Abstract 15336: Aneurysm-like Remodeling at Left Ventricular Posterobasal Wall Can Predict Cardiac Events in Advanced Heart Failure Patients with Non-ischemic Dilated Cardiomyopathy
Introduction: Aneurysm-like change at LV posterobasal wall (LVPW) is often observed in patients with non-ischemic dilated cardiomyopathy (NIDCM, Figure A).
Hypothesis: LVPW may be vulnerable to progressed myocardial damage as compared to other LV segments and this ventricular change may infer an end-staged LV remodeling. Thus we examined whether the severity of this aneurysm-like change (SIA, Figure B) can predict cardiac events in advanced HF patients.
Methods: Consecutive 42 hospitalized NIDCM patients with less than 30% of LVEF (mean 20±6%) and NYHA class 3 or 4 were studied. Myocardial viability was evaluated using rest myocardial perfusion imaging by visual 5 rankings based on a 17-segment model in 18 out of the study patients.
Results: A summed defect score of perfusion imaging in the inferobasal segments (LVPW in echocardiography) was significantly higher than those in the other segments (p=0.02 for anterobasal, p=0.03 for septal-basal). During the 1-year follow-up period, 22 cardiac events (2 cardiac deaths and 20 LVAD implantations) were observed. Patients with SIA>8.4 (median) had higher prevalence of cardiac events (Figure C). Systolic blood pressure, serum hemoglobin level and right ventricular end-diastolic diameter were also associated with cardiac events. Even after adjusting with these parameters, SIA was still predictor of cardiac events (HR: 1.28, 95%C.I.: 1.04-1.60, p=0.02).
Conclusions: Higher SIA is likely to indicate end-staged disease and less chance to reverse LV remodeling.
Author Disclosures: Y. Ichibori: None. T. Ohtani: None. T. Taniguchi: None. K. Nakamoto: None. M. Kanzaki: None. H. Kioka: None. O. Yamaguchi: None. S. Nakatani: None. Y. Sakata: None.
- © 2014 by American Heart Association, Inc.