Nithima Chaowalit MD*, Ruedeekorn Auesethasak, MD*, Yingsak Santanakorn MD*, Decho Jakrapanichakul MD*, Maytinee Kittipovanonth MD*, Srisakul Chirakarnjanakorn MD*
Affiliation : * Division of Cardiology, Department of Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
Background : Patients with non ST-segment elevation acute coronary syndrome (NSTEACS) present with diverse clinical,
electrocardiographic, cardiac biomarker, echocardiographic and angiographic characteristics. We sought to determine
whether there was any difference in the indices of left ventricular systolic and diastolic function among subgroups of patients
with NSTEACS.
Material and Method: We studied 121 consecutive patients (mean age 68.6 + 11.3 years, 45% male) with NSTEACS who
underwent comprehensive echocardiography within 48 hours of admission. Two-dimensional and Doppler echocardiography
was performed for the evaluation of left ventricular systolic and diastolic function.
Results : Non ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) were reported in 59% and
41% of patients, respectively. Clinical characteristics (such as age, gender, cardiovascular risk factors, prior myocardial
infarction and revascularization, medication) were not significantly different between patients with NSTEMI and UA. Patients
with NSTEMI were more likely to have wall motion abnormalities and lower left ventricular ejection fraction (p < 0.05) as
compared to those with UA. Diastolic dysfunction was significantly more frequent and more severe in patients with NSTEMI
than in those with UA.
Conclusion : Among patients with NSTEACS, left ventricular systolic and diastolic dysfunction was more frequent and more
severe in patients with NSTEMI that in those with UA. These findings may be used to characterize the sicker group among
patients with NSTEACS.
Keywords : Diastolic dysfunction, Echocardiography, Non ST-segment elevation myocardial infarction, Unstable angina
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