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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

4.3K

Prognostic implications of left ventricular mass-geometry in patients with no or nonobstructive coronary artery

You-Jung Choi1, Jun-Bean Park2,3, Chan Soon Park1,4

  • 1Division of Cardiology, Department of Internal Medicine/Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

BMC Cardiovascular Disorders
|April 16, 2021
PubMed

Insights

Abnormal left ventricular (LV) geometry worsens prognosis in patients with no or nonobstructive coronary artery disease (CAD). LV geometry assessment aids in risk stratification for these individuals.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Coronary computed tomography angiography (CCTA) is a primary noninvasive tool for diagnosing coronary artery disease (CAD).
  • Many patients exhibit no or nonobstructive CAD on CCTA but have abnormal left ventricular (LV) geometry on echocardiography.
  • The prognostic significance of combined CCTA and echocardiographic findings is not fully understood.

Purpose of the Study:

  • To investigate the prognostic implications of abnormal LV geometry in individuals with no or nonobstructive CAD.
  • To determine if LV geometry assessment improves risk stratification in this patient group.

Main Methods:

  • 5806 subjects with no or nonobstructive CAD (<50% luminal narrowing) on CCTA were analyzed.
  • Abnormal LV geometry was defined by LV mass index and/or relative wall thickness.
  • All-cause mortality was the primary outcome, assessed over a mean follow-up of 6.2 years.

Main Results:

  • Abnormal LV geometry was present in 30.3% of subjects.
  • Subjects with abnormal LV geometry had significantly higher all-cause mortality rates (2.32% vs 1.24%).
  • Abnormal LV geometry independently predicted mortality (aHR 1.64, P=0.034) and worsened survival in both no CAD and nonobstructive CAD groups.

Conclusions:

  • Abnormal LV geometry is associated with a worse prognosis in patients with no or nonobstructive CAD.
  • Assessing LV geometry can enhance risk stratification for individuals identified by CCTA.
  • These findings highlight the importance of evaluating LV structure alongside coronary imaging.
Abstract

Keywords:
Coronary artery diseaseCoronary computed tomography angiographyLeft ventricular remodelingMortality

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