Presystolic wave is associated with carotid intima media thickness

Abstract

Introduction Carotid intima media thickness (CIMT), a direct marker of atherosclerosis, has emerged as a promising means for cardiovascular risk evaluation. Presystolic wave (PSW) is commonly detected by the Doppler interrogation of the left ventricular outflow tract (LVOT). It is thought to be a result of a stiff left ventricle and impaired LV compliance. Herein, we aimed to investigate a possible association between carotid intima media thickness, an atherosclerotic marker, and PSW. Method We prospectively enrolled 282 patients divided into two groups based on the presence of PSW: 221 (89F; mean age: 49.3 ± 11.5 years) had PSW on Doppler examination while 61 patients (32F; mean age: 46.4 ± 10.3 years) did not. Both groups were compared with respect to demographic, clinical properties, and CIMT. Results Both groups had comparable age, body mass index, and diabetes mellitus, hypertension, dyslipidemia, smoking, and family history for coronary heart disease. PSW‐positive group had significantly higher CIMT (PSW‐positive: 0.59 ± 0.22 mm vs PSW‐negative: 0.42 ± 0.11 mm; P < 0.001) than PSW‐negative group. Multivariate analysis showed that the independent predictors of increased CIMT were age (95% CI; 1.044–1.101, P < 0.001), dyslipidemia (95% CI; 0.147–0.664, P = 0.002), and the presence of PSW (95% CI; 2.168–7.836, P < 0.001).Correlation analysis showed that PSW velocity is correlated with increased CIMT in PSW‐positive group (r: 0.418, P < 0.001). Conclusion Assessment of PSW on TTE is easy and feasible method. Presence of PSW and increased PSW velocity on TTE might provide information that we should be careful in terms of subclinical atherosclerosis.

Prevalence of the presystolic wave in echocardiography and its association with the extent of coronary artery disease in patients with chronic stable angina

“…The main drawbacks of echocardiography in IHD patients include being operator dependent and the variability in cardiac echogenicity 10 . One of the indices in the Doppler assessment of the left ventricular outflow tract is the presystolic wave (PSW) 11 . The exact mechanism of the PSW is not yet known, but it is hypothesized that the PSW is mainly due to the left ventricular stiffness and also, is a marker of impaired LV compliance 11 .…”

“…The exact mechanism of the PSW is not yet known, but it is hypothesized that the PSW is mainly due to the left ventricular stiffness and also, is a marker of impaired LV compliance 11 . Presence and velocity of the PSW are related to the carotid‐ intima media thickness that is a useful factor for assessment of subclinical atherosclerosis 11 . It was also shown, the absence of PSW in asymptomatic patients was related to the increased risk for cardiovascular disease 12 .…”

“…10 One of the indices in the Doppler assessment of the left ventricular outflow tract is the presystolic wave (PSW). 11 The exact mechanism of the PSW is not yet known, but it is hypothesized that the PSW is mainly due to the left ventricular stiffness and also, is a marker of impaired LV compliance. 11 Presence and velocity of the PSW are related to the carotid-intima media thickness that is a useful factor for assessment of subclinical atherosclerosis.…”

“…11 Presence and velocity of the PSW are related to the carotid-intima media thickness that is a useful factor for assessment of subclinical atherosclerosis. 11 It was also shown, the absence of PSW in asymptomatic patients was related to the increased risk for cardiovascular disease. 12 The PSW velocity was significantly lower in patients with abnormal systolic function.…”

Yeni̇ Tani Esansi̇yel Hi̇pertansi̇yon Hastalarinda Presi̇stoli̇k Dalga Aorti̇k Sertli̇k Derecesi̇ni̇ Öngördürebi̇lmekte, Fakat Si̇rkadi̇yen Kan Basinci Paterni̇ni̇ Öngörememektedi̇r

“…Presystolic wave (PSW) is an image which is frequently, albeit not necessarily, observed on the outflow tract of the left ventricle (LVOT) later in the diastolic period upon Doppler echocardiographic imaging (13,14). Although PSW's exact prevalence and clinical importance in diverse medical conditions are not well recognized, preliminary evidence suggested that its absence could indicate adverse CV events in patients with overt left ventricular (LV) failure (14,15), subclinical LV dysfunction in asymptomatic HT patients (16), higher Syntax score in patients with acute myocardial infarction (15), worsening arterial elasticity in asymptomatic subjects (13), and increased carotid plaque burden in patients with multiple CV comorbidities (17). Not only its absence, but its velocity was also proposed to have clinical implications (13,14,16,17).…”