1002 Women with severe ischemic cardiomyopathy have worse survival than men despite similar degree of myocardial scar: a
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BioMed Central
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Meeting abstract
1002 Women with severe ischemic cardiomyopathy have worse survival than men despite similar degree of myocardial scar: a delayed hyper-enhancement MRI study Deborah H Kwon*, Carmel M Halley, Thomas P Carrigan, Victoria Zysek, Randall Setser, Zoran Popovic Paul Schoenhagen, Randall Starling, Scott D Flamm and Milind Y Desai Address: Cleveland Clinic Foundation, Cleveland, OH, USA * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A127
doi:10.1186/1532-429X-10-S1-A127
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A127 © 2008 Kwon et al; licensee BioMed Central Ltd.
Background Patients with severe ischemic cardiomyopathy (ICM) have reduced survival. The association between degree of scarring, gender and survival is unclear in such patients. We sought to determine, using delayed hyperenhancement magnetic resonance imaging (DHE-MRI), if female gender is associated with increased mortality in ICM patients with severe left ventricular (LV) dysfunction.
ment model on custom software, Siemens Research) on DHE-MR images, as intensity > 2 standard deviation above viable myocardium. Transmurality score was recorded in all segments as follows: 0 = no scar, 1 = 1– 25% scar, 2 = 26–50%, 3 = 51–75% and 4 = > 75%. Global LV scar burden was calculated as transmurality score for all segments/17. LV volumes, EF, demographic/clinical data, history of cardiac transplantation and all-cause mortality were recorded.
Methods 349 patients (24% women) with severe ICM >/= 70% stenosis in >/= 1 epicardial vessel on angiography and mean LV ejection fraction (EF) 23%], that underwent DHE-MRI (Siemens 1.5 T scanner, Erlangen, Germany) from 2003– 6 were studied. DHE-MR images were obtained in standard long and short axis orientations (covering the entire LV), after injection of Gadolinium dimenglumine using an inversion recovery spoiled gradient echo sequence: TE 4 msec, TR 8 msec, flip angle 300, bandwidth 140 Hz/ pixel, 23 k-space lines acquired every other RR-interval, field of view (varied from 228–330 in the x-direction and 260–330 in the y-direction) and matrix size (varied from 140–180 in the x-direction and 256 in the y-direction). For DHE-MRI analysis, a custom analysis package (VPT software, Siemens, Erlangen, Germany) was used to manually delineate endocardial and epicardial myocardial edges. Scar was defined (as % of myocardium in a 17-seg-
Results There were 56 events (51 deaths and 5 cardiac transplantations) over a mean follow up 2.6 ± 1.2 years. Characteristics of men vs. women are shown in Table. On univariate survival analysis, women had worse outcomes, compared to men (log-rank p = 0
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