolic function (LV-T)surrogate

Peripheral arterial compliance decreases and correlates with left ventricular diastolic dysfunction when coronary artery stenosis exceeds 50%, suggesting its potential as an early diagnostic marker for diastolic dysfunction.

Implication

Peripheral arterial T changes associate with LV diastolic dysfunction in >50% stenosis; hypothesis-generating for noninvasive marker, needs prospective validation.

Abstract

Background: Diastolic dysfunction emerges early in patients with cardiac insufficiency and is prevalent, underscoring the importance of its early identification and intervention in the prevention of heart failure. The study leverages the convenience and accuracy of measuring peripheral arterial sclerosis to facilitate the early detection of diastolic dysfunction, which is instrumental in mitigating and delaying the onset and progression of heart failure, holding significant clinical relevance. Methods: This research enrolled 556 patients suspected of experiencing Acute Coronary Syndrome (ACS) and stratified them into Groups A, B, C, and D according to the severity of coronary artery stenosis. The diastolic function of the left ventricle was indicated by the relaxation time constant, denoted as T value, which measures the temporal span from the peak rate of left ventricular pressure rise (dp/dt) to the end-diastolic pressure. Results: < 0.05).When coronary artery stenosis exceeds 50%, the changes in peripheral arterial T values are significantly correlated with changes in LV-T. Conclusions: When coronary artery stenosis exceeds 50%, there is a decrease in peripheral artery compliance, showing a positive correlation with changes in left ventricular diastolic function. Measuring this compliance might offer an early diagnostic tool for assessing diastolic function.