Table 1.
Population Characteristics
| Overall (n=2051) |
RV Dysfunction − (n=1928)* |
RV Dysfunction + (n=123) |
p | |
|---|---|---|---|---|
| Clinical | ||||
| Age (years) | 64 ± 12 | 63 ± 12 | 66 ± 12 | 0.01 |
| Male gender | 1211 (59%) | 1118 (58%) | 93 (76%) | <0.001 |
| Body Mass Index (kg/m2) | 28.5 ± 5.8 | 28.5 ± 5.9 | 28.0 ± 5.2 | 0.36 |
| Atherosclerosis risk factors | ||||
| Diabetes mellitus | 528 (26%) | 477 (25%) | 51 (41%) | <0.001 |
| Hypertension | 1311 (64%) | 1221 (63%) | 90 (73%) | 0.03 |
| Tobacco use | 166 (8%) | 161 (8%) | 5 (4%) | 0.09 |
| Hypercholesterolemia | 1339 (65%) | 1252 (65%) | 87 (71%) | 0.19 |
| Family history of coronary artery disease | 636 (31%) | 602 (31%) | 34 (28%) | 0.41 |
| Known coronary artery disease | 566 (28%) | 489 (25%) | 77 (63%) | <0.001 |
| Prior myocardial infarction | 215 (10%) | 197 (10%) | 18 (15%) | 0.12 |
| Prior coronary revascularization (PCI / CABG) |
459 (22%) | 389 (20%) | 70 (57%) | <0.001 |
| Chronic Obstructive Pulmonary Disease (COPD) |
84 (4%) | 78 (4%) | 6 (5%) | 0.65 |
| Pulmonary Embolism (prior history) | 27 (1%) | 25 (1%) | 2 (2%) | 0.68 |
| Sleep Apnea | 131 (6%) | 129 (7%) | 2 (2%) | 0.02 |
| Indication for stress testing | ||||
| Chest Pain | 1169 (57%) | 1113 (58%) | 56 (46%) | 0.008 |
| Dyspnea | 662 (32%) | 622 (32%) | 40 (33%) | 0.95 |
| Medication Regimen | ||||
| Aspirin | 1089 (53%) | 1003 (52%) | 86 (70%) | <0.001 |
| Thienopyridines | 239 (12%) | 223 (12%) | 16 (13%) | 0.63 |
| Beta blocker | 809 (39%) | 726 (38%) | 83 (67%) | <0.001 |
| ACE Inhibitor/Angiotensin Receptor Blocker | 830 (40%) | 769 (40%) | 61 (50%) | 0.03 |
| HMG CoA Reductase Inhibitor | 1092 (53%) | 1003 (52%) | 89 (72%) | <0.001 |
| Calcium channel blockers | 419 (20%) | 394 (20%) | 25 (20%) | 0.98 |
| Nitrates | 72 (4%) | 65 (3%) | 7 (6%) | 0.18 |
| Electrocardiography | ||||
| Sinus Rhythm | 1987 (97%) | 1880 (98%) | 107 (87%) | <0.001 |
| Atrial Fibrillation or Flutter | 45 (2%) | 34 (2%) | 11(9%) | <0.001 |
| Q-Wave Myocardial Infarction | ||||
| Anterior | 31 (2%) | 29 (2%) | 2 (2%) | 0.71 |
| Lateral | 12 (1%) | 11 (1%) | 1 (1%) | 0.53 |
| Inferior | 46 (2%) | 37 (2%) | 9 (7%) | <0.001 |
| Imaging | ||||
| Right ventricular function/morphology | ||||
| Echocardiography | ||||
| TAPSE | 2.1 ± 0.4 | 2.2 ± 0.4 | 1.3 ± 0.2 | <0.001 |
| RV S’ | 12.5 ± 2.5 | 12.8 ± 2.3 | 8.0 ± 1.2 | <0.001 |
| RV end-diastolic diameter (cm/m2) | 1.7 ± 0.3 | 1.7 ± 0.3 | 1.8 ± 0.4 | 0.31 |
| Qualitative RV Dilation | 85 (4%) | 62 (3%) | 23 (19%) | <0.001 |
| Qualitative RV Dysfunction | 70 (3%) | 21 (1%) | 49 (40%) | <0.001 |
| Left ventricular function/morphology | ||||
| SPECT | ||||
| Post-stress ejection fraction (%) | 64 ± 11 | 64 ± 10 | 56 ± 13 | <0.001 |
| LV end-diastolic volume (ml/m2) | 48 ± 17 | 48 ± 16 | 55 ± 23 | <0.001 |
| Echocardiography | ||||
| Ejection fraction (%) | 62 ± 9 | 62 ± 9 | 53 ± 14 | <0.001 |
| Advanced LV Dysfunction (EF < 35%) | 2.6 ± 0.3 | 2.6 ± 0.3 | 2.7 ± 0.4 | 0.12 |
| LV end-diastolic diameter (cm/m2) | 1.7 ± 0.3 | 1.7 ± 0.3 | 1.9 ± 0.4 | <0.001 |
| LV end-systolic diameter (cm/m2) | 85 ± 24 | 85 ± 24 | 90 ± 25 | 0.04 |
| LV mass (g/m2) | 62 ± 9 | 62 ± 9 | 53 ± 14 | <0.001 |
| Left atrial size (cm2/m2) | 9.8 ± 2.3 | 9.8 ± 2.2 | 11.1 ± 3.1 | <0.001 |
| Left atrial diameter (cm/m2) | 2.0 ± 0.3 | 2.0 ± 0.3 | 2.2 ± 0.4 | <0.001 |
| Mitral regurgitation (≥ moderate) | 64 (3%) | 55 (3%) | 9 (7%) | 0.01 |
| Tricuspid regurgitation (≥ moderate) | 64 (3%) | 54 (3%) | 10 (8%) | 0.001 |
| PASP** | 31 ± 8 | 30 ± 7 | 34 ± 12 | 0.008 |
| Pulmonary hypertension (PASP ≥35 mmHg) | 377 (22%) | 341 (21%) | 36 (32%) | 0.006 |
Numbers in boldface indicate p values < 0.05
*
Defined based on established cutoffs as employed in consensus guidelines (TAPSE < 1.6 cm, S’<10 mm/s)16
**
Available in 83% of study population (n=1711)