Prevalence of microvascular dysfunction in patients with heart failure with preserved ejection fraction : Angiographic pararmeters

Title : Prevalence of microvascular dysfunction in patients with heart failure with preserved ejection fraction : Angiographic pararmeters

Abstract:

Objective: To study, using validated angiography indices, coronary blood flow and myocardial perfusion of the microcirculation to assess whether there is greater Microvascular Disease (MVD) in patients with microvascular angina and HFpEF compared to those who do not have.

Patients and methods: This retrospective study took place in El-Mahalla Cardiac Center on 160 patients with stable angina undergoing coronary angiography and echocardiography. All patients were subjected to complete history taking, full clinical examination, echocardiography, coronary angiography and angiography indices. Our patients were divided into two categories: 80 patients with HFpEF and 80 without HFpEF.

Results: There were statistically significant differences between the studied groups. We found lower myocardial blush grades (MBG) in three coronary arteries in HFpEF than non-HFpEF patients, with good statistical significance regarding MBG left anterior descending (LAD) and MBG left circumflex (LCX). Also, there was statistically.
significant difference between the studied groups regarding total MBG value. Between thrombosis in myocardial infarction frame count (TFC) and MBG, there was a good correlation. The best cutoff of total TFC in diagnosis in diagnosis of HFpEF was ≥ 98.55 with sensitivity of 92.5% and specificity of 73.8%. Also, the best cutoff of total MBG in diagnosis in diagnosis of HFpEF was ≤ 6.55 with sensitivity of 80% and specificity of 87.5%.

Conclusion: The HFpEF population has a greater involvement of microcirculation than patients without HFpEF.

Keywords: Angiography, Coronary microvascular dysfunction, Heart failure with preserved ejection fraction

Biography:

Tamer Moustafa has a medical degree (M.B.B.Ch.) from Zagazig University and completed house officer and cardiology residency in the same university hospitals from 1997-2001. He have a Master's degree in Cardiology and completed a fellowship of coronary intervention in Paris in 2004. He later completed an M.D. in Cardiology and became an Assistant Professor of Cardiology at Zagazig University. He currently hold the position of Professor of Cardiology & Intervention. He have 22 years of experience in echocardiography and are an interventional cardiologist with a specialization in coronary intervention, including primary PCI, and skills in dealing with IABP, pacemakers, IVUS & FFR. Tamer Moustafa also have specific training in congenital echocardiography and IVUS. He was previously an instructor in the European Advanced Life Support and Egyptian Echocardiography for Congenital Echocardiography. He is the founder of the Sharkia Cardiac Association group and an executive member of the Egyptian Atherosclerosis and Vascular Biology (EAVA).