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Changes in left ventricular function after spontaneous coronary artery dissection.

Christopher Franco1, Andrew Starovoytov1, Milad Heydari1

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|February 21, 2017
PubMed
Summary
This summary is machine-generated.

Spontaneous coronary artery dissection (SCAD) often presents with impaired left ventricular function, but most patients show significant recovery of ejection fraction and wall motion over time. This study highlights the potential for spontaneous healing in SCAD patients.

Keywords:
left ventricular functionspontaneous coronary artery dissectionwall motion abnormality

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Spontaneous Coronary Artery Dissection (SCAD) is a non-atherosclerotic condition leading to myocardial infarction.
  • While spontaneous healing of SCAD and recovery of Left Ventricular Ejection Fraction (LVEF) are clinically observed, detailed descriptions of LVEF changes are limited.

Purpose of the Study:

  • To investigate the changes in LVEF and Wall Motion Abnormality (WMA) from initial presentation to follow-up in patients with SCAD.
  • To identify predictors of impaired baseline LVEF in SCAD patients.

Main Methods:

  • Prospective cohort study of nonatherosclerotic SCAD patients at Vancouver General Hospital.
  • Baseline and follow-up assessments of LVEF and WMA were performed.
  • Comparison of baseline and follow-up ventricular function, correlated with long-term cardiovascular outcomes.

Main Results:

  • 277 SCAD patients were included; 90.3% were female, average age 52.4 years.
  • At baseline, mean LVEF was 55.6%, with 26.0% having LVEF <50%. WMA was present in 85.6%.
  • In 164 patients with follow-up, LVEF improved to 60.7% (P < 0.001) and WMA decreased to 44.5% (P < 0.001). STEMI presentation, high troponin I, and LAD involvement predicted lower baseline LVEF.

Conclusions:

  • The majority of SCAD patients present with WMA and relatively normal LVEF.
  • Over half of SCAD patients experience normalization of WMA and LVEF on follow-up.
  • These findings underscore the significant potential for cardiac recovery after SCAD.