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Kilcullen NM, Uthamalingam S, Gurm GS, et al. The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia. Cardiol Res. 2014;4(6):178-185doi: 10.4021/cr240w.
Kilcullen, N. M., Uthamalingam, S., Gurm, G. S., Gregory, S. A., & Picard, M. H. (2013). The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia. Cardiology research, 4(6), 178-185. https://doi.org/10.4021/cr240w
Kilcullen, Niamh M, et al. "The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia." Cardiology research vol. 4,6 (2013): 178-185. doi: https://doi.org/10.4021/cr240w
Kilcullen NM, Uthamalingam S, Gurm GS, Gregory SA, Picard MH. The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia. Cardiol Res. 2013 Dec;4(6):178-185. doi: 10.4021/cr240w. Epub 2014 Jan 02. PMID: 28352442; PMCID: PMC5358306.
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Cardiol Res. 2013 Dec;4(6):178-185. doi: 10.4021/cr240w. Epub 2014 Jan 02.

The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia.

Cardiology research

Niamh M Kilcullen, Shanmugan Uthamalingam, Gagandeep S Gurm, Shawn A Gregory, Michael H Picard

Affiliations

  1. Division of Cardiology, Massachusetts General Hospital, USA.

PMID: 28352442 PMCID: PMC5358306 DOI: 10.4021/cr240w

Abstract

BACKGROUND: Our aim was to determine whether regional left ventricular (LV) function on a resting transthoracic echo (TTE) provides prognostic information in patients with varying degrees of ischemia on myocardial perfusion imaging.

METHODS: Between 2004 - 2009, we identified 503 patients (mean age 69 (SD 11); 79% male) with reversible ischemia on a myocardial SPECT scan who had a TTE within 30 days. We evaluated the rate of subsequent revascularization and death for all patients.

RESULTS: Following the SPECT scan and TTE, 246/503(49%) patients underwent revascularization, 64/503 (13%) patients died, 369 (73%) patients had a normal left ventricular ejection fraction (LVEF), 242 (48%) patients had a resting wall motion abnormality (WMA), 21/261 (8%) with no WMA died compared to 43/242 (18%) in patients with a WMA. In patients with a WMA (n = 242) there was no significant difference in mortality when comparing patients with small (< 6 segments) and large (> 6 segments) WMA (P = 0.44). In patients with moderate/severe ischemia, the presence of a resting WMA was associated with a higher mortality rate (18% v 7%; P = 0.005). In a multivariable model, LVEF (< 50%) was associated with a hazard ratio of 2.2 (P = 0.002, 95% CI 1.34 - 3.68) however, WMA and number of abnormal segments did not reach statistical significance.

CONCLUSION: A resting wall motion abnormality in patients with moderate/severe ischemia is associated with a higher mortality compared to patients with mild ischemia on myocardial perfusion imaging. Regional left ventricular dysfunction unlike LVEF was not an independent predictor of mortality.

Keywords: Ischemic heart disease; Transthoracic echocardiography; Wall motion

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