Iranian Heart Journal

Iranian Heart Journal

Relationship Between Left Ventricular Diastolic Dysfunction Echocardiographic Indices and SYNTAX Score in Triple-Vessel CAD: A Cross-Sectional Study

Document Type : Original Article

Authors
Niloufar Akbari Parsa
Amir Savarrakhsh
Salman Nikfarjam
Seyyed Aboozar Fakhr-Mousavi
Amir Aris
Arsalan Salari
Aseme Pourrajabi
Bahareh Gholami-Chaboki
Sorna Naseri
Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran.
Abstract
Background: Whether left ventricular diastolic dysfunction (LVDD) relates to anatomic coronary disease burden remains uncertain. We examined the association between echocardiographic diastolic indices and the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score among patients with triple-vessel coronary artery disease (CAD).
Methods: We performed an analytical cross-sectional study of 153 consecutive patients with angiographically confirmed triple-vessel disease at the Dr Heshmat Rasht Heart Training Center (Iran) from 2022 through 2023. Eligible patients had blood pressure below 140/90 mm Hg and preserved systolic function; standard exclusions applied. We recorded demographics and cardiac risk factors and measured diastolic indices (left ventricular ejection fraction, E/A, average E/e′, left atrial volume index, deceleration time, tricuspid regurgitation velocity, septal and lateral e′, and left ventricular end-diastolic volume index). Coronary complexity was graded by the SYNTAX score (≤ 22, low and > 22, high). We used χ2, t, and Mann–Whitney tests and logistic regression (adjusted for age and sex; secondarily for diabetes and hyperlipidemia).
Results: Of 153 patients, 68 (44.4%) had low SYNTAX scores and 85 (55.6%) had high SYNTAX scores. None of the diastolic echocardiographic parameters differed between SYNTAX score groups or were independently associated with high SYNTAX scores on multivariable analysis. In contrast, diabetes and hyperlipidemia were associated with high SYNTAX scores: diabetes adjusted odds ratio (aOR) 3.71 (95% CI, 1.84 to 7.50) and hyperlipidemia aOR 2.83 (95% CI, 1.31 to 6.10).
Conclusions: In patients with triple-vessel CAD, echocardiographic indices of LV diastolic function were not associated with anatomic disease complexity, whereas diabetes and hyperlipidemia were. Larger studies across a broader spectrum of LVDD severity are warranted. (Iranian Heart Journal 2026; 27(4): 6-15)
Keywords
diastolic dysfunction
left ventricle
coronary artery disease
severity of coronary artery involvement
SYNTAX Score
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Iranian Heart Journal
Volume 27, Issue 4
Autumn 2026
Pages 6-15