Echocardiographic changes in patients with coronary artery disease

Echocardiographic changes in patients with coronary artery disease | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Echocardiographic changes in patients with coronary artery disease Dana Alnaqawah, Majd Samra, Chamieh Marwan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3970704/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To study cardiac echocardiographic changes in patients with coronary artery disease. Study location: Cardiac Ecology Unit, Damascus Hospital (Al-Mujtahid), Damascus, Syria. Study period: The period extending between 1/8/2018 and 1/8/2023. Type of study: Descriptive, cross-sectional, retrospective study Patients: The study included 200 patients who were admitted to Damascus Hospital in the Cardiac Echo Unit for investigation of retrosternal chest pain without a history of coronary artery disease. Results The incidence of dyskinesia was higher among myocardial infarction patients without ST displacement (P = 0.000), dyskinesia was more common among patients with unstable angina (P = 0.003), and in our study akinesia was more common among patients with unstable angina and patients with infarction with ST displacement. ST (0.353), mitral valve insufficiency was more common in myocardial infarction with ST displacement, while tricuspid valve failure was more common in patients with unstable angina, pulmonary valve insufficiency was more common in patients with infarction without ST displacement, while aortic valve failure was more common in patients with infarction with ST displacement. ST (P < 0.05), and it was found that dyskinesia, akinesia, cardiac aneurysm, and all valve lesions except aortic valve insufficiency are common in patients with arterial hypertension (P < 0.05), and cardiac aneurysm and all valve lesions except tricuspid valve insufficiency are common in patients Diabetes (P < 0.05), myocardial aneurysm, and valve lesions, except for mitral valve insufficiency, are common in patients with high blood cholesterol (P < 0.05), and we found a statistically significant relationship between the expansion of the heart chambers and the type of disease. Coronary artery disease (P < 0.05). There is a statistically significant difference in ejection fraction depending on the type of coronary artery disease. We found that the average ejection fraction as the obstruction and damage to the heart muscle becomes more severe, the ejection fraction decreases in a direct relationship (p = 0.000). Conclusion The echocardiogram had a role in evaluating the function of the four cardiac chambers, especially systolic, diastolic, ejection fraction and other functions, which had great significance and value in diagnosing some complications early. Cardiac & Cardiovascular Systems cardiac echo coronary artery disease Introduction Acute coronary syndrome refers to the clinical manifestation of coronary artery disease, as it is one of the main causes of death from cardiovascular diseases.1 It is classified into coronary syndrome without ST-segment displacement and myocardial infarction with ST-segment displacement.2 The clinical manifestations vary from the classic characteristics of pain. Thoracic imaging in acute coronary syndrome indicates the presence of non-specific symptoms that especially affect women, the elderly, and diabetics. 4,5 Many investigations are used in diagnosing acute coronary syndrome, the most important of which are electrocardiograms and biochemical markers. We should not forget the role of echocardiography, which is considered a non-invasive, available and easy procedure, which played an important role in detecting abnormalities in the movement of the cardiac wall and detecting complications resulting from myocardial infarction, leading to the evaluation of the systolic and diastolic function of the left ventricle5. As for management, the treatment that distinguishes myocardial infarction with ST-segment displacement from acute coronary syndrome without ST-segment displacement is primary percutaneous intervention and thrombolytic therapy.6,4 Materials and methods Although the association between coronary artery disease and some isolated cardiac echo findings has been examined, no study has conducted a study on the changes that occur on echocardiography in patients with coronary artery disease. Therefore, we sought in our research to study the changes in echocardiography in patients with coronary artery disease. Study design: A descriptive, cross-sectional, retrospective study in the period extending between 8/1/2018 and 8/1/2023. Patients: The study included 200 patients who were admitted to Damascus Hospital in the Cardiac Echo Unit for investigation of retrosternal chest pain without a history of coronary artery disease. Methods: A group of patients admitted to Al-Mujtahid Hospital was studied according to the following inclusion criteria . All adult patients over 18 years of age. Accepting patients who have symptoms and signs leading to the diagnosis of coronary artery disease were diagnosed based on cardiac echo. While the exclusion criterias were as follows: Patients with a family history of coronary artery disease. Patients under 18 years of age. Patients who have cardiac motor lesions caused by something other than coronary artery disease. Damaged patient records and records in which there is insufficient information to serve our study. After the approval of the institutional ethics committee from Al-Mujtahid Hospital, Faculty of Medicine at the Syrian Private University, information was collected according to the research form to set the inclusion and exclusion criteria, and information was recorded. The detailed clinical history included: age, gender, habits, and medical history (diabetes, hyperlipidemia, high blood pressure), and information was also taken from the cardiac echo report (ejection fraction, heart chamber measurements, and cardiac muscle movement was studied. The valves were evaluated completely. Statistical analysis: The data was completed from the forms into an Excel file, simple statistics were conducted, the results were summarized and explained with tables and graphs, and the descriptive statistics were reviewed based on percentages and graphical shapes in addition to measures of central tendency (arithmetic mean and standard deviation). To test the statistical relationships between the basic characteristics, we used methods The following statistics: One Anova test, Chi-square test, and goodness of fit test. The Spss-28 statistical program was used, and a predictive value of less than 0.05 (p.value < 0.05) was considered a statistically significant value. Ethical considerations: Ethical approval was obtained from the Institutional Review Board (IRB), Faculty of Medicine, Syrian Private University and the Director of Al-Mujtahid University Hospital. Results 200 patients who met the criteria were included in this study. The arithmetic mean age of the patients was (54.71 years), with a standard deviation of (10.6 years). The ages of the patients ranged within the range (23 to 72 years), and the percentage of males in our study was (70%). While the percentage of females was (30%), and the percentage of smokers and alcoholics was (92% and 2%, respectively), the percentage of patients with high blood pressure was (76.5%), the percentage of diabetes was (37%), while the percentage of patients with high cholesterol was (24%) %), and we found that the percentage of myocardial infarction with ST displacement was (40%), and the percentage of myocardial infarction without ST displacement was (20%), while the percentage of unstable thoracic angina was (40%), and we found that the incidence rate Hypokinesia (HYPOKINESIA) in patients with coronary artery disease (28%), the percentage of cardiac dyskinesia (DYSKINESIA) (6%), the percentage of cardiac akinesia (AKINESIA) (4%), and the percentage of cardiac aneurysm (ANEURYSM) ( 8%), and we found that the percentage of mitral valve insufficiency (MR) is (59.5%), the percentage of tricuspid valve insufficiency is (34%), the percentage of pulmonary valve insufficiency is (4%), and the percentage of aortic valve insufficiency is (8%). We found that the percentage of dilatation in the left ventricle was (22%), the percentage of dilation and stenosis in the left atrium was (6%), the percentage of dilation and stenosis in the right ventricle was (16%), and the percentage of dilation and stenosis in the right atrium was (4%). The arithmetic mean of ejection fraction was (55.9%) with a standard deviation of (9.9%), and the values ranged within the range (34–70%). In this statistical relationship, we found that there was a statistically significant relationship between the presence of (hypokinesia) and Dyskinesia, cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and the type of coronary heart disease. The statistical significance is smaller than 0.05, and we show in this statistical relationship There is a statistically significant relationship between each of (cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency) and the presence of high arterial pressure. The statistical significance is smaller than 0.05, and we show in this statistical relationship that there is an important relationship. Statistically, between (cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), pulmonary valve insufficiency, and aortic valve insufficiency) and the presence of diabetes, the statistical significance is smaller than 0.05, and we show in this statistical relationship that there is a statistically significant relationship between each of ( Cardiac aneurysm (ANEURYSM), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and the presence of high cholesterol. The statistical significance is smaller than 0.05. In this statistical relationship, we show that there is a statistically significant relationship between the dilatation of the heart chambers and the type of coronary artery disease. The statistical significance is smaller. of 0.05, and we found that there are statistically significant differences in ejection fraction depending on the type of coronary artery disease. The statistical significance is less than 0.05, and in this statistical relationship we show that there is a statistically significant relationship between each of (dyskinesia), mitral valve insufficiency (MR), Tricuspid valve insufficiency) and gender, the statistical significance is less than 0.05, and we show in this statistical relationship that there is a statistically significant relationship between the presence of (hypokinesia), cardiac dyskinesia (DYSKINESIA), cardiac akinesia (AKINESIA), and cardiac aneurysm. (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and coronary smoking. Statistical significance is smaller than 0.05. Discussion Echocardiography (cardiac echo) is often performed, and through it, valve disorders and movement disorders that occur after coronary artery disease are found, especially in patients who do not have a history of coronary artery disease or one of these disorders, so it provides a unique opportunity to identify patients. Those suffering from motor and valvular disorders who may have worse outcomes and require early medical or surgical intervention. 12 The average age of patients in our study was 54.71 years, and the percentage of males was twice that of females, which means that males are a risk factor for the occurrence of movement disorders after myocardial infarction. In a study conducted in Denmark 13 on 270 patients to evaluate complications after myocardial infarction with cardiac echo, the average age of the patients was They were 61 years old and 68% were male, and this study is similar to our study in terms of age and gender. In our study, the percentage of smokers was 92%, and the percentage of alcohol drinkers was 2%. Smoking is considered an important risk factor for the occurrence of coronary artery disease and the occurrence of severe complications. 14 The percentage of presence of high blood pressure was very high, 76.5%, compared to the Danish study, where the percentage of patients they sampled was 52%, and the percentage of presence of diabetes in our study was 37%, while in their study it was 55%, and the percentage of presence of high cholesterol in our study was 24%, while in Their studies are 41%. The rate of myocardial infarction with ST displacement in our study was 40%, the rate of myocardial infarction without ST displacement was 20%, and the rate of unstable chest angina was 40% in an American study found 15 in the American Heart Journal conducted at Embury University Hospital in 2000. A study was conducted. A retrospective cross-sectional study between the years 1984–1990, where a cardiac echocardiogram was performed within a week of the infarction. The study included 690 patients. 188 patients had a myocardial infarction with ST displacement and 196 patients had an infarction without ST displacement. The rest of the patients were distributed between cases of stable thoracic angina and non-ST angina. stable. In our study, the percentage of presence of cardiac dyskinesia was 28%, while in the American study it was 17%, and the percentage of presence of cardiac dyskinesia in our study was 6%, while in the American study it was 1.5%, and the percentage of presence of cardiac dyskinesia in our study was 4%, while in the American study it was 5.1%. It was found that the percentage of hyperkinesia in the American study was 3.1%, and the percentage of aneurysms in our study was 8%, while in the American study it was 6.4%, and the percentage of aneurysms in a previous Syrian study was 7%5 and in the VISSER study 22%. 15 The percentage of mitral valve insufficiency in our study was 59.5%, and in a study conducted at Emorx University Hospital 16 the percentage in a study conducted on 325 patients was 55.1%, and the percentage of presence of tricuspid valve insufficiency in our study was 34%, while in the Emorx Hospital study 22%, and the percentage of presence of tricuspid valve insufficiency in our study was 34%. The presence of pulmonary valve insufficiency in our study was 4%, while in the Emorx Hospital study it was 6%, and the percentage of aortic valve insufficiency in our study was 8%, while in the Emorx Hospital study it was 10.6%. The percentage of dilatation in the left ventricle (22%), the percentage of dilatation in the left atrium (6%), the percentage of dilatation in the right ventricle (16%), the percentage of dilatation in the right atrium (4%), and the arithmetic mean ejection fraction was (55.9%) with a standard deviation of (9.9%), and the values ranged within the range (34–70%), and these results are consistent with the study of Marseille Hospital and Tzanio Hospital 17, 18 The incidence of dyskinesia was higher among patients with myocardial infarction without ST displacement (P = 0.000), while in the American study it was more common among patients with unstable angina, dyskinesia was more common among patients with unstable angina (P = 0.003), similar to the American study. In our study, immobility was more common among patients with unstable angina and infarction patients with ST displacement (0.353), also similar to the American study, and hyperkinesia in the American study was more common among infarction patients with ST displacement. Mitral valve failure was more common in myocardial infarction with ST shift, while tricuspid valve failure was more common among patients with unstable angina. Similar to the American study, pulmonary valve failure was more common in patients with infarction without ST shift, while aortic valve failure was more common among patients with infarction with ST shift ( P < 0.05). In our study, it was found that dyskinesia, akinesia, myocardial aneurysm, and all valve lesions except aortic valve insufficiency are common in patients with arterial hypertension (P < 0.05). In our study, it was found that cardiac aneurysms and all valve lesions except tricuspid valve insufficiency are common in patients with diabetes mellitus (P < 0.05). In our study, it was found that cardiac aneurysms and all valve lesions except mitral valve insufficiency are common in patients with hypercholesterolemia (P < 0.05). In our study, we found a statistically significant relationship between the expansion of the heart chambers (dilatation or stenosis) and the type of coronary artery disease (P < 0.05). There is a statistically significant difference in the ejection fraction depending on the type of coronary artery disease, as we found that the average ejection fraction as the obstruction and damage to the heart muscle becomes more severe, the ejection fraction decreases in an inverse relationship (p = 0.000), similar to the Danish study where the value of the ejection fraction in infarction patients with ST displacement was 48. ± 12%, and in our study 48.4% ± 10.9%. In our study, dyskinesia was more common among females (p = 0.004), while mitral valve insufficiency was more common among males (p = 0.001), and tricuspid valve insufficiency was also more common among males (p = 0.006). In our study, all motor and valvular heart lesions were more common among smokers (P < 0.05). Conclusion In this study, many complications were diagnosed by two-dimensional echocardiography, such as aneurysms, ventricular thrombi, cardiac movement disorders, and valve lesions, and the death rate increases with their occurrence, so early diagnosis and appropriate treatment are necessary and reduce the death rate. The echocardiogram played a role in evaluating the function of the four cardiac chambers, especially systolic and diastolic function, as well as ejection fraction (EF) and other functions, which were of great significance and value in diagnosing some complications early. Declarations Ethics approval and consent to participate: The Research Ethics Committee at Syria Private University and the ethical committees at the relevant Damascus Hospital approved the study protocol, and all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. With the 1964 Helsinki Declaration and its subsequent amendments or similar ethical standards. Consent for publication: Not applicable. Availability of data and materials: All data related to this paper’s conclusion are available and stored by the authors. All data are available from the corresponding author on a reasonable request. Conflict of interest: The authors declare that they have no conflict of interest Funding: This research received no specific grant from ASPU or any other funding agency in the public, commercial or non-profit sectors. Authors’ contributions: D.A and M.S conceptualized the study and wrote the study protocol, performed the statistical analysis, participated in data collection, and did the literature search and participated in the literature search, interpret the results, wrote the main manuscript M.S. revised the draft. All authors read and approved the final draft. Acknowledgments: We thank the administration of Syrian Private University for their support in the field of medical training and research. And the medical staff at Damascus Hospital. We would also like to thank Dr. Chamieh Marwan for his assistance and supervision of the paper. References Eisen A, Giugliano RP, Braunwald E. Updates on Acute Coronary Syndrome: A Review. JAMA Cardiol. 2016 Sep 1;1(6):718-30. doi: 10.1001/jamacardio.2016.2049. PMID: 27438381. Brian P. Griffin MD, FACC, Ischemic Heart Disease, Manual of Cardiovascular Medicine 5th Edition, Wolters Kluwer, Philadelphia 2019 (29-99). Makki N, Brennan TM, Girotra S. Acute coronary syndrome. J Intensive Care Med. 2015 May;30(4):186-200. doi: 10.1177/0885066613503294. Epub 2013 Sep 18. PMID: 24047692. J. Alastair Innes, Cardiovascular disease, Davidson's Essentials of Medicine 2nd Edition, Churchill Livingstone, United Kingdom, 2016, (201-263). Echo Cardio Graphy and Its Role in the Early Diagnosis of Complication of Myocardial Infarction Tishreen University Journal-Medical Sciences Series, 29(3). Retrieved from https: //journal.tishreen.edu.sy/index.php/hlthscnc/article /view /6471. Elias B. Hanna, Coronary Artery Disease. Practical Cardiovascular Medicine 2 nd edition, Wiley-Blackwell, United Kingdom, 2017, (1-62). Bergmark BA, Mathenge N, Merlini PA, Lawrence-Wright MB, Giugliano RP. Acute coronary syndromes. Lancet. 2022 Apr 2;399(10332):1347-1358. doi: 10.1016/S0140-6736(21)02391-6. PMID: 35367005; PMCID: PMC8970581. Overbaugh KJ. Acute coronary syndrome. Am J Nurs. 2009 May;109(5):42-52; quiz 53. doi: 10.1097/01.NAJ.0000351508. 39509.e2. PMID: 19411905. Deckers JW. Classification of myocardial infarction and unstable angina: a re-assessment. Int J Cardiol. 2013 Sep 10;167(6):2387-90. doi: 10.1016/j.ijcard.2013.01.008. Epub 2013 Feb 4. PMID: 23384481. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20): e618-e651. doi: 10.1161/CIR.0000000000000617. Erratum in: Circulation. 2018 Nov 13;138(20): e652. PMID: 30571511. Greaves, Sally C. “Role of echocardiography in acute coronary syndromes.” Heart (British Cardiac Society) vol. 88,4 (2002): 419-25. doi:10.1136/heart.88.4.419 VISSER, C.A.; KON, G.; DAVID, G.K.LIE, K.I. DURRER graphic-cineangio graphic correlation in detecting left ventricular aneurysm: aprospective study of 422 patients.Am.J. Cardiol; 1982, 50, 337-341. RUNYON, J. P.; GERSON, M.C.; Selection of noninvasive tests in the coronary care unit: Complecations of acute myocardial infarction left ventricular aneurysmIn Gerson M.C.; ed, cardiac Nuclear Medicine New York. McGraw –Hill.1991.360-362. BOTVINICK, E. H.; SHAMES, D.; HUTCHINSON, J.C.; ROE, B. B.; FITZ, P. M.; Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging: differentiation form true aneurysm.Am. J. Cardiol 1976;37,1089-93. DYMOND, D.S.; ELLIOTT, A. T.; BANIM, S. Detection of left ventricular aneurysm dy first –pass radionuclide ventriculogrrphyJ. Nucl. Med. 1979,20,851-4. DIETHRICH, E.B.; KINARD, S. A. Pseudoaneurysm of artioventricular groove a late complication valve replacement, J thorac, Cardiovasc Surg, 1977;74-50. VAN BRABANDT, H.; PIESSENS, J.; STALPARET, J.J DE GEEST Pseudo aneurysm of the left ventricular following cardiac surgery: report of 3 cases and review of the literature. Thorac cardio vase Surg, 1985, 33, 118-24. STANLEY, J.H.; HANGER, K.H.; USHER, B. W.; GRAYSON, J. M.; ROSS, P.; SCHABEL, S. I. Noninvasive diagnosis of left ventricular aneurysm. Comput Tomogerm1982;6,17-21. Additional Declarations The authors declare potential competing interests as follows: no Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3970704","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":273738258,"identity":"a4bd6c29-f0d4-48b1-8b3e-10a0d0b06d01","order_by":0,"name":"Dana Alnaqawah","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYDCCAyCigEHOAMwzsCBWiwGDsQEDM4ghQbyWxA1gLQxEaOE7fvbgBwaDO+nb2fuPbvhRIMHA396dgFeL5Jm8ZAkGg2e5O3sOs93sATpM4szZDXi1GBzIASozOJy74UYy2w0eEFsil4CW82+MfwC1pBsAtdz8Q5SWGzlmIFsSQFpuE2WL5I03ZhYJBocNN5w5bHZbxkCCh6Bf+M7nGN/4UHFY3uB447Obb/7YyPG39+LXAgYJSGwewspHwSgYBaNgFBAEAPNGR+Crs9D+AAAAAElFTkSuQmCC","orcid":"","institution":"Faculty of medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":true,"prefix":"","firstName":"Dana","middleName":"","lastName":"Alnaqawah","suffix":""},{"id":273738259,"identity":"30c226b1-91ce-440a-9b0a-507898b55e62","order_by":1,"name":"Majd Samra","email":"","orcid":"","institution":"Faculty of medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":false,"prefix":"","firstName":"Majd","middleName":"","lastName":"Samra","suffix":""},{"id":273738260,"identity":"ef6fda33-fce3-4fe8-b688-eebaf1aeba15","order_by":2,"name":"Chamieh Marwan","email":"","orcid":"","institution":"Department of Internal Medicine at the Syrian Private University.","correspondingAuthor":false,"prefix":"","firstName":"Chamieh","middleName":"","lastName":"Marwan","suffix":""}],"badges":[],"createdAt":"2024-02-19 18:54:41","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-3970704/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3970704/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51420231,"identity":"1e831954-1571-4075-b740-7e9c3351e839","added_by":"auto","created_at":"2024-02-21 08:55:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":231688,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3970704/v1/88887c00-0c70-4008-9246-f6b6d0a44ebe.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: no","formattedTitle":"\u003cp\u003e\u003cstrong\u003eEchocardiographic changes in patients with coronary artery disease\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAcute coronary syndrome refers to the clinical manifestation of coronary artery disease, as it is one of the main causes of death from cardiovascular diseases.1 It is classified into coronary syndrome without ST-segment displacement and myocardial infarction with ST-segment displacement.2 The clinical manifestations vary from the classic characteristics of pain. Thoracic imaging in acute coronary syndrome indicates the presence of non-specific symptoms that especially affect women, the elderly, and diabetics. 4,5 Many investigations are used in diagnosing acute coronary syndrome, the most important of which are electrocardiograms and biochemical markers. We should not forget the role of echocardiography, which is considered a non-invasive, available and easy procedure, which played an important role in detecting abnormalities in the movement of the cardiac wall and detecting complications resulting from myocardial infarction, leading to the evaluation of the systolic and diastolic function of the left ventricle5. As for management, the treatment that distinguishes myocardial infarction with ST-segment displacement from acute coronary syndrome without ST-segment displacement is primary percutaneous intervention and thrombolytic therapy.6,4\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eAlthough the association between coronary artery disease and some isolated cardiac echo findings has been examined, no study has conducted a study on the changes that occur on echocardiography in patients with coronary artery disease. Therefore, we sought in our research to study the changes in echocardiography in patients with coronary artery disease.\u003c/p\u003e\n\u003cp\u003eStudy design:\u003c/p\u003e\n\u003cp\u003eA descriptive, cross-sectional, retrospective study in the period extending between 8/1/2018 and 8/1/2023.\u003c/p\u003e\n\u003cp\u003ePatients:\u003c/p\u003e\n\u003cp\u003eThe study included 200 patients who were admitted to Damascus Hospital in the Cardiac Echo Unit for investigation of retrosternal chest pain without a history of coronary artery disease.\u003c/p\u003e\n\u003cp\u003eMethods:\u003c/p\u003e\n\u003cp\u003eA group of patients admitted to Al-Mujtahid Hospital was studied according to the following \u003cstrong\u003einclusion criteria\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eAll adult patients over 18 years of age.\u003c/p\u003e\n\u003cp\u003eAccepting patients who have symptoms and signs leading to the diagnosis of coronary artery disease were diagnosed based on cardiac echo.\u003c/p\u003e\n\u003cp\u003eWhile the \u003cstrong\u003eexclusion criterias\u003c/strong\u003e were as follows:\u003c/p\u003e\n\u003cp\u003ePatients with a family history of coronary artery disease.\u003c/p\u003e\n\u003cp\u003ePatients under 18 years of age.\u003c/p\u003e\n\u003cp\u003ePatients who have cardiac motor lesions caused by something other than coronary artery disease.\u003c/p\u003e\n\u003cp\u003eDamaged patient records and records in which there is insufficient information to serve our study.\u003c/p\u003e\n\u003cp\u003eAfter the approval of the institutional ethics committee from Al-Mujtahid Hospital, Faculty of Medicine at the Syrian Private University, information was collected according to the research form to set the inclusion and exclusion criteria, and information was recorded.\u003c/p\u003e\n\u003cp\u003eThe detailed clinical history included: age, gender, habits, and medical history (diabetes, hyperlipidemia, high blood pressure), and information was also taken from the cardiac echo report (ejection fraction, heart chamber measurements, and cardiac muscle movement was studied. The valves were evaluated completely.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical analysis:\u003c/h2\u003e\n \u003cp\u003eThe data was completed from the forms into an Excel file, simple statistics were conducted, the results were summarized and explained with tables and graphs, and the descriptive statistics were reviewed based on percentages and graphical shapes in addition to measures of central tendency (arithmetic mean and standard deviation). To test the statistical relationships between the basic characteristics, we used methods The following statistics: One Anova test, Chi-square test, and goodness of fit test. The Spss-28 statistical program was used, and a predictive value of less than 0.05 (p.value\u0026thinsp;\u0026lt;\u0026thinsp;0.05) was considered a statistically significant value.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eEthical considerations:\u003c/h2\u003e\n \u003cp\u003eEthical approval was obtained from the Institutional Review Board (IRB), Faculty of Medicine, Syrian Private University and the Director of Al-Mujtahid University Hospital.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e200 patients who met the criteria were included in this study. The arithmetic mean age of the patients was (54.71 years), with a standard deviation of (10.6 years). The ages of the patients ranged within the range (23 to 72 years), and the percentage of males in our study was (70%). While the percentage of females was (30%), and the percentage of smokers and alcoholics was (92% and 2%, respectively), the percentage of patients with high blood pressure was (76.5%), the percentage of diabetes was (37%), while the percentage of patients with high cholesterol was (24%) %), and we found that the percentage of myocardial infarction with ST displacement was (40%), and the percentage of myocardial infarction without ST displacement was (20%), while the percentage of unstable thoracic angina was (40%), and we found that the incidence rate Hypokinesia (HYPOKINESIA) in patients with coronary artery disease (28%), the percentage of cardiac dyskinesia (DYSKINESIA) (6%), the percentage of cardiac akinesia (AKINESIA) (4%), and the percentage of cardiac aneurysm (ANEURYSM) ( 8%), and we found that the percentage of mitral valve insufficiency (MR) is (59.5%), the percentage of tricuspid valve insufficiency is (34%), the percentage of pulmonary valve insufficiency is (4%), and the percentage of aortic valve insufficiency is (8%). We found that the percentage of dilatation in the left ventricle was (22%), the percentage of dilation and stenosis in the left atrium was (6%), the percentage of dilation and stenosis in the right ventricle was (16%), and the percentage of dilation and stenosis in the right atrium was (4%). The arithmetic mean of ejection fraction was (55.9%) with a standard deviation of (9.9%), and the values ranged within the range (34\u0026ndash;70%). In this statistical relationship, we found that there was a statistically significant relationship between the presence of (hypokinesia) and Dyskinesia, cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and the type of coronary heart disease. The statistical significance is smaller than 0.05, and we show in this statistical relationship There is a statistically significant relationship between each of (cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency) and the presence of high arterial pressure. The statistical significance is smaller than 0.05, and we show in this statistical relationship that there is an important relationship. Statistically, between (cardiac aneurysm (ANEURYSM), mitral valve insufficiency (MR), pulmonary valve insufficiency, and aortic valve insufficiency) and the presence of diabetes, the statistical significance is smaller than 0.05, and we show in this statistical relationship that there is a statistically significant relationship between each of ( Cardiac aneurysm (ANEURYSM), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and the presence of high cholesterol. The statistical significance is smaller than 0.05. In this statistical relationship, we show that there is a statistically significant relationship between the dilatation of the heart chambers and the type of coronary artery disease. The statistical significance is smaller. of 0.05, and we found that there are statistically significant differences in ejection fraction depending on the type of coronary artery disease. The statistical significance is less than 0.05, and in this statistical relationship we show that there is a statistically significant relationship between each of (dyskinesia), mitral valve insufficiency (MR), Tricuspid valve insufficiency) and gender, the statistical significance is less than 0.05, and we show in this statistical relationship that there is a statistically significant relationship between the presence of (hypokinesia), cardiac dyskinesia (DYSKINESIA), cardiac akinesia (AKINESIA), and cardiac aneurysm. (ANEURYSM), mitral valve insufficiency (MR), tricuspid valve insufficiency, pulmonary valve insufficiency, aortic valve insufficiency) and coronary smoking. Statistical significance is smaller than 0.05.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eEchocardiography (cardiac echo) is often performed, and through it, valve disorders and movement disorders that occur after coronary artery disease are found, especially in patients who do not have a history of coronary artery disease or one of these disorders, so it provides a unique opportunity to identify patients. Those suffering from motor and valvular disorders who may have worse outcomes and require early medical or surgical intervention. 12\u003c/p\u003e \u003cp\u003eThe average age of patients in our study was 54.71 years, and the percentage of males was twice that of females, which means that males are a risk factor for the occurrence of movement disorders after myocardial infarction. In a study conducted in Denmark 13 on 270 patients to evaluate complications after myocardial infarction with cardiac echo, the average age of the patients was They were 61 years old and 68% were male, and this study is similar to our study in terms of age and gender.\u003c/p\u003e \u003cp\u003eIn our study, the percentage of smokers was 92%, and the percentage of alcohol drinkers was 2%. Smoking is considered an important risk factor for the occurrence of coronary artery disease and the occurrence of severe complications. 14\u003c/p\u003e \u003cp\u003eThe percentage of presence of high blood pressure was very high, 76.5%, compared to the Danish study, where the percentage of patients they sampled was 52%, and the percentage of presence of diabetes in our study was 37%, while in their study it was 55%, and the percentage of presence of high cholesterol in our study was 24%, while in Their studies are 41%.\u003c/p\u003e \u003cp\u003eThe rate of myocardial infarction with ST displacement in our study was 40%, the rate of myocardial infarction without ST displacement was 20%, and the rate of unstable chest angina was 40% in an American study found 15 in the American Heart Journal conducted at Embury University Hospital in 2000. A study was conducted. A retrospective cross-sectional study between the years 1984\u0026ndash;1990, where a cardiac echocardiogram was performed within a week of the infarction. The study included 690 patients. 188 patients had a myocardial infarction with ST displacement and 196 patients had an infarction without ST displacement. The rest of the patients were distributed between cases of stable thoracic angina and non-ST angina. stable.\u003c/p\u003e \u003cp\u003eIn our study, the percentage of presence of cardiac dyskinesia was 28%, while in the American study it was 17%, and the percentage of presence of cardiac dyskinesia in our study was 6%, while in the American study it was 1.5%, and the percentage of presence of cardiac dyskinesia in our study was 4%, while in the American study it was 5.1%. It was found that the percentage of hyperkinesia in the American study was 3.1%, and the percentage of aneurysms in our study was 8%, while in the American study it was 6.4%, and the percentage of aneurysms in a previous Syrian study was 7%5 and in the VISSER study 22%. 15\u003c/p\u003e \u003cp\u003eThe percentage of mitral valve insufficiency in our study was 59.5%, and in a study conducted at Emorx University Hospital 16 the percentage in a study conducted on 325 patients was 55.1%, and the percentage of presence of tricuspid valve insufficiency in our study was 34%, while in the Emorx Hospital study 22%, and the percentage of presence of tricuspid valve insufficiency in our study was 34%. The presence of pulmonary valve insufficiency in our study was 4%, while in the Emorx Hospital study it was 6%, and the percentage of aortic valve insufficiency in our study was 8%, while in the Emorx Hospital study it was 10.6%.\u003c/p\u003e \u003cp\u003eThe percentage of dilatation in the left ventricle (22%), the percentage of dilatation in the left atrium (6%), the percentage of dilatation in the right ventricle (16%), the percentage of dilatation in the right atrium (4%), and the arithmetic mean ejection fraction was (55.9%) with a standard deviation of (9.9%), and the values ranged within the range (34\u0026ndash;70%), and these results are consistent with the study of Marseille Hospital and Tzanio Hospital 17, 18\u003c/p\u003e \u003cp\u003eThe incidence of dyskinesia was higher among patients with myocardial infarction without ST displacement (P\u0026thinsp;=\u0026thinsp;0.000), while in the American study it was more common among patients with unstable angina, dyskinesia was more common among patients with unstable angina (P\u0026thinsp;=\u0026thinsp;0.003), similar to the American study. In our study, immobility was more common among patients with unstable angina and infarction patients with ST displacement (0.353), also similar to the American study, and hyperkinesia in the American study was more common among infarction patients with ST displacement.\u003c/p\u003e \u003cp\u003eMitral valve failure was more common in myocardial infarction with ST shift, while tricuspid valve failure was more common among patients with unstable angina. Similar to the American study, pulmonary valve failure was more common in patients with infarction without ST shift, while aortic valve failure was more common among patients with infarction with ST shift ( P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eIn our study, it was found that dyskinesia, akinesia, myocardial aneurysm, and all valve lesions except aortic valve insufficiency are common in patients with arterial hypertension (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eIn our study, it was found that cardiac aneurysms and all valve lesions except tricuspid valve insufficiency are common in patients with diabetes mellitus (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eIn our study, it was found that cardiac aneurysms and all valve lesions except mitral valve insufficiency are common in patients with hypercholesterolemia (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eIn our study, we found a statistically significant relationship between the expansion of the heart chambers (dilatation or stenosis) and the type of coronary artery disease (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eThere is a statistically significant difference in the ejection fraction depending on the type of coronary artery disease, as we found that the average ejection fraction as the obstruction and damage to the heart muscle becomes more severe, the ejection fraction decreases in an inverse relationship (p\u0026thinsp;=\u0026thinsp;0.000), similar to the Danish study where the value of the ejection fraction in infarction patients with ST displacement was 48. \u0026plusmn; 12%, and in our study 48.4% \u0026plusmn; 10.9%.\u003c/p\u003e \u003cp\u003eIn our study, dyskinesia was more common among females (p\u0026thinsp;=\u0026thinsp;0.004), while mitral valve insufficiency was more common among males (p\u0026thinsp;=\u0026thinsp;0.001), and tricuspid valve insufficiency was also more common among males (p\u0026thinsp;=\u0026thinsp;0.006).\u003c/p\u003e \u003cp\u003eIn our study, all motor and valvular heart lesions were more common among smokers (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this study, many complications were diagnosed by two-dimensional echocardiography, such as aneurysms, ventricular thrombi, cardiac movement disorders, and valve lesions, and the death rate increases with their occurrence, so early diagnosis and appropriate treatment are necessary and reduce the death rate.\u003c/p\u003e \u003cp\u003eThe echocardiogram played a role in evaluating the function of the four cardiac chambers, especially systolic and diastolic function, as well as ejection fraction (EF) and other functions, which were of great significance and value in diagnosing some complications early.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Research Ethics Committee at Syria Private University and the ethical committees at the relevant Damascus Hospital approved the study protocol, and all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. With the 1964 Helsinki Declaration and its subsequent amendments or similar ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data related to this paper\u0026rsquo;s conclusion are available and stored by the authors. All data are available from the corresponding author on a reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from ASPU or any other funding agency in the public, commercial or non-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eD.A and M.S\u0026nbsp;conceptualized the study and wrote the study protocol, performed the statistical analysis, participated in data collection, and did the literature search and participated in the literature search, interpret the results, wrote the main manuscript M.S. revised the draft. All authors read and approved the final draft.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the administration of Syrian Private University for their support in the field of medical training and research. And the medical staff at Damascus Hospital. We would also like to thank Dr. Chamieh Marwan for his assistance and supervision of the paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eEisen A, Giugliano RP, Braunwald E. Updates on Acute Coronary Syndrome: A Review. JAMA Cardiol. 2016 Sep 1;1(6):718-30. doi: 10.1001/jamacardio.2016.2049. PMID: 27438381.\u003c/li\u003e\n\u003cli\u003eBrian P. Griffin MD, FACC, Ischemic Heart Disease, Manual of Cardiovascular Medicine 5th Edition, Wolters Kluwer, Philadelphia 2019 (29-99).\u003c/li\u003e\n\u003cli\u003eMakki N, Brennan TM, Girotra S. Acute coronary syndrome. J Intensive Care Med. 2015 May;30(4):186-200. doi: 10.1177/0885066613503294. Epub 2013 Sep 18. PMID: 24047692.\u003c/li\u003e\n\u003cli\u003eJ. Alastair Innes, Cardiovascular disease, Davidson\u0026apos;s Essentials of Medicine 2nd Edition, Churchill Livingstone, United Kingdom, 2016, (201-263).\u003c/li\u003e\n\u003cli\u003eEcho Cardio Graphy and Its Role in the Early Diagnosis of Complication of Myocardial Infarction\u003cspan dir=\"RTL\"\u003e \u003c/span\u003eTishreen University Journal-Medical Sciences Series, 29(3). Retrieved from https: //journal.tishreen.edu.sy/index.php/hlthscnc/article /view /6471.\u003c/li\u003e\n\u003cli\u003eElias B. Hanna, Coronary Artery Disease. Practical Cardiovascular Medicine 2\u003csup\u003end\u003c/sup\u003e edition, Wiley-Blackwell, United Kingdom, 2017, (1-62).\u003c/li\u003e\n\u003cli\u003eBergmark BA, Mathenge N, Merlini PA, Lawrence-Wright MB, Giugliano RP. Acute coronary syndromes. Lancet. 2022 Apr 2;399(10332):1347-1358. doi: 10.1016/S0140-6736(21)02391-6. PMID: 35367005; PMCID: PMC8970581.\u003c/li\u003e\n\u003cli\u003eOverbaugh KJ. Acute coronary syndrome. Am J Nurs. 2009 May;109(5):42-52; quiz 53. doi: 10.1097/01.NAJ.0000351508. 39509.e2. PMID: 19411905.\u003c/li\u003e\n\u003cli\u003eDeckers JW. Classification of myocardial infarction and unstable angina: a re-assessment. Int J Cardiol. 2013 Sep 10;167(6):2387-90. doi: 10.1016/j.ijcard.2013.01.008. Epub 2013 Feb 4. PMID: 23384481.\u003c/li\u003e\n\u003cli\u003eThygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20): e618-e651. doi: 10.1161/CIR.0000000000000617. Erratum in: Circulation. 2018 Nov 13;138(20): e652. PMID: 30571511.\u003c/li\u003e\n\u003cli\u003eGreaves, Sally C. \u0026ldquo;Role of echocardiography in acute coronary syndromes.\u0026rdquo; Heart (British Cardiac Society) vol. 88,4 (2002): 419-25. doi:10.1136/heart.88.4.419\u003c/li\u003e\n\u003cli\u003eVISSER, C.A.; KON, G.; DAVID, G.K.LIE, K.I. DURRER graphic-cineangio graphic correlation in detecting left ventricular aneurysm: aprospective study of 422 patients.Am.J. Cardiol; 1982, 50, 337-341.\u003c/li\u003e\n\u003cli\u003eRUNYON, J. P.; GERSON, M.C.; Selection of noninvasive tests in the coronary care unit: Complecations of acute myocardial infarction left ventricular aneurysmIn Gerson M.C.; ed, cardiac Nuclear Medicine New York. McGraw \u0026ndash;Hill.1991.360-362.\u003c/li\u003e\n\u003cli\u003eBOTVINICK, E. H.; SHAMES, D.; HUTCHINSON, J.C.; ROE, B. B.; FITZ, P. M.; Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging: differentiation form true aneurysm.Am. J. Cardiol 1976;37,1089-93.\u003c/li\u003e\n\u003cli\u003eDYMOND, D.S.; ELLIOTT, A. T.; BANIM, S. Detection of left ventricular aneurysm dy first \u0026ndash;pass radionuclide ventriculogrrphyJ. Nucl. Med. 1979,20,851-4.\u003c/li\u003e\n\u003cli\u003eDIETHRICH, E.B.; KINARD, S. A. Pseudoaneurysm of artioventricular groove a late complication valve replacement, J thorac, Cardiovasc Surg, 1977;74-50.\u003c/li\u003e\n\u003cli\u003eVAN BRABANDT, H.; PIESSENS, J.; STALPARET, J.J DE GEEST Pseudo aneurysm of the left ventricular following cardiac surgery: report of 3 cases and review of the literature. Thorac cardio vase Surg, 1985, 33, 118-24.\u003c/li\u003e\n\u003cli\u003eSTANLEY, J.H.; HANGER, K.H.; USHER, B. W.; GRAYSON, J. M.; ROSS, P.; SCHABEL, S. I. Noninvasive diagnosis of left ventricular aneurysm. Comput Tomogerm1982;6,17-21.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"db373fd5-1ca8-47d4-99ec-40500376a3a1","identifier":"10.13039/100016418","name":"B.K. Kee Foundation","awardNumber":"0996066591","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Syrian Private University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"cardiac echo, coronary artery disease","lastPublishedDoi":"10.21203/rs.3.rs-3970704/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3970704/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo study cardiac echocardiographic changes in patients with coronary artery disease.\u003c/p\u003e\u003ch2\u003eStudy location:\u003c/h2\u003e \u003cp\u003eCardiac Ecology Unit, Damascus Hospital (Al-Mujtahid), Damascus, Syria.\u003c/p\u003e\u003ch2\u003eStudy period:\u003c/h2\u003e \u003cp\u003eThe period extending between 1/8/2018 and 1/8/2023.\u003c/p\u003e\u003ch2\u003eType of study:\u003c/h2\u003e \u003cp\u003eDescriptive, cross-sectional, retrospective study\u003c/p\u003e\u003ch2\u003ePatients:\u003c/h2\u003e \u003cp\u003eThe study included 200 patients who were admitted to Damascus Hospital in the Cardiac Echo Unit for investigation of retrosternal chest pain without a history of coronary artery disease.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe incidence of dyskinesia was higher among myocardial infarction patients without ST displacement (P\u0026thinsp;=\u0026thinsp;0.000), dyskinesia was more common among patients with unstable angina (P\u0026thinsp;=\u0026thinsp;0.003), and in our study akinesia was more common among patients with unstable angina and patients with infarction with ST displacement. ST (0.353), mitral valve insufficiency was more common in myocardial infarction with ST displacement, while tricuspid valve failure was more common in patients with unstable angina, pulmonary valve insufficiency was more common in patients with infarction without ST displacement, while aortic valve failure was more common in patients with infarction with ST displacement. ST (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and it was found that dyskinesia, akinesia, cardiac aneurysm, and all valve lesions except aortic valve insufficiency are common in patients with arterial hypertension (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and cardiac aneurysm and all valve lesions except tricuspid valve insufficiency are common in patients Diabetes (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), myocardial aneurysm, and valve lesions, except for mitral valve insufficiency, are common in patients with high blood cholesterol (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and we found a statistically significant relationship between the expansion of the heart chambers and the type of disease. Coronary artery disease (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There is a statistically significant difference in ejection fraction depending on the type of coronary artery disease. We found that the average ejection fraction as the obstruction and damage to the heart muscle becomes more severe, the ejection fraction decreases in a direct relationship (p\u0026thinsp;=\u0026thinsp;0.000).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe echocardiogram had a role in evaluating the function of the four cardiac chambers, especially systolic, diastolic, ejection fraction and other functions, which had great significance and value in diagnosing some complications early.\u003c/p\u003e","manuscriptTitle":"Echocardiographic changes in patients with coronary artery disease","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-21 08:46:56","doi":"10.21203/rs.3.rs-3970704/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"741a6a07-d64d-4c91-9163-cb5c40d3ecf8","owner":[],"postedDate":"February 21st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":28848988,"name":"Cardiac \u0026 Cardiovascular Systems"}],"tags":[],"updatedAt":"2024-02-21T08:46:56+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-21 08:46:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3970704","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3970704","identity":"rs-3970704","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}