Effect of gender on cardiovascular risk stratification with ECG gated SPECT left ventricular volume indices and ejection fraction.
J Nucl Cardiol
; 16(1): 28-37, 2009.
Article
in En
| MEDLINE
| ID: mdl-19152126
ABSTRACT
BACKGROUND:
Optimal gender-specific risk prediction using ECG-gated SPECT left ventricular (LV) volumes and ejection fraction (EF) remains undefined despite reported gender differences in baseline LV function.METHODS:
ECG-gated SPECT studies of 891 consecutively referred patients (43% women) were evaluated for LV end-systolic and diastolic volume indices (ESVI, EDVI) and EF. Effects of gender on prediction of hard cardiac events (HCE) and the combined endpoint of all-cause mortality or non-fatal infarction (ACMMI) were evaluated.RESULTS:
Women had smaller ESVI (37 vs 55 mL/m(2)), EDVI (78 vs 99 mL/m(2)), and higher LVEF (56 vs 47%, P < 0.0001 for each) with equivalent rates of HCE (6.1%) and ACMMI (11.8%). HCE risk started at smaller ESVI and EDVI in women compared to men (P < or = 0.05 for each). In women, ESVI 37 mL/m(2) provided maximum HCE prediction compared to 53 mL/m(2) in men. A 1 mL/m(2) increase in ESVI was associated with a 2.9% increased HCE risk in women (P < 0.0001) and a 0.9% increased ACMMI risk in men (P = 0.03). Women with ESVI > 35 mL/m(2) had HCE HR 12.0 compared to women with ESVI < 23 mL/m(2).CONCLUSION:
LV volume indices and LVEF predict subsequent morbid clinical events in men and women. In women, risk of subsequent events started at smaller LV volume indices compared to men despite similar risk profiles.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Stroke Volume
/
Coronary Artery Disease
/
Ventricular Dysfunction, Left
/
Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Nucl Cardiol
Journal subject:
CARDIOLOGIA
Year:
2009
Document type:
Article
Affiliation country:
United States