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Inducible myocardial ischemia due to obstructive coronary artery disease is associated with subclinical LV dysfunction in patients with stable angina

Session Poster Session 3

Speaker Danilo Neglia

Event : Heart Failure 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure
  • Session type : Poster Session

Authors : C Caselli (Pisa,IT), V Lorenzoni (Pisa,IT), M Lombardi (San Donato Milanese,IT), R Sicari (Pisa,IT), AJ Scholte (Leiden,NL), J Knuuti (Turku,FI), SR Underwood (London,GB), A Clerico (Pisa,IT), M Emdin (Pisa,IT), D Neglia (Pisa,IT)

Authors:
C Caselli1 , V Lorenzoni2 , M Lombardi3 , R Sicari1 , AJ Scholte4 , J Knuuti5 , SR Underwood6 , A Clerico2 , M Emdin7 , D Neglia7 , 1Institute of Clinical Physiology of CNR - Pisa - Italy , 2Scuola Superiore Sant'Anna - Pisa - Italy , 3IRCCS, Policlinico San Donato - San Donato Milanese - Italy , 4Leiden University Medical Center - Leiden - Netherlands , 5University of Turku and Turku University Hospital - Turku - Finland , 6Imperial College London - London - United Kingdom , 7Gabriele Monasterio Foundation - Pisa - Italy ,

On behalf: EVINCI study

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 419

Background: Repetitive myocardial ischemia might impair LV function in patients with stable coronary artery macrovascular and/or microvascular disease (CAD). Purpose: To assess the relationship between inducible myocardial ischemia, presence of obstructive CAD and LV 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 echocardiography and circulating NT-proBNP measurements to assess LV function, stress imaging to detect myocardial ischemia and coronary computed tomography angiography (CCTA) to assess the presence of obstructive CAD (>50% stenosis of a major coronary vessel). Only patients with LVEF ≥50% were included in this substudy. Results: LVEF was 60 [55-66] %, median [25-75 percentiles], and NT-proBNP was 60.7 [30.7-128.0] ng/L in the whole population. Patients were subdivided in 4 groups according to the presence/absence of myocardial ischemia and obstructive CAD. LVEF and NT-proBNP values are compared among groups in Figure 1. Patients with obstructive CAD+Ischemia had significantly lower LVEF and significantly higher NT-proBNP values than the other groups. At multivariate analysis including age, sex, cardiovascular risk factors, drugs, CTA and stress imaging results, presence of obstructive CAD+Ischemia was the only coronary pattern predicting both LVEF (Coefficient: - 0.119 ± 0.03 (SE), p < 0.0001 ) and NT-proBNP (0.512 ± 0.15, p = 0.0009) values. Conclusions: In patients with stable angina, inducible myocardial ischemia caused by macrovascular obstructive CAD is associated with early impairment of LV function.

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