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[Coronary score in patients with low ejection fraction after myocardial infarct]
T Momcilov-Popin1, D Benc, D Stojsić
1Institut za kardiovaskularne bolesti, Sremska Kamenica, Medicinski fakultet, Novi Sad.
Insights
Patients with low ejection fraction after myocardial infarction show significantly higher coronary artery scores, particularly in the anterior descending artery. This indicates more severe coronary artery disease in those with reduced heart function.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Cardiac Imaging and Diagnostics
Context:
- Ischemic heart disease is the leading cause of heart failure.
- Sustained myocardial infarction can lead to reduced left ventricular ejection fraction.
- Coronary artery scoring is used to quantify atherosclerotic burden.
Purpose:
- To compare the coronary artery scores in patients with low ejection fraction versus those with preserved ejection fraction after myocardial infarction.
- To investigate differences in total and individual coronary artery scores based on ejection fraction status.
Summary:
- A study of 56 post-myocardial infarction patients revealed significantly higher total coronary artery scores in those with ejection fraction ≤35% compared to those with ejection fraction >35%.
- The anterior descending artery score was notably higher (nearly double) in the low ejection fraction group.
- No significant differences were found in the dominant coronary artery or between sexes regarding total coronary scores.
Impact:
- Findings suggest a stronger correlation between reduced ejection fraction and more extensive coronary artery disease.
- Highlights the anterior descending artery as a key predictor of disease severity in this patient cohort.
- Informs risk stratification and potential therapeutic strategies for patients with ischemic cardiomyopathy.
Introduction:
The most frequent cause of heart failure is ischemic heart disease (1). This paper was aimed at comparing the coronary score of patients with low ejection fraction whose ejection fraction was not significantly changed after sustained myocardial infarction.
Material And Methods:
The study involved patients after sustained myocardial infarction treated at the Institute of Cardiovascular Diseases in Sremska Kamenica. Total coronary score and score of each individual coronary artery were emphasized.
Results:
The investigation study comprised 56 patients aged 33-83 years of various occupations. Patients were divided into two groups: the first--A group consisted of 28 (50%) patients with ejection fraction 35% or lower; the second--B group also consisted of 28 (50%) patients with ejection fraction higher that 35%. Table 1. shows the dominant coronary artery in investigated groups of patients. Table 2. shows values of total and scores of each coronary artery. The right coronary artery was dominant in 75% of patients from the A group and in 82.1% of patients from the B group. A significantly higher individual score of coronary arteries, as well as the total score, was established in the group of patients with low ejection fraction, and especially the score of the anterior descendent artery which is almost twice higher in regard to the second group of examined patients. Table 3. describes the analyzed score in male and female patients.
Discussion:
Patients with low ejection fraction after sustained myocardial infarction have more changes of coronary arteries than patients with better ejection fraction. The total score, score of the right coronary artery (ACD), circumflex artery (RCX) and especially anterior descendent artery (LAD) are significantly higher in patients with ejection fraction lower than 35%. There are no differences in the dominant coronary artery in investigated patients. In both investigated groups women had a smaller score of ACD and RCX and a higher score of LAD, but the difference is not significant. In regard to total score there were no differences in men and women. Numerous investigations also point to the fact that patients with lower ejection fraction and ischemic heart disease have more changes on coronary artery than patients with better ejection fraction.
Conclusion:
1. Patients with low ejection fraction after sustained myocardial infarction have a higher total score and scores of ACD. LAD and RCX. 2. There are no differences in coronary score of men and women within the same investigated groups. 3. There are no differences in dominant coronary artery in investigated groups of patients.