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￭ S-161 ￭
Prognostic value of coronary computed tomographic angiography in type 2 diabetes mellitus patients
1Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea, 2Department of Cardiology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
*Minah Kim1, Gyung-Min Park2, Seong Wook Byeon1
Background: There are limited data regarding the long-term prognostic value of coronary computed tomographic angiography (CCTA) in type 2 dia- betes mellitus patients. Methods: We analyzed clinical outcomes of 591 type 2 diabetic patients who underwent CCTA between January 2007 and June 2011 (mean age, 62.2±8.3 years and 352 men [59.6%]). A cardiac event was defined as a composite of cardiac death, non-fatal myocardial in- farction, unstable angina requiring hospitalization, or late coronary revascularization. Patients were categorized into three groups according to severity of coronary artery disease (CAD) on CCTA: normal coronary arteries, non-obstructive CAD (＜50%), and obstructive CAD (≥50%). Results: One hun- dred sixty-eight patients (28.4%) had normal coronary arteries, whereas 236 (39.9%) had non-obstructive CAD and 187 (31.6%) had obstructive CAD.
During the follow-up period (median 5.3 years), 37 cardiac events occurred in 29 patents: 10 cardiac deaths, 2 non-fatal myocardial infarctions, 8 un- stable angina, and 17 late coronary revascularizations. The 6-year event-free survival rates were 99.3 in patients with normal coronary arteries, 96.7 in those with non-obstructive CAD, and 86.2 in those with obstructive CAD. Conclusions: Type 2 diabetic patients with normal coronaries and non-ob- structive CAD on CCTA show excellent clinical outcomes over a follow-up period of more than 5 years, while prognosis is worse in those with ob- structive CAD. These findings suggest the long-term prognostic value of CCTA for type 2 diabetes.
￭ S-162 ￭
Association of Rt. ventricular systolic function and conduction delay in patients with RBBB
Division of cardiology, Kosin university Gospel Hospital
*Sun Min Kim, Kyoung Im Cho, Sung Il Im, Hyun Su Kim, Jeong Ho Heo, Tae Joon Cha
Background: Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which may affect its electrical properties resulting in conduction delay or block. We hypothesized that R′ wave duration in lead V1, prolonged laterportion of the QRS complex, would be an indicator of reduced RV function in patients with RBBB. Methods: The Kosin University echocardiography and electrocardiogram (ECG) database was reviewed from 2013 to 2014 to identify patients with complete RBBB. ECGs recorded closest to the time of the echocardiogram were carefully reviewed and measured QRS and R′ wave duration. RV systolic dysfunction was defined as RV fractional area change (FAC) ＜35%, as indicated by echocardiography guidelines. Results: Patients with RV dysfunction (n＝241) showed more pro- longed QRS duration (145.3±19.3 vs. 132.2±13.4 ms, p＜0.001) predominantly due to R′ prolongation (84.8±13.0 vs. 102.9±12.0 ms, p＜0.001) com- pared to the patients with normal RV function (n＝123) (Table). R’duration was significantly associated with RV FAC (r＝-0.609, p＜0.001), as well as RV systolic pressure (r＝0.142, p＝0.008), RV dimension (r＝0.193, p＝≤0.001) and RV myocardial performance index (r＝0.199, p＜0.001) Conclusion: Prolonged R′ wave duration in lead V1would be an indicator of RV dysfunction as well as pressure and/or volume overload in patients with RBBB.
