Key result
MI scar and ischemia extent linked to LVMD, affecting ~29% of CAD patients.
Why the study?
Determinants of left ventricular mechanical dyssynchrony in patients with coronary artery disease needed to be characterized.
What are the clinical and imaging determinants of left ventricular mechanical dyssynchrony in patients with coronary artery disease?
Observational (n=326)
No
What are the clinical and imaging determinants of left ventricular mechanical dyssynchrony in patients with coronary artery disease?
Effect estimate: OR 1.056
p-value: p=0.004
In patients with CAD, left ventricular mechanical dyssynchrony is present in nearly a third and is independently predicted by myocardial infarction scar size, ischemia extent, and QRS duration.
LVMD in CAD associates with scar and ischemia extent; hypothesis-generating, should not yet change practice.
AIMS: The aim of this study was to characterize determinants of left ventricular mechanical dyssynchrony (LVMD) in patients with coronary artery disease (CAD). METHODS: Medical records and results of myocardial perfusion SPECT/CT studies were evaluated in 326 patients with previously diagnosed CAD. LVMD was assessed with the phase analysis of ECG-gated myocardial SPECT. Dyssynchrony was described with phase histogram bandwidth (PHBW), standard deviation (PHSD) or entropy (PHE) values above limit of the highest normal. RESULTS: Prevalence of LVMD was 29% in CAD patients. Size of the infarction scar and ischemia extent correlated significantly with PHBW, PHSD and PHE (P < 0.001 for all). Independent predictors of LVMD were myocardial infarction scar (P = 0.004), ischemia extent (P = 0.003), and QRS duration (P = 0.003). Previous percutaneous coronary intervention and coronary artery bypass grafting did not independently predict dyssynchrony. CONCLUSIONS: Almost one-third of CAD patients had significant LVMD. Dyssynchrony was associated with earlier myocardial infarction and presence of myocardial ischemia. Previous percutaneous coronary intervention and coronary artery bypass grafting did not independently predict dyssynchrony.
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Hämäläinen et al. (2020) conducted an observational in Coronary artery disease (n=326). Myocardial infarction scar and ischemia vs. Absence of infarction scar and ischemia was evaluated on Left ventricular mechanical dyssynchrony (LVMD) (OR 1.056, p=0.004). In patients with coronary artery disease, left ventricular mechanical dyssynchrony was present in 29% of cases and was independently predicted by myocardial infarction scar extent (OR 1.056, P=0.004) and ischemia extent.
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