The Role of Carotid Atheroscleros is in the Distinction BetweenIs chemic and Non-is chemic Cardiomyopathy.
- Author:
Yung Woo SHIN
1
Author Information
1. Department of Int ernal Medicine, Pusan University College of Medicine, Pusan, Korea. pnuhshin@hanmail.net
- Publication Type:Original Article
- Keywords:
Ischemic cardiomyopathy;
Non-ischemic Cardiomyopathy;
Carotid atherosclerosis
- MeSH:
Aged;
Cardiomyopathies*;
Cardiomyopathy, Dilated;
Carotid Arteries;
Carotid Artery Diseases;
Carotid Stenosis;
Constriction, Pathologic;
Coronary Angiography;
Coronary Artery Disease;
Coronary Vessels;
Female;
Humans;
Myocardial Revascularization;
Plaque, Atherosclerotic;
Prognosis;
Sensitivity and Specificity;
Ultrasonography
- From:Journal of the Korean Geriatrics Society
2004;8(2):104-109
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS: Ischemic cardiomyopathy in the elderly bears a worse prognosis than non-ischemic cardiomyopathy, and may show an improved outcome after myocardial revascularization. The noninvasive techniques which can reliably distinquish between ischemic and non-ischemic cardiomyopathy have been tested. As ultrasonographically assessed carotid atherosclerosis is being used as a surrogate measure of coronary atherosclerosis, non studies to date have used carotid atherosclerosis to distinguish between ischemic and non-ischemic cardiomyopathy in the elderly. METHODS: One hundred forty eight patients(61 women, 87 male) greater than 65 years of age who have dilated cardiomyopathy with left ventricular enddiastolic inner dimension 55mm and fractional shortening 25% were evaluated by B-mode ultrasound imaging of carotid artery for measurement of atherosclerotic plaque. Also coronary angiography was done, and ischemic cardiomyo- pathy was defined as the presence of any 2 or more epicardial coronary vessels with 75% stenosis. and then the value of carotid athe rosclerosis in the distinction between ischemic and non-ischemic etiology in the elderly with dilated cardiomyopathy was examined. RESULTS: Ischemic etiology of dilated cardiomyopathy in the elderly can be defined as the presence of carotid atherosclerosis with 25% stenosis. Carotid stenosis 25% had sensitivity 82.5%(74% in women, 91% in male), specificity 85.5%(92% in women, 79% in male), positive predictive value 90.5%(93% in women, 88% in male) and negative predictive value 78.5%(73% in women, 84% in male) as whole in the identification of patients with ischemic cardiomyopathy. CONCLUSION: Carotid stenosis by B-mode ultrasonography is noninvasive and useful in the distinction between ischemic and nonischemic etiology in the elderly patients with clinically unexplained cardiomyopathy
