Abstract 12260: Comprehensive Computed Tomography Evaluation is Useful for Detection of Cardiac or Lung Abnormalities in Subjects With Second or Third Degree Atrio-Ventricular Block
Purpose: To evaluate usefulness of computed tomography (CT) for detection of cardiac or lung abnormalities in diagnosis and appropriate treatment of subjects with second or third degree atrio-ventricular block (AVB).
Materials and Methods: 50 consecutive subjects with suspected coronary artery disease (26 male; 64 ± 16 years; hypertension, 54%; diabetes mellitus, 16%; dyslipidemia, 42%; smokers, 30%) and second or third degree AVB on ECG who underwent cardiac 320 slice CT from 2008 to 2013, were included. If there were significant-sized lymph nodes and/or lung nodules typical of sarcoidosis on cardiac CT, CT acquisition of upper part of lung was added. All subjects were followed for a median of 24 months after CT.
Results: 33 subjects (66%) had third degree AVB and 17 (34%) had second degree AVB (including Wenckebach type, Morbitz type 2, 2:1 and advanced type). 7 had significant stenosis in coronary arteries and 5 had delayed enhancement on left ventricular myocardium (LVM). 9 subjects had thinned and 6 had thickened LVM. 3 subjects had swelling of mediastinum or hilar lymph nodes and 4 had lung nodules typical of sarcoidosis. Serum angiotensin-converting enzyme levels were significantly higher in 6 subjects with swelling of mediastinum or hilar lymph nodes and/or lung nodules typical of sarcoidosis (22.0 ± 5.8 IU/L) than in others (14.3 ± 4.9 IU/L) (P=0.01). Finally 7 subjects were diagnosed as coronary artery disease, 6 as cardiac sarcoidosis, 2 as hypertrophic cardiomyopathy and 3 as myocarditis. 45 subjects were implanted with a permanent pacemaker, only 2 of whom (4%) had MACE (both cardiac failure). No subject was newly diagnosed as cardiomyopathy including cardiac sarcoidosis, nor coronary artery disease during follow-up periods.
Conclusions: 18 (36%) of 50 subjects with second or third degree AVB, were diagnosed as organic cardiovascular disease. CT was useful for detection of latent cardiac abnormalities and for decision of appropriate treatments in such subjects.
- © 2013 by American Heart Association, Inc.