Abstract | OBJECTIVE:
Chest pain is a common symptom in patients with hypertrophic cardiomyopathy (HCM), causing difficulty determining whether there is coexistent coronary artery disease (CAD). We investigated whether coronary computed tomography angiography (CCTA) can assess the prevalence and clinical significance of CAD in adult patients with HCM showing chest pain through longitudinal follow-up. METHODS: RESULTS: The prevalence of obstructive CAD (≥ 50% in luminal stenosis) and APC was 14.7% and 18.9%, respectively. During the follow-up period (median, 37 months; range, 2-108 months), there were 31 occurrences of ACEs (13.0%). Using multivariate Cox regression analysis, age, atrial fibrillation, low ejection fraction, obstructive CAD, and APCs were associated with ACEs (all p < 0.05). Among the prediction models for ACEs, the area under the curve (AUC) was higher (AUC = 0.92) when CCTA variables were added to the clinical (AUC = 0.84) and echocardiographic factors (AUC = 0.88) (p < 0.001). CONCLUSIONS: Using CCTA, about 20% of symptomatic HCM patients were associated with clinically significant atherosclerosis. Adding these CCTA variables to the clinical and echocardiographic variables may increase the predictions of ACEs; therefore, evaluating coronary atherosclerosis using CCTA may be helpful for symptomatic HCM patients. KEY POINTS:
|
Authors | Yoon Joo Shin, Jae Hwan Lee, Jin Young Yoo, Jeong A Kim, Yongho Jeon, Yeonyee E Yoon, Eun Ju Chun |
Journal | European radiology
(Eur Radiol)
Vol. 29
Issue 9
Pg. 4593-4602
(Sep 2019)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 30796567
(Publication Type: Journal Article)
|
Topics |
- Adult
- Aged
- Angina, Unstable
(etiology)
- Area Under Curve
- Cardiomyopathy, Hypertrophic
(complications, diagnostic imaging)
- Chest Pain
(diagnostic imaging, etiology)
- Computed Tomography Angiography
(methods)
- Coronary Angiography
(methods)
- Coronary Artery Disease
(complications, diagnostic imaging)
- Coronary Stenosis
(complications, diagnostic imaging)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(etiology)
- Plaque, Atherosclerotic
(complications, diagnostic imaging)
- Retrospective Studies
- Risk Factors
- Severity of Illness Index
- Stroke
(etiology)
|