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Updated: Sep 4, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

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Coronary Jeopardy Score Predicts Ischemic Etiology in Patients With Left Ventricular Systolic Dysfunction

Holly Morgan, Matthew Ryan, Natalia Briceno

  • 1Cardiology Department, Guys and St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH United Kingdom. divaka.perera@kcl.ac.uk.

The Journal of Invasive Cardiology
|July 21, 2022
PubMed

Insights

Quantifying coronary artery disease on angiography can predict if heart failure is caused by ischemia. This method offers high accuracy, potentially reducing the need for cardiac MRI in diagnosing heart failure etiology.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Cardiac magnetic resonance imaging (CMR) is the gold standard for diagnosing heart failure causes but lacks universal availability.
  • Heart failure with reduced ejection fraction (HFrEF) requires accurate etiological diagnosis for effective management.

Purpose of the Study:

  • To determine if the extent of coronary artery disease (CAD) on coronary angiography can predict an ischemic etiology in patients with new HFrEF.
  • To assess the diagnostic performance of coronary angiography in identifying ischemic heart failure.

Main Methods:

  • Retrospective analysis of 176 patients with new HFrEF who underwent both CMR and coronary angiography.
  • Quantification of coronary disease extent using the BCIS jeopardy score.
  • Comparison of angiography findings with CMR-based etiological diagnosis.

Main Results:

  • Based on CMR, 65% of patients had an ischemic etiology, while 35% had a non-ischemic cause.
  • A BCIS jeopardy score threshold of ≥6 demonstrated 76% sensitivity and 97% specificity for predicting ischemic etiology.
  • Coronary angiography findings effectively differentiated ischemic from non-ischemic causes of HFrEF.

Conclusions:

  • The extent of coronary disease visualized on coronary angiography can reliably predict or exclude an ischemic etiology in patients with HFrEF.
  • Coronary angiography serves as a valuable tool for diagnosing heart failure etiology when CMR is unavailable.

Keywords:
angiographycardiac MRcardiomyopathy

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