Correlation between S'-Wave Dispersion of Mitral Annular Tissue Velocity and Severity of Coronary Artery Disease Assessed by SYNTAX Score

Abstract
Background: Coronary Artery Disease (CAD) is a para-mount cause of death. Coronary angiography is considered the gold standard for the invasive assessment of obstructive CAD. The SYNTAX score is frequently used to comprehen-sively assess the complexity and burden of CAD. The technique of Tissue Doppler Imaging (TDI) emerged as a unique, easily performed, and reproducible modality for assessing systolic and diastolic LV performance. We aimed to examine the value of the S'-wave dispersion of TDI derived mitral annular velocities for the prediction of severity of coronary artery stenosis.
Methods: We included 60 patients with symptoms sug-gesting CAD in the study. We excluded patients with previous myocardial infarction, atrial fibrillation, significant valvular disease, and congestive heart failure. All patients had undergone full history taken and clinical examination; complete 12-leads electrocardiography, echocardiographic with assessment of LV systolic and diastolic dimensions, fraction of shortening, ejection fraction, and Doppler derived mitral valve velocities; TDI with measuring of S'-wave, S'-wave dispersion, S' mean, E'-wave, A'-wave and E'/A' ratio of the septal, lateral, anterior and inferior walls; and coronary angiography.
Results: Mean S' was decreased in patients with severe CAD and S'-wave dispersion was high in patients with single or two vessel disease and low in patients with multi vessel disease.
Conclusion: S'-wave dispersion in combination with S' mean can predict severity of CAD and number of affected vessel.