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Bio-humoral determinants of early LV dysfunction in patients with stable angina.

Session Poster Session 2

Speaker Danilo Neglia

Event : Heart Failure 2016

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Biomarkers
  • Session type : Poster Session

Authors : C Caselli (Pisa,IT), C Prontera (Pisa,IT), V Lorenzoni (Pisa,IT), R Ragusa (Pisa,IT), S Del Ry (Pisa,IT), A Clerico (Pisa,IT), M Emdin (Pisa,IT), J Knuuti (Turku,FI), SR Underwood (London,GB), D Neglia (Pisa,IT)

Authors:
C Caselli1 , C Prontera2 , V Lorenzoni3 , R Ragusa3 , S Del Ry1 , A Clerico3 , M Emdin2 , J Knuuti4 , SR Underwood5 , D Neglia2 , 1Institute of Clinical Physiology of CNR - Pisa - Italy , 2Fondazione Toscana Gabriele Monasterio - Pisa - Italy , 3Scuola Superiore Sant'Anna - Pisa - Italy , 4Turku University Hospital - Turku - Finland , 5Imperial College London - London - United Kingdom ,

On behalf: EVINCI study

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 243

Background: In patients with stable coronary artery disease (CAD) LV function can be impaired as a result of repetitive myocardial ischemia. It is not known whether circulating biomarkers of atherosclerosis/ischemia are associated with early LV functional impairment in these patients. Purpose: To evaluate whether particular biohumoral profiles are related with LV systolic function in patients with stable angina. Methods. Clinical, functional and imaging data were collected in 362 patients (212 males, 150 females, mean age 60 ± 9 years) with stable angina and suspected CAD enrolled in the Evaluation of INtegrated Cardiac Imaging (EVINCI) study. All patients underwent baseline echocardiography measurements to assess LV function, stress imaging to detect myocardial ischemia (SDS>2) and coronary computed tomography angiography (CTA) to assess the presence of obstructive CAD (>50% stenosis of a major coronary vessel). Only patients with LVEF ≥50% were included in this substudy. Biohumoral profile involved 39 markers associated with atherosclerosis/ischemia including lipid/glucose, inflammatory and cardiac specific markers. Results: LVEF was 60 [55-66] %, median [25-75 percentiles]. Myocardial ischemia was present in 90 patients (25%), obstructive CAD in 112 (31%), and myocardial ischemia + obstructive CAD in 46 (13%). At multivariate analysis including age, sex, cardiovascular risk factors, medical treatment, CTA and stress imaging results, high levels of adiponectin (Coefficient: -0.044 ± 0.01 (SE), p < 0.0001 ) and low levels of HDL cholesterol (0.055 ± 0.02, p = 0.0167) were predictors of lower LVEF independently of the presence of myocardial ischemia and/or obstructive CAD. Conclusions: Adiponectin and HDL cholesterol are associated with low-normal systolic LV function in patients with stable angina independently of the presence of myocardial ischemia and obstructive CAD.

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