Key result
Increased carotid intima-media thickness predicts ~161% higher odds of CAD in severe LV dysfunction.
Why the study?
Do carotid IMT and plaque predict ischemic etiology in patients with severe left ventricular systolic dysfunction?
Observational (n=73)
No
Do carotid IMT and plaque predict ischemic etiology in patients with severe left ventricular systolic dysfunction?
Carotid IMT and bulb plaque are useful non-invasive predictors for identifying ischemic etiology in patients with severe left ventricular systolic dysfunction.
Answers are grounded in this paper and cite their sources.
Carotid IMT and bulb plaque may aid noninvasive identification of ischemic etiology in severe LV systolic dysfunction; hypothesis-generating and requires prospective validation.
BACKGROUND AND OBJECTIVES: Coronary artery disease (CAD) is a major cause of heart failure associated with left ventricular systolic dysfunction (LVSD). The prognosis of LVSD is significantly influenced by the etiology of heart failure and therefore, differentiation of significant CAD from other etiologies is important. Carotid intima-media thickness (IMT) and plaque are useful predictors for cardiovascular events, including stroke and CAD. The purpose of this study was to evaluate the predictive value of carotid IMT and plaque for the diagnosis of CAD in LVSD patients. SUBJECTS AND METHODS: Seventy-three (n= 73, 47 male, 67.6±12.4 years) patients hospitalized for heart failure with severe LVSD were retrospectively enrolled. The severity of CAD was analyzed by the Duke Jeopardy Score system, and carotid IMT and plaque were measured according to the Mannheim Carotid IMT Consensus. RESULTS: Significant CAD was found in 41 patients (56.1%, CAD group) on coronary angiography. Mean common carotid artery (CCA) IMT (0.74±0.05 mm vs. 1.04±0.04 mm, p<0.01) was significantly higher in the CAD group. Plaque in CCA (6.25% vs. 19.5%, p<0.01) and plaque in bulb (25.0% vs. 60.9%, p<0.001) were significantly higher in the CAD group. Mean CCA IMT {odds ratio (OR) 2.61, 95% confidence interval (CI) 1.134-4.469, p<0.01} and plaque in bulb (OR 4.69, 95% CI 1.702-12.965, p<0.01) were significant predictors for the diagnosis of CAD according to multivariate logistic regression analysis. CONCLUSION: In patients with severe LVSD, mean CCA IMT and bulb plaque can be useful additional predictors for the diagnosis of CAD.
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Suh et al. (2010) conducted an observational in Severe Left Ventricular Systolic Dysfunction (n=73). Carotid intima-media thickness and plaque vs. Normal IMT and absence of plaque was evaluated on Diagnosis of significant coronary artery disease (OR 2.61, 95% CI 1.134-4.469, p=<0.01). Increased mean common carotid artery intima-media thickness (OR 2.61) and the presence of carotid bulb plaque (OR 4.69) were significant independent predictors for the diagnosis of coronary artery disease in patients with severe left ventricular systolic dysfunction.
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