2018, Number 3
<< Back Next >>
Gac Med Mex 2018; 154 (3)
Left ventricular ejection fraction decrease after adenosine-induced stress as a predictor of ischemia
Meléndez RG, Posada-Martínez EL, Meave-González A, Vera-Urquiza R, Betuel Ivey-Miranda J
Language: Spanish
References: 14
Page: 315-319
PDF size: 217.54 Kb.
ABSTRACT
Background: The decrease in left ventricular ejection fraction (LVEF) has been observed to be associated with three-vessel
coronary disease in nuclear medicine studies; however, the role played by LVEF decrease has not been studied with cardiovascular
magnetic resonance (CMR).
Objective: To assess the association between LVEF decrease and cardiac ischemia in
patients with CMR studies with adenosine.
Method: Cross-sectional, comparative study. Inclusion criteria were: patients assessed
with CMR with adenosine between January 2009 and June 2015. LVEF change was compared between patients
testing positive for ischemia versus those who tested negative.
Results: Fifty nine patients were included: 41 were males
(70%), mean age was 59.7 ± 10.9 years; 38% of the studies tested positive for ischemia. Delta LVEF (post-stress LVEF –
resting LVEF) was –0.16 ± 5.9 versus 5.3 ± 4.7 (p ‹ 0.001) in patients with and without ischemia, respectively.
Conclusion:
Patients who tested positive for ischemia had lower delta LVEF than those with negative studies for ischemia.
REFERENCES
Griffin BP, Kapadia SR, Rimmerman CM. The Cleveland Clinic Cardiology Board Review. USA: Lippincott Williams and Wilkins; 2013.
Instituto Nacional de Estadística, Geografía e Informática. Boletín de estadísticas vitales. México: Instituto Nacional de Estadística, Geografía e Informática; 2008.
Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949-3003.
Bestetti A, Triulzi A, Di-Leo C, Tagliabue L, Del-Sole A, Lomuscio A, et al. Myocardial scintigraphy by the gated SPECT method in coronary artery disease patients with post-ischemic stunning. G Ital Cardiol. 1999;29:143-148.
Bestetti A, Di-Leo C, Alessi A, Triulzi A, Tagliabue L, Tarolo GL. Poststress end-systolic left ventricular dilation: a marker of endocardial post-ischemic stunning. Nucl Med Commun. 2001;22:685-693.
Gómez-Martínez MV, Ortega-Manrique A, Álvarez-Hernando J, Theillac-Falcones B, De Jesús-Acosta M, Pereira-Del Moral R, et al. Disminución de la FEVI post-estrés en pacientes con cardiopatía isquémica y disfunción ventricular. Rev Esp Med Nucl Imagen Mol. 2014;33:160.
Lockie T, Ishida M, Perera D, Chiribiri A, De Silva K, Kozerke S, et al. High-resolution magnetic resonance myocardial perfusion imaging at 3.0-Tesla to detect hemodynamically significant coronary stenosis as determined by fractional flow reserve. J Am Coll Cardiol. 2011;57:70-75.
Pfeiffer MP, Biederman RW. Cardiac MRI: a general overview with emphasis on current use and indications. Med Clin North Am. 2015;99:849-861.
Selvanayagam JB, Kardos A, Francis JM, Wiesmann F, Petersen SE, Taggart DP, et al. Value of delayed-enhancement cardiovascular magnetic resonance imaging in predicting myocardial viability after surgical revascularization. Circulation. 2004;110:1535-1541.
Jahnke C, Nagel E, Gebker R, Kokocinski T, Kelle S, Manka R, et al. Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging. Circulation. 2007;115:1769-1776.
Greenwood JP, Maredia N, Younger JF, Brown J, Nixon J, Everett C, et al. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CEMARC): a prospective trial. Lancet. 2012;379:453-460.
Nandalur KR, Dwamena BA, Choudhri AF, et al. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2007;50(14):1343-1353.
Schwitter J, Wacker CM, Wilke N, Al-Saadi N, Sauer E, Huettle K, et al. MR-IMPACT II: Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary artery disease Trial: perfusion-cardiac magnetic resonance vs. single-photon emission computed tomography for the detection of coronary artery disease: a comparative multicenter, multivendor trial. Eur Heart J. 2013;34(10):775-781.
Odagiri K, Machii M, Tanaka T, Uehara A, Kurata C, Sakahara H, et al. Vasodilator stress impairs the left ventricular function obtained with gated single photon emission computed tomography in patients with known or suspected coronary artery disease. Circ J. 2010;74:2666-2673.