RESUMO
Background: There is growing recognition that congestive heart failure caused by a predominant abnormality in left ventricular diastolic function is common and causes significant morbidity and mortality. Diastolic function usually declines before systolic function, and this precedes clinical signs. 12-lead electrocardiogram is a commonly used tool to assess left atrial enlargement, which is a marker of left ventricular diastolic dysfunction. We investigated the relationship between P wave dispersion, which is easily measured on the surface electrocardiogram and left ventricular diastolic function. Methods: There were 100 patients: 50 with diastolic dysfunction and 50 without. P wave dispersions were calculated by measuring minimum and maximum P wave duration values on the surface electrocardiogram. The relationships between P wave dispersion and echocardiographic measurements of diastolic dysfunction were assessed. Results: Maximum P wave duration was observed significantly (p=0.001) in patients with left ventricular diastolic dysfunction (119.60±8.2 ms vs 114.0±6.4 ms). Minimum P wave duration was observed significantly (p=0.001) higher in patients without diastolic dysfunction (72.6±7.5 ms vs 62.70±7.4 ms). P wave dispersion was observed significantly (p=0.001) higher in patients with left ventricular diastolic dysfunction (56.6±6.3 ms vs 41.5±5.2 ms). When patients were grouped according to grades of diastolic dysfunction, P wave dispersion was observed sequentially increased among 3 grades of left ventricular diastolic dysfunction (55.8±5.2 ms vs 55.9±7.0 ms vs 61.4±4.7) but the differences were not statistically significant (p=0.09). Conclusion: We conclude that P wave dispersion increases in diastolic dysfunction of LV. When clinical and echocardiographic variables are taken into account, there is a weak but significant correlation between P wave dispersion and left ventricular ejection fraction.
RESUMO
Background: The association between extent and severity of coronary artery disease (CAD) and renal artery stenosis (RAS) has been well established in many studies. The aim of this study was to assess the incidence and severity of RAS in patients with CAD. Methods: Coronary angiogram (CAG) and renal angiogram was done in standard protocol. A total of 95 patients was included in the study and divided into two groups according to the presence of significant renal artery stenosis. In Group I 45 patients were having normal or insignificant renal artery stenosis. In Group II 50 patients were having significant renal artery stenosis. All data were recorded systematically in preformed data collection form. Results: In Group I, most common CAG findings were single vessel disease (SVD) (91.1%), triple vessel disease (TVD) (2.2%) and double vessel disease (DVD) (6.7%). No patients in Group I had Left Main (LM) disease. In Group II, most common CAG findings were DVD (42.0%) followed by SVD 32.0%, TVD 26.0% and LM 8.0%. There is statistically significant difference in Vessels Score, Friesinger Score and Leaman Score between the groups (p<0.05). Conclusion: The study revealed significant association between atherosclerotic renal artery stenosis (RAS) and severity of coronary artery disease (CAD). This indicates significant atherosclerotic renal artery stenosis (RAS) predict the severity of coronary artery disease.