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.

Maternal and neonatal outcomes in women with history of coronary artery disease

Heart ◽  
2019 ◽  
Vol 106 (5) ◽  
pp. 380-386 ◽  
Author(s):  
Matthew Cauldwell ◽  
Philip J Steer ◽  
Katherine von Klemperer ◽  
Mandeep Kaler ◽  
Sarah Grixti ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Left Ventricular ◽  
Neonatal Outcomes ◽  
Artery Dissection ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Maternal And Neonatal Outcomes ◽  
Artery Disease

BackgroundPregnancy outcomes in women with pre-existing coronary artery disease (CAD) are poorly described. There is a paucity of data therefore on which to base clinical management to counsel women, with regard to both maternal and neonatal outcomes.MethodWe conducted a retrospective multicentre study of women with established CAD delivering at 16 UK specialised cardiac obstetric clinics. We included pregnancies of 24 weeks’ gestation or more, delivered between January 1998 and October 2018. Data were collected on maternal cardiovascular, obstetric and neonatal events.Results79 women who had 92 pregnancies (94 babies including two sets of twins) were identified. 35.9% had body mass index >30% and 24.3% were current smokers. 18/79 (22.8%) had prior diabetes, 27/79 (34.2%) had dyslipidaemia and 21/79 (26.2%) had hypertension. The underlying CAD was due to atherosclerosis in 52/79 (65.8%), spontaneous coronary artery dissection (SCAD) in 11/79 (13.9%), coronary artery spasm in 7/79 (8.9%) and thrombus in 9/79 (11.4%).There were six adverse cardiac events (6.6% event rate), one non-ST elevation myocardial infarction at 23 weeks’ gestation, two SCAD recurrences (one at 26 weeks’ gestation and one at 9 weeks’ postpartum), one symptomatic deterioration in left ventricular function and two women with worsening angina. 14% of women developed pre-eclampsia, 25% delivered preterm and 25% of infants were born small for gestational age.ConclusionWomen with established CAD have relatively low rates of adverse cardiac events in pregnancy. Rates of adverse obstetric and neonatal events are greater, highlighting the importance of multidisciplinary care.

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

scholarly journals Epidemiology and prognostic implications of panic disorder and generalized anxiety disorder in patients with coronary artery disease: rationale and design for a longitudinal cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guillaume Foldes-Busque ◽  
Clermont E. Dionne ◽  
Stéphane Turcotte ◽  
Phillip J. Tully ◽  
Marie-Andrée Tremblay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Cohort Study ◽  
Coronary Artery ◽  
Anxiety Disorder ◽  
Generalized Anxiety ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background Anxiety is associated with poorer prognosis in patients with coronary artery disease (CAD). Due to their severity and chronic course, anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder (PD), are of considerable interest and clinical importance in this population. This study has two main objectives: (1) to estimate the prevalence and incidence of GAD and PD in patients with CAD over a 2-year period and (2) to prospectively assess the association between PD or GAD and adverse cardiac events, treatment adherence, CAD-related health behaviors, quality of life and psychological distress. Design/Method This is a longitudinal cohort study in which 3610 participants will be recruited following a CAD-related revascularization procedure. They will complete an interview and questionnaires at 5 time points over a 2-year period (baseline and follow-ups after 3, 6, 12 and 24 months). The presence of PD or GAD, adherence to recommended treatments, health behaviors, quality of life and psychological distress will be assessed at each time point. Data regarding mortality and adverse cardiac events will be collected with a combination of interviews and review of medical files. Discussion This study will provide essential information on the prevalence and incidence of anxiety disorders in patients with CAD and on the consequences of these comorbidities. Such data is necessary in order to develop clear clinical recommendations for the management of PD and GAD in patients with CAD. This will help improve the prognosis of patients suffering from both conditions.

Leukocyte telomere length: a potential biomarker for the prognosis of coronary artery disease

2020 ◽  
Vol 14 (11) ◽  
pp. 933-941
Author(s):  
Ying Sun ◽  
Wei Wang ◽  
Yue-Ru Jiao ◽  
Jian Ren ◽  
Lei Gao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Telomere Length ◽  
Healthy Subjects ◽  
Independent Predictor ◽  
Cox Proportional Hazards ◽  
Leukocyte Telomere Length ◽  
Cardiac Events ◽  
Potential Biomarker ◽  
Artery Disease

Aim: This study aimed to explore the prognostic value of leukocyte telomere length (LTL) in patients with coronary artery disease (CAD). Materials & methods: We enrolled 366 CAD patients and 76 healthy subjects in this study. LTL was measured. All subjects were followed up for 6 months for further analysis regarding major adverse cardiac events (MACEs). Results: CAD patients had a significantly shortened LTL compared with healthy subjects (p < 0.05). The area under the curve for LTL prediction of MACEs was 0.769 (p < 0.001), with a shorter LTL being an independent predictor of MACEs (Cox proportional hazards regression, hazard ratio: 2.866; p < 0.001). Conclusion: LTL could be considered as an independent predictor of short-term MACEs in CAD.

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