Abstract 12176: Higher CHADS2 Score is Associated With Impairment of Coronary Flow Reserve Evaluated by Phase-Contrast Cine Cardiovascular Magnetic Resonance Imaging
Background: The CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes, prior stroke) score is used to evaluate the risk of ischemic stroke in patients with atrial fibrillation (AF). Recent study showed that the CHADS2 score was associated with higher rate of mortality and stroke in patients with acute coronary syndrome (ACS), irrespective of the presence or absence of AF. Phase contrast (PC) cine magnetic resonance imaging (MRI) allows for non-invasive and accurate assessment of coronary flow reserve (CFR). The hypothesis of this study is that CHADS2 score can predict impairment of CFR in patients with known or suspected coronary artery disease (CAD).
Materials and Methods: One hundred forty three patients with known or suspected CAD (mean age 70.3 ± 9.5 years) without significant coronary arterial stenosis on X-ray coronary angiography (CAG) were studied. By using 1.5T MR scanner, breath-hold PC cine MR images of coronary sinus (CS) were obtained to assess the blood flow of CS both at rest and during ATP infusion. CFR was calculated as CS blood flow during ATP infusion divided by CS blood flow at rest. Patients were allocated to four groups based on the CHADS2 score (group1: CHADS2 score=0, group2: CHADS2 score=1; group3: CHADS2 score=2, and Group4: CHADS2 score≥3, respectively).
Results: In entire patient population (n=143), Mean LVEF was 61.3 ± 11.0%, MI was found in 63 (44%) patients on LGE MRI, mean CFR was 2.81 ± 0.95 (77.6 ± 32.7 ml/min at rest, 208.2 ± 86.5 ml/min during ATP infusion, p<0.001). Significant difference in CFR was found between 4 groups [3.37 ± 1.13 in group1 (n=15), 2.98 ± 1.09 in group2 (n=45), 2.84 ± 0.73 in group3 (n=44), 2.39 ± 0.75 in group4 (n=39), p=0.002 by one-way ANOVA]. In the multiple logistic regression analysis, CHADS2 score was an independent and significant predictor for impaired CFR (impaired CFR was defined as CFR <2.5; odds ratio=0.61, 95% confidence interval (CI): 0.37-1.00).
Conclusions: Higher CHADS2 score was associated with impaired CFR in CAD patients without significant coronary arterial stenosis on X-ray CAG. The results in the current study indicate that CHADS2 score might be of great value for evaluating coronary microcirculation.
Author Disclosures: H. Kirigaya: None. S. Kato: None. D. Gyoutoku: None. N. Yamada: None. N. Iinuma: None. Y. Kusakawa: None. K. Iguchi: None. Y. Miki: None. T. Nakachi: None. K. Fukui: None. K. Kimura: None. S. Umemura: None.
- © 2014 by American Heart Association, Inc.