FREQUENCY OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON ECHOCARDIOGRAPHY IN PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME AT TERTIARY CARE HOSPITAL, KARACHI

Abstract

Objective:
To determine the frequency and grades of left ventricular diastolic dysfunction (LVDD) on echocardiography in patients presenting with acute coronary syndrome (ACS) at a tertiary care hospital in Karachi.

Methodology:
This cross-sectional study was conducted at Tabba Heart Institute, Karachi, over six months following approval from the College of Physicians and Surgeons Pakistan. A total of 179 patients aged 30–80 years, presenting with ACS for the first time, were enrolled using non-probability consecutive sampling. Patients with prior ischemic heart disease, thromboembolic disorders, pulmonary hypertension, myocardial/pericardial disease, or arrhythmias were excluded. Demographic and clinical data were recorded. Echocardiography was performed by an experienced cardiologist, and LVDD was classified according to ASE/EACVI criteria. Data were analyzed using SPSS v22. Continuous variables were presented as mean ± SD and categorical variables as frequencies and percentages. Post-stratification chi-square test was applied, with p ≤ 0.05 considered significant.

Results:
Of the 179 patients, 133 (74.2%) were male and 46 (25.8%) female. NSTEMI was the most frequent ACS subtype (36.8%), followed by AWMI (31.8%) and IWMI (27.5%). Comorbidities included diabetes mellitus in 90 (50.3%) and hypertension in 89 (49.7%) patients. Echocardiography revealed LVEF <35% in 18.5%, 35–45% in 36.8%, and 45–55% in 44.7% of patients. Overall, LVDD was observed in all patients: Grade I in 115 (64.0%), Grade II in 60 (33.7%), and Grade III in 4 (2.2%).

Conclusion:
LVDD is highly prevalent in ACS patients, even among those with preserved systolic function. Routine assessment of diastolic parameters by echocardiography is recommended for accurate risk stratification and improved management strategies.