P3355Stress-induced left ventricular dyssynchrony predicts future cardiac events in patients with known or suspected coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Katoh ◽  
T Watanabe ◽  
T Arimoto ◽  
T Narumi ◽  
T Aono ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Event ◽  
Suspected Coronary Artery Disease ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Future Cardiovascular Event ◽  
Lv Dyssynchrony ◽  
Artery Disease

Abstract Background Prognostic value of stress induced left ventricular (LV) dyssynchrony has not been fully understood. The aim of this study was to evaluate the possible impact between cardiovascular events and stress induced worsening LV dyssynchrony. Methods and results One hundred and eighty consecutive subjects with known or suspected coronary artery disease (CAD) (142 men, mean age 68±12 years) underwent both gated myocardial single photon emission computed tomography (SPECT) with 99mTc-sestamibi or tetrofosmin according to a standard same day stress-rest protocol and coronary angiography or coronary computed tomography. The summed difference score (SDS) was calculated in every subjects. LV ejection fraction (EF) and phase Entropy at after stress and rest were determined by cardioREPO software. We determined %ΔEntropy = (stress Entropy - rest Entropy)/rest Entropy x100, as an indicator of stress-induced LV dyssynchrony. In the study population, the mean SDS was 2.7±3.9 and LVEF was 58±16%, stress and rest Entropy were 0.62±0.15 and 0.57±0.13, respectively. %ΔEntropy was higher in patients with CAD than in those without CAD (3.3±11.5 vs. 10.2±15.0, respectively). Moreover, there was a strict correlation between the presence of CAD and %ΔEntropy, indicator of stress induced LV dyssynchrony (non-CAD vs. CAD and/or 1 vessel disease vs. multivessel disease: 4.3±12.5 vs. 8.8±15.6 vs. 12.7±14.3, respectively. p<0.05) We examined all study subjects and they were divided into 2 groups by cut off value of the %ΔEntropy constructed with receiver operating characteristic curve (=15.4). Kaplan-Meier analysis revealed that future cardiovascular event rate was significantly higher in %ΔEntropy >15.4 group (20/57) than in %ΔEntropy <15.4 group (24/123) (Log-rank p<0.01). On the other hand, summed stress score and SDS were no significant differences between 2 groups. However, SDS was higher in patients with future cardiovascular event than in those without cardiovascular event (4.4±5.4 vs. 2.2±3.2, respectively. p=0.001). Conclusion In patients with known or suspected CAD, stress-induced worsening LV dyssynchrony may predict the presence of CAD and future cardiac events. Acknowledgement/Funding None

Abstract 15856: Left Ventricular Longitudinal Contractility Measured During Routine Cine-cardiac Magnetic Resonance Imaging is an Independent Predictor of Adverse Cardiac Events

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Vibhav Rangarajan ◽  
Satish J Chacko ◽  
Nikhil Jariwala ◽  
Simone Romano ◽  
Jaehoon Chung ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Independent Predictor ◽  
Suspected Coronary Artery Disease ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Kaplan Meier ◽  
Adverse Cardiac Events ◽  
Longitudinal Fiber ◽  
Artery Disease

Background: Left ventricular systole involves coordinated contraction of longitudinal, circumferential, and radial myocardial fibers. Longitudinal fiber dysfunction appears to be an early marker for a number of pathological states. We hypothesized that reduced mitral annular plane systolic excursion (MAPSE) measured during cine-Cardiac Magnetic Resonance (CMR) imaging reflects changes in longitudinal fiber function and may be an early marker for adverse cardiovascular outcomes. Methods: 400 consecutive patients with known or suspected coronary artery disease undergoing CMR were prospectively enrolled. Lateral MAPSE was measured in the 4-chamber cine view by two independent observers. Patients were prospectively followed for major adverse cardiac events (MACE) - death, non-fatal myocardial infarction, hospitalization for heart failure or chest pain, and late revascularization. Cox proportional hazards regression modeling was used to identify factors independently associated with MACE. Results: The mean age of the study population was 58(±15) years, with a mean ejection fraction of 59(±14%). 31% of the individuals had known coronary artery disease and 33% were diabetic. 72 MACE occurred during a median follow-up of 14.5 months. By Kaplan-Meier analysis, patients with lateral MAPSE ≤1.11cm (median) experienced significantly higher incidence of MACE than patients with a MAPSE >1.11cm (p = 0.0270) (Figure). After adjustment for established predictors (ejection fraction, age, sex, diabetes, hyperlipidemia, smoking, hypertension, late gadolinium enhancement) lateral MAPSE remained a significant independent predictor of MACE (HR=2.43 per cm decrease; p=0.037). Conclusions: Reduced longitudinal fiber function assessed with lateral MAPSE during cine-CMR is an independent predictor of MACE in patients with known or suspected coronary artery disease. Figure: Kaplan-Meier curves for MACE in patients with MAPSE above and below the median.

scholarly journals Prognostic value of normal and non-obstructive coronary artery disease based on CT angiography findings. A 12 month follow up study

2019 ◽  
Vol 11 (4) ◽  
pp. 318-321
Author(s):  
Amirreza Sajjadieh Khajouei ◽  
Atoosa Adibi ◽  
Zahra Maghsodi ◽  
Majid Nejati ◽  
Mohaddeseh Behjati
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Prognostic Value ◽  
Significant Finding ◽  
Cardiac Events ◽  
Luminal Narrowing ◽  
Artery Disease

Introduction: The advent of multi-slice computed tomography (CT) technology has provided a new promising tool for non-invasive assessment of the coronary arteries. However, as the prognostic outcome of patients with normal or non-significant finding on computed tomography coronary angiography (CTCA) is not well-known, this study was aimed to determine the prognostic value of CTCA in patients with either normal or non-significant CTCA findings.|<br /> Methods: This retrospective cohort study was performed on patients who were referred for CTCA to the hospital. 527 patients with known or suspected coronary artery disease (CAD), who had undergone CTCA within one year were enrolled. Among them, data of 465 patients who had normal (no stenosis, n=362) or non-significant CTCA findings (stenosis <50% of luminal narrowing, n=103) were analyzed and prevalence of cardiac risk factors and major adverse cardiac events (MACE) were compared between these groups. In addition, a correlation between these factors and the number of involved coronary arteries was also determined. <br /> Results: After a mean follow-up duration of 13.11±4.63 months, all cases were alive except for three patients who died by non-cardiac events. Prevalence of MACE was 0% and 3% in normal CTCA group and non-significant groups, respectively. There was no correlation found between the number of involved coronary arteries and the prevalence of MACE (P = 0.57). <br /> Conclusion: A normal CTCA could be associated with extremely low risk of MACE over the first year after the initial imaging, whereas non-significant obstruction in coronary arteries may be associated with a slightly higher risk of MACE.

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