The association between tissue doppler-derived E/(e′s′) ratio and coronary atherosclerosis severity measured by the SYNTAX score in patients with non-ST elevation-acute coronary syndrome

Abstract

Background: The prognosis of patients hospitalized with non-ST elevation-acute coronary syndrome (NSTE-ACS) is typically determined by the existence and severity of myocardial necrosis and left ventricular (LV) remodeling. Aim: The present study was to assess the association between the E/(e′s′) ratio and the coronary atherosclerosis severity, measured by the SYNTAX score, in patients with NSTE-ACS. Methods: Utilizing a descriptive correlational research design, this study was prospectively conducted on 252 patients with NSTE-ACS, undergoing an echocardiography to determine the left ventricular ejection fraction (LVEF), the left atrial (LA) volume, the pulsed-wave (PW) Doppler-derived transmitral early (E) and late (A) diastolic velocities, and the tissue Doppler (TD)-derived mitral annular early diastolic (e′) and peak systolic (s′) velocities. After that, a coronary angiography (CAG) was performed, and the SYNTAX score was calculated. Results: The patients were divided into two groups, viz., those with the E/(e′s′) ratio < 1.63 and the cases with the ratio ≥ 1.63. The results revealed that the patients with a high ratio were older, had a higher prevalence of females, a SYNTAX score ≥ 22, and a lower glomerular filtration rate than those with a low ratio (p-value < 0.001). Besides, these patients had larger indexed LA volume and lower LVEF than others (p-value: 0.028 and 0.023, respectively). Furthermore, the multiple linear regression outcomes established a positive independent association between the E/(e′s′) ratio ≥ 1.63 (B = 5.609, 95% CI 2.324–8.894, p-value = 0.001) and the SYNTAX score. Conclusion: The study results demonstrated that the patients hospitalized with NSTE-ACS and the E/(e′s′) ratio ≥ 1.63 had worse demographic, echocardiographic, and laboratory profiles and a higher prevalence of a SYNTAX score ≥ 22 than those with a lower ratio.