Abstract 17038: A Role of Invasive Left Ventriculography during Cardiac Catheterization for Predicting Incidence of Major Cardiovascular Events

Abstract

Introduction: We have developed the new index of left ventricular longitudinal axis shortening (LAS) using contrast left ventriculography (LVG) during Cardiac Catheterization. Objective: The purpose of this study was to evaluate whether LAS provided additive prognostic information beyond traditional ejection fraction (EF). Methods: Nine hundred and ninety eight consecutive patients who had undergone conventional catheters based on clinical indications between 2009 and 2012 were followed retrospectively from our clinical chart. LAS was assessed from LVG (see Figure). Cox regression analysis was used to predict the endpoints of all-cause mortality and congestive heart failure (HF). Receiver operating characteristic curve analysis was used for the discrimination ability of LAS for event beyond traditional EF. Results: Sixty-two events were observed during the follow-up period for mean 3.1±1.1 years. In the adjusted model, the endpoints were associated with lower LAS (hazard ratio 0.89; 95% confidence interval 0.80 to 0.90 per 1% LAS increment, p=0.036) after adjustment for the Framingham risk score, history of myocardial infarction and HF, number of stenosis vessels, EF, left ventricular end-diastolic pressure and Log brain natriuretic peptide (BNP). LAS improved ROC area by 7% compared with EF, and LAS combined with EF and log BNP by 13% (see Figure). Conclusion: LAS by LVG can be a predictor of death and congestive HF and appears to be a better parameter than traditional EF in patients who underwent invasive coronary angiography for clinical indications.