Petre-Adrian Barzache

Background and Objectives: Coronary artery disease may be difficult to detect by resting echocardiography when left ventricular ejection fraction is preserved and regional wall motion abnormalities are absent. This study aimed to assess whether resting Tissue Doppler Imaging-derived mitral annular velocities can help identify CAD in patients with suspected angina pectoris. Materials and Methods: We conducted a cross-sectional observational study of 92 patients hospitalized with suspected angina pectoris who underwent elective coronary angiography at the Institute of Cardiovascular Diseases in Timișoara (January 2025–February 2026). Patients with conditions known to affect TDI-derived parameters were excluded, including previous acute coronary syndrome or myocardial revascularization, significant valvular disease, cardiomyopathies, relevant arrhythmias or conduction abnormalities, permanent pacing, reduced ejection fraction, and pericardial disease. Laboratory and echocardiographic data were collected. ROC curve analysis, univariable logistic regression and multivariable logistic regression were performed to evaluate the diagnostic performance of TDI-derived parameters and their independent association with coronary artery disease. Results: Patients with CAD had significantly lower average E′ values (7.4 ± 1.9 vs. 8.9 ± 1.8 cm/s, p < 0.001) and average S′ values [7.0 (IQR 6.0–7.5) vs. 9.0 (IQR 8.1–10.0) cm/s, p < 0.001], together with higher E/E′ ratios [9.33 (IQR 8.23–11.15) vs. 7.87 (IQR 5.93–9.51), p = 0.002]. Average S′ showed the highest discriminative ability for coronary artery disease, with an AUC of 0.899 (95% CI: 0.819–0.952, p < 0.0001). The optimal Youden-derived cut-off was ≤7.5 cm/s, yielding 77.42% sensitivity and 93.33% specificity. After adjustment for age, male sex, body mass index, diabetes, smoking status, hypertension and LVEF, dichotomized S′ remained an independent predictor of coronary artery disease (OR = 45.49, 95% CI: 8.03–257.68, p < 0.0001), with an adjusted model AUC of 0.92 and 88.04% correct classification. Conclusions: TDI, particularly S′ velocity, may be a useful resting echocardiographic parameter for identifying CAD in selected patients with preserved LVEF and no resting regional wall motion abnormalities. Rather than serving as a universal diagnostic marker, S′ should be considered a complementary, easily obtainable parameter that may improve non-invasive assessment in this specific clinical setting.

Background/Objectives: Red cell distribution width, platelet distribution width, and mean platelet volume are hematological indices derived from complete blood counts that have been increasingly investigated as potential cardiovascular biomarkers. This study aimed to assess the association between these indices and the extent of coronary artery disease, quantified by the Gensini score. Methods: We conducted a retrospective observational study of 240 patients hospitalized with typical angina who underwent elective coronary angiography at the Institute of Cardiovascular Diseases in Timișoara (January 2023–April 2024). Patients with hematological disorders, prior revascularization, or severe comorbidities were excluded. CAD severity was assessed by the Gensini score, with patients stratified into a low-score group (Results: Among 240 patients (81% male), 161 (67%) were in the high-score group. Compared with the low-score group, these patients had higher RDW (12.43 ± 0.68 vs. 12.70 ± 1.01, 95%CI: −0.52 to −0.02, p = 0.03), MPV (9.20 ± 0.88 vs. 9.45 ± 0.84, 95%CI: −0.48 to −0.02, p = 0.03), serum creatinine (p = 0.01), and potassium (p = 0.02), and lower ejection fraction (p < 0.001). RDW correlated positively with the Gensini score (rho = 0.28, 95%CI: 0.16–0.39, p = 0.001). Multivariate analysis identified RDW, MPV, and diastolic dysfunction as independent predictors. RDW showed weak discrimination for high Gensini burden (AUC = 0.57, 95% CI: 0.49–0.65, p > 0.05), consistent with a borderline, non-significant result. Conclusions: Elevated RDW and MPV are independently associated with greater coronary lesion burden. These routinely available indices may serve as novel, cost-effective markers for CAD risk stratification, warranting validation in prospective studies.