372 Left Ventricular Sphericity Index is a Predictor of Cardiovascular Events in Patients With Anterior Transmural Myocardial Infarction but not in Takotsubo Syndrome

Abstract

Left ventricular sphericity index (LVSI) is a simple measure to evaluate changes in left ventricular (LV) geometry. The aim of our study was to evaluate the prognostic role of LVSI in patients with Takotsubo Syndrome (TS) and Anterior Myocardial Infarction (AMI). Consecutive patients with TS admitted to our institution in the period of Jan 2013 to Dec 2018 were evaluated (n=66). Patients with complete two-dimensional transthoracic echocardiograms were included in analysis (n=49) and matched with a cohort of AMI (n=50). Appraisal of demographic, clinical and echocardiographic parameters of patients was undertaken, and patients were followed for the composite outcome of cardiovascular death, heart failure and arrhythmia. Biplane SI was calculated as an average of the short- and long-axis length in the 4- and 2-chamber apical views. TS patients (64.3±13.7 years, 92% female) were followed for a median of 25.6 months, with a total of 9 patients reaching a primary outcome. LVSI was not predictive of cardiovascular outcomes for patients with TS (p=0.34). Patients with anterior STEMI (62.10±12.84 years, 73% male) were followed up for a median of 29.06 months with 9 patients reaching a primary outcome. In the AMI group, there was a significant association between LVSI and composite primary outcomes (p=0.04). LVSI is reflective of geometric changes in the left ventricle and is associated with adverse cardiovascular outcomes in patients with AMI but not TS (likely secondary to the reversible nature of TS). LVSI may be an important prognostication tool for patients with AMI.