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Left ventricular energy model predicts adverse events in women with suspected myocardial ischemia: results from the NHLBI-sponsored women’s ischemia syndrome evaluation (WISE) study

  
@article{CDT1879,
	author = {Mark Doyle and Nicole Weinberg and Gerald M. Pohost and C. Noel Bairey Merz and Leslee J. Shaw and George Sopko and Anthon Fuisz and William J. Rogers and Edward G. Walsh and B. Delia Johnson and Barry L. Sharaf and Carl J. Pepine and Sunil Mankad and Steven E. Reis and Geetha Rayarao and Diane A. Vido and Vera Bittner and Lindsey Tauxe and Marian B. Olson and Sheryl F. Kelsey and Robert WW Biederman},
	title = {Left ventricular energy model predicts adverse events in women with suspected myocardial ischemia: results from the NHLBI-sponsored women’s ischemia syndrome evaluation (WISE) study},
	journal = {Cardiovascular Diagnosis and Therapy},
	volume = {3},
	number = {2},
	year = {2013},
	keywords = {},
	abstract = {Objectives: To assess the prognostic value of a left ventricular energy-model in women with suspected myocardial ischemia.
Background: The prognostic value of internal energy utilization (IEU) of the left ventricle in women with suspected myocardial ischemia is unknown.
Methods: Women [n=227, mean age 59±12 years (range, 31-86 years)], with symptoms of myocardial ischemia, underwent myocardial perfusion imaging (MPI) assessment for regional perfusion defects along with measurement of ventricular volumes separately by gated Single Photon Emission Computed Tomography (SPECT) (n=207) and magnetic resonance imaging (MRI) (n=203). During follow-up (40±17 months), time to first major adverse cardiovascular event (MACE, death, myocardial infarction or hospitalization for congestive heart failure) was analyzed using MRI and gated SPECT variables.
Results: Adverse events occurred in 31 (14%). Multivariable Cox models were formed for each modality: IEU and wall thickness by MRI (Chi-squared 34, P<0.005) and IEU and systolic blood pressure by gated SEPCT (Chi-squared 34, P<0.005). The models remained predictive after adjustment for age, disease history and Framingham risk score. For each Cox model, patients were categorized as high-risk if the model hazard was positive and not high-risk otherwise. Kaplan-Meier analysis of time to MACE was performed for high-risk vs. not high-risk for MR (log rank 25.3, P<0.001) and gated SEPCT (log rank 18.2, P<0.001) models.
Conclusions: Among women with suspected myocardial ischemia a high internal energy utilization has higher prognostic value than either a low EF or the presence of a myocardial perfusion defect assessed using two independent modalities of MR or gated SPECT.},
	issn = {2223-3660},	url = {http://cdt.amegroups.com/article/view/1879}
}