Assessment of the probability of obstructive coronary artery disease in patients with paroxysmal dyspnea due to myocardial ischemia
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim. To characterize the potential of assessing the probability of obstructive coronary atherosclerosis in patients with stable coronary artery disease (CAD) and paroxysmal dyspnea due to myocardial ischemia. Material and methods. In a cross-sectional study of 36 stable patients with CAD, complaining of paroxysmal dyspnea during stress echocardiography, transient myocardial ischemia was detected. According to coronary angiography data, coronary artery stenosis ≥50% was detected in 30 (83,3%) of them: ≥70% — in 25 (69,4%), ≥90% — in 18 (50,0%) patients. Results. Independent parameters associated with stenosis ≥50% were a lower anxiety-depression scale score, the presence of pathological Q waves and higher e'lateral (early diastolic mitral annular velocity along the left ventricular lateral wall); for ≥70% — no bendopnea, greater duration and severity of dyspnea, a history of coronary stenting, no prior paroxysmal atrial fibrillation and a higher e'lateral; for stenosis ≥90% — greater severity of dyspnea, lower scores on the visual analogue scale of depression and greater e'lateral. The area under the characteristic curve when predicting stenosis ≥50% was 0,81 for the regression equation and 0,68 for the point scale, while ≥70% — 0,91 and 0,71, ≥90% — 0,82 and 0,75, respectively. Conclusion. The most informative indicators of obstructive CAD in the studied patients were a longer duration and severity of dyspnea, a low anxiety-depression scale score, as well as the absence of left ventricular diastolic dysfunction.
Authors: S. F. Yarmedova, I. S. Yavelov, O. M. Drapkina
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413129476