Authors: Christopher Uebleis Stefan Hellweger Rüdiger Paul Laubender Alexander Becker HaeYoung Sohn Sebastian Lehner Alexander Haug Peter Bartenstein Paul Cumming Serge D Van Kriekinge Piotr J Slomka Marcus Hacker
Publish Date: 2012/07/03
Volume: 39, Issue: 10, Pages: 1561-1569
Abstract
Left ventricular LV mechanical dyssynchrony LVMD was assessed by gated singlephoton emission CT myocardial perfusion imaging MPI as an independent predictor of death from any cause in patients with known coronary artery disease CAD and reduced LV functionBetween 2001 and 2010 135 patients 64 ± 11 years of age 84 men with known CAD reduced LV ejection fraction LVEF 38 ± 15 and without an implanted cardiac resynchronization therapy device underwent gated MPI at rest LV functional evaluation which included phase analysis was conducted to identify patients with LVMD KaplanMeier survival curves were calculated for death of any cause during a mean followup of 20 ± 17 years Uni and multivariate Cox proportional hazards regression models were calculated to identify independent predictors of death from any causeOf the 135 patients 30 22 died during followup 18 cardiac deaths and 12 deaths from other causes KaplanMeier curves showed a significantly shorter survival time in the patients with severely reduced LVEF 30 n = 45 or with LVMD n = 81 logrank test P 0005 Cox models identified LVMD LVEF 30 and a total perfusion deficit at rest of ≥20 as independent predictors of death from any cause While patients with LVEF 30 in conjunction with LVMD had similar survival times irrespective of whether they had early revascularization or medical therapy those patients with LVEF ≥30 and LVMD who underwent revascularization had significantly longer survival
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