The prognostic value of diastolic and systolic mechanical left ventricular dyssynchrony among patients with coronary artery disease and heart failure.

Journal Article (Journal Article)

BACKGROUND: Prevalence and prognostic value of diastolic and systolic dyssynchrony in patients with coronary artery disease (CAD) + heart failure (HF) or CAD alone are not well understood. METHODS: We included patients with gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) between 2003 and 2009. Patients had at least one major epicardial obstruction ≥ 50%. We assessed the association between dyssynchrony and outcomes, including all-cause and cardiovascular death. RESULTS: Of the 1294 patients, HF was present in 25%. Median follow-up was 6.7 years (IQR 4.9-9.3) years with 537 recorded deaths. Patients with CAD + HF had a higher incidence of dyssynchrony than patients with CAD alone (diastolic BW 28.8% for the HF + CAD vs 14.7% for the CAD alone). Patients with CAD + HF had a lower survival than CAD alone at 10 years (33%; 95% CI 27-40 vs 59; 95% CI 55-62, P < 0.0001). With one exception, HF was found to have no statistically significant interaction with dyssynchrony measures in unadjusted and adjusted survival models. CONCLUSIONS: Patients with CAD + HF have a high prevalence of mechanical dyssynchrony as measured by GSPECT MPI, and a higher mortality than CAD alone. However, clinical outcomes associated with mechanical dyssynchrony did not differ in patients with and without HF.

Full Text

Duke Authors

Cited Authors

  • Fudim, M; Fathallah, M; Shaw, LK; James, O; Samad, Z; Piccini, JP; Hess, PL; Borges-Neto, S

Published Date

  • October 2020

Published In

Volume / Issue

  • 27 / 5

Start / End Page

  • 1622 - 1632

PubMed ID

  • 31392509

Pubmed Central ID

  • 31392509

Electronic International Standard Serial Number (EISSN)

  • 1532-6551

Digital Object Identifier (DOI)

  • 10.1007/s12350-019-01843-4

Language

  • eng

Conference Location

  • United States