Author + information
- Hitesh Agrawal,
- Carlos Mery,
- Rajesh Krishnamurthy,
- Kristen Sexson,
- Cory Noel,
- Prakash Masand,
- Siddharth Jadhav,
- Emmett McKenzie,
- Athar Qureshi,
- Charles Fraser and
- Silvana Molossi
Background: Patients (pts) with anomalous aortic origin of a coronary artery (AAOCA) are at risk of sudden cardiac arrest (SCA) and there is limited data on assessment of myocardial perfusion following a uniform approach prior to and after surgical intervention.
Methods: Prospective study from 12/2012 to 4/2016 in AAOCA pts following a uniform algorithm. All pts had treadmill stress nuclear perfusion imaging (sNPI) +/- dobutamine stress cardiac MRI (sCMR), but those presenting in SCA/shock or young age. High-risk pts had surgery, low risk pts had clinical follow up. Univariate analyses were performed.
Results: 122 pts were evaluated, 42 had surgery (10 left and 32 right anomalous CA), median age 12.8 y (IQR 8.6-15.6) for the surgical and 10.9 y (IQR 6-14.9) for the non-surgical cohorts. The table depicts the total results. In the surgical group, 6 pts had abnormal sNPI pre-op, 3 persisting post-op and 1 improved. 3 pts had new abnormal sNPI post-op with normal sCMR in 1, pending in 2. In the non-surgical group, 4 pts had abnormal sNPI: 3 deemed false-+, 1 awaits surgery. Median follow up was 1.8 y (1.1-2.9) for the surgical and 1.1 y (0.4-2.1) for the non-surgical cohorts. Surgical pts are alive and all but 5 have returned to full physical activities.
Conclusions: Assessment of myocardial perfusion with provocative stress in this cohort of AAOCA pts following a uniform approach contributed to risk stratification and decision-making to return to exercise activities. Its role in predicting the future risk of SCA is unclear.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Role of Exercise Testing
Abstract Category: 31. Non Invasive Imaging: Sports and Exercise
Presentation Number: 1289-206
- 2017 American College of Cardiology Foundation