Left Ventricular End Systolic Volume as an Indicator of Remodelling after Myocardial Necrosis after the Spect Examination with Technetium Tetrofosmin Drug
Author(s): Hilfan AP Lubis*, Manoefris Kasim, Elen Sahara and Celly A Atmadikoesoemah
Abstract
Background: Left Ventricular End Systolic Volume (LVESV) is one of the parameters to assess left ventricular function other than ejection fraction. The LVESV value is an indicator of remodelling after myocardial necrosis and has been shown to have prognostic value in post-infarction patients. Research on the relationship between end systolic volume and mortality or major cardiovascular events has been carried out in post-infarction patients. Similar studies in the population of stable angina pectoris have not been widely carried out.
Objective: To determine the prognostic role of LVESV in predicting major cardiovascular events (MACE) and determine the median LVESV value that can predict MACE in patients with stable CHD.
Research methods: The study was conducted using a retrospective cohort method on 103 stable CHD patients without a history of infarction or revascularization who underwent SPECT Tc99m tetrofosmin examination at the nuclear department of the Harapan Kita National Heart Center from January 2017 to June 2018 which will be followed for 6 months unless MACE occurs.
Results: The numbers of subjects analyzed in this study were 103 patients. During the observation period there were a total of 29 patients (28.2%) who experienced major cardiovascular events. Patients who experienced MACE had a higher LVESV value (190.31 ± 115.63 mL vs 105.76 ± 80.44 mL) when compared to patients who did not experience MACE (p=0.001). The results of the bivariate analysis showed that the final systolic volume was statistically significant. The results of cox regression analysis showed that the final systolic volume value of ≥ 113mL was a predictor of major cardiovascular events in patients with stable coronary heart disease with hazard ratio 3,753 (CI 1.595-8,855; p value=0.001).
Conclusion: End systolic volume (ESV) is one of the significant independent predictors of MACE. The value of the end systolic volume (ESV) of ≥113 mL has a predictor value for the occurrence of MACE.
