Subclinical Ischemic Change Of Myocardium: Left Ventricular Geometry In Patients With First Unstable Angina Pectoris

Aim of the present study was to assess the grade of left ventricular (LV) geometry changes in pts with the first unstable angina pectoris (UAP) without prior clinically manifested IHD and to determine the informative variables predicting the changed LV geometry in the subclinical period of IHD. Demographic, clinical, echocardiographic, angiographic and biochemical data was analyzed in 143 patients (mean age 58.7 +/- 9.2 years) with first UAP without prior symptoms of IHD.Changed geometry was defined in 77.6 percent. Concentric remodeling was the most frequent (59.7 percent) pattern of the changed LV geometry while concentric hypertrophy and eccentric hypertrophy were rarer (32.5 percent and 7.8 percent, respectively). In univariate analysis, severe proximal stenosis of the left coronary artery (OR 6.0-5.9), age (OR 4.9), overweight (OR 2.7), increased plasma concentration of angiotensinconverting enzyme (ACE) (OR 2.4) and malondialdehyde (MDA) (OR 2. 1), arterial hypertension (OR 2.0), disturbed LV diastolic function (OR 3.0), index of LV wall motion > 1.3 (OR 2.6) were the predictors of the changed LV geometry.Significant LV geometry changes evaluated in pts with the first UAP are evident features of subclinical chronic ischernic changes in the myocardium.