Effect of gender on cardiovascular risk stratification with ECG gated SPECT left ventricular volume indices and ejection fraction

Orren Wexler; Scott R. Yoder; Jessica L. Elder; Maria L. Mackin; Leway Chen; Lonnie Mixon; Ronald G. Schwartz

doi:10.1007/s12350-008-9000-x

$Effect of gender on cardiovascular risk stratification with ECG gated SPECT left ventricular volume indices and ejection fraction$

Journal article

Peer reviewed

Effect of gender on cardiovascular risk stratification with ECG gated SPECT left ventricular volume indices and ejection fraction

Orren Wexler, Scott R. Yoder, Jessica L. Elder, Maria L. Mackin, Leway Chen, Lonnie Mixon and Ronald G. Schwartz

Journal of nuclear cardiology, Vol.16(1), pp.28-37

02/01/2009

DOI: 10.1007/s12350-008-9000-x

PMID: 19152126

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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/m2), EDVI (78 vs 99 mL/m2), 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 ≤ 0.05 for each). In women, ESVI 37 mL/m2 provided maximum HCE prediction compared to 53 mL/m2 in men. A 1 mL/m2 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/m2 had HCE HR 12.0 compared to women with ESVI < 23 mL/m2. 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.

Gated SPECT

Gender

Left ventricular function

Risk stratification

Details

Title: Subtitle: Effect of gender on cardiovascular risk stratification with ECG gated SPECT left ventricular volume indices and ejection fraction
Creators: Orren Wexler - University of Rochester
Scott R. Yoder - University of Rochester
Jessica L. Elder - University of Rochester
Maria L. Mackin - University of Rochester
Leway Chen - University of Rochester
Lonnie Mixon - Wheaton Franciscan Healthcare
Ronald G. Schwartz - University of Rochester
Resource Type: Journal article
Publication Details: Journal of nuclear cardiology, Vol.16(1), pp.28-37
DOI: 10.1007/s12350-008-9000-x
PMID: 19152126
NLM abbreviation: J Nucl Cardiol
ISSN: 1071-3581
eISSN: 1532-6551
Number of pages: 10
Grant note: University of Rochester (http://data.elsevier.com/vocabulary/SciValFunders/100008091)
Language: English
Date published: 02/01/2009
Academic Unit: Internal Medicine
Record Identifier: 9985016524202771

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