Ratio of end systolic volume over left atrial area is a respectable yardstick of systolic impairment in non-ischemic cardiomyopathies

    Authors

    Abstract

    **Background:** Impairment of systolic function and late gadolinium enhancement (LGE) are well known negative prognostic markers in non-ischemic cardiomyopathies (NICMPs). (1, 2) The aim of our study was to analyze power of connection existing between individual volumetric parameters over left atrial area and systolic dysfunction or existence of LGE in patients with non-ischemic cardiomyopathy and healthy controls. **Patients and Methods**: Consecutive cases of NICMPs and controls were included from computerized data base of cardiac magnetic resonance exams for 2.6-year period. Ratios made from volumetric parameters over left atrial area (LAA) were calculated. **Results:** Study included 210 cases referred to cardiac magnetic resonance (CMR); age was 49.6±16.9 years (range 15.2-79.3), male to female ratio 132 (62.9%) vs 78 (37.1%). LGE significantly correlated with impairment of systolic function (Rho CC=0.338; p<0.001), and linear-LGE as well (Rho CC=0.430; p<0.001). For detection of systolic impairment, a critical value of End-systolic-volume(ESV)/LAA of ≥2.6 had area under curve (AUC) 0.910 (0.862-0.945), p<0.001; stroke-volume(SV)/LAA had AUC=0.814 (0.754-0.864), p<0.001 and end-diastolic-volume (EDV)/LAA had AUC 0.653 (0.584-0.718); p<0.001. ESV/LAA correlated with systolic dysfunction (Rho-correlation-coefficient:0.604; p<0.001) and existence of linear midventricular LGE stripe (Rho-CC=0.286; p<0.001). **Conclusions:** ESV/LAA was the most effective of studied parameters for detection of systolic dysfunction and also connected with existence of LGE. Prospective validation of cardiac remodeling for prognostic significance would be needed in future studies.

    Keywords

    cardiac magnetic resonance, non-ischemic cardiomyopathy, late gadolinium enhancement

    DOI

    https://doi.org/10.15836/ccar2018.400

    Literature

    1. Boban M, Pesa V, Persic V, Zulj M, Malcic I, Beck N, et al. Overlapping Phenotypes and Degree of Ventricular Dilatation Are Associated with Severity of Systolic Impairment and Late Gadolinium Enhancement in Non-Ischemic Cardiomyopathies. Med Sci Monit. 2018 Jul 22;24:5084–92. https://doi.org/10.12659/MSM.909172
    2. Boban M, Pesa V, Gabric ID, Manola S, Persic V, Antic-Kauzlaric H, et al. Auxiliary diagnostic potential of ventricle geometry and late gadolinium enhancement in left ventricular non-compaction; non-randomized case control study. BMC Cardiovasc Disord. 2017 Dec 6;17(1):286. https://doi.org/10.1186/s12872-017-0721-0
    Cardiologia Croatica
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    Ratio of end systolic volume over left atrial area is a respectable yardstick of systolic impairment in non-ischemic cardiomyopathies

    Extended Abstract
    Issue11-12
    Published
    Pages400
    PDF via DOIhttps://doi.org/10.15836/ccar2018.400
    cardiac magnetic resonance
    non-ischemic cardiomyopathy
    late gadolinium enhancement

    Authors

    Marko Boban*ORCIDKlinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska

    *Correspondence email: marcoboban@yahoo.com

    Abstract

    **Background:** Impairment of systolic function and late gadolinium enhancement (LGE) are well known negative prognostic markers in non-ischemic cardiomyopathies (NICMPs). (1, 2) The aim of our study was to analyze power of connection existing between individual volumetric parameters over left atrial area and systolic dysfunction or existence of LGE in patients with non-ischemic cardiomyopathy and healthy controls. **Patients and Methods**: Consecutive cases of NICMPs and controls were included from computerized data base of cardiac magnetic resonance exams for 2.6-year period. Ratios made from volumetric parameters over left atrial area (LAA) were calculated. **Results:** Study included 210 cases referred to cardiac magnetic resonance (CMR); age was 49.6±16.9 years (range 15.2-79.3), male to female ratio 132 (62.9%) vs 78 (37.1%). LGE significantly correlated with impairment of systolic function (Rho CC=0.338; p<0.001), and linear-LGE as well (Rho CC=0.430; p<0.001). For detection of systolic impairment, a critical value of End-systolic-volume(ESV)/LAA of ≥2.6 had area under curve (AUC) 0.910 (0.862-0.945), p<0.001; stroke-volume(SV)/LAA had AUC=0.814 (0.754-0.864), p<0.001 and end-diastolic-volume (EDV)/LAA had AUC 0.653 (0.584-0.718); p<0.001. ESV/LAA correlated with systolic dysfunction (Rho-correlation-coefficient:0.604; p<0.001) and existence of linear midventricular LGE stripe (Rho-CC=0.286; p<0.001). **Conclusions:** ESV/LAA was the most effective of studied parameters for detection of systolic dysfunction and also connected with existence of LGE. Prospective validation of cardiac remodeling for prognostic significance would be needed in future studies.

    Literature

    1. 1.
      Boban M, Pesa V, Persic V, Zulj M, Malcic I, Beck N, et al. Overlapping Phenotypes and Degree of Ventricular Dilatation Are Associated with Severity of Systolic Impairment and Late Gadolinium Enhancement in Non-Ischemic Cardiomyopathies. Med Sci Monit. 2018 Jul 22;24:5084–92.DOI
    2. 2.
      Boban M, Pesa V, Gabric ID, Manola S, Persic V, Antic-Kauzlaric H, et al. Auxiliary diagnostic potential of ventricle geometry and late gadolinium enhancement in left ventricular non-compaction; non-randomized case control study. BMC Cardiovasc Disord. 2017 Dec 6;17(1):286.DOI