CAD: Chronic Coronary Syndromes

1354239 - The Role of Cardiac Magnetic Resonance Imaging and Viability in Multidisciplinary Management of Coronary Artery Disease by a Heart Team

Wednesday, January 25, 2023

Location: E-POSTER

Presenting Author(s)

CK

Connor Kerndt, DO

Resident Physican
Michigan State University/Spectrum Health Internal Medicine Residency
Grand rapids, Michigan, United States

Primary Author(s)

CK

Connor Kerndt, DO

Resident Physican
Michigan State University/Spectrum Health Internal Medicine Residency
Grand rapids, Michigan, United States

Co-Author(s)

CM

Christopher Madison, MD

Advanced Imaging Fellow
Spectrum Health
Grand Rapids, Michigan, United States
MA

Mohammad Ahmed, MD

Resident Physician
Spectrum Health/Michigan State University College of Human Medicine, United States
MA

Mahkukh Akram, MD

Cardiovascular Fellow
Spectrum Health/Michigan State University
Grand rapids, Michigan, United States
SV

Stacie M. VanOosterhout

Clinical Research Coordinator/ M Ed
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, Michigan, United States
JP

Jessica L. Parker, MSc

Manager, Scholarly Activity and Scientific Support
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, Michigan, United States
AB

Andrea Burgess, RN

Clinical Research Coordinator
Spectrum Health/Michigan State University College of Human Medicine, United States
DS

Deeann Stickland, RN

Heart Team Coordinator
Spectrum Health/Michigan State University College of Human Medicine, United States
JM

John Mulder, MSc

Advance Practice Provider
Spectrum Health/Michigan State University College of Human Medicine, United States
DW

David H. Wohns, MD

Attending Physician
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, Michigan, United States
RM

Ryan D. Madder, MD

Attending Physician
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, Michigan, United States
RM

Richard F. McNamara, MD

Attending Physician
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, Michigan, United States
Jose Mariano T. Tan, II, MD, MBA

Attending Physician
Spectrum Health
Grand Rapids, Michigan, United States
WA

Wissam M. Abdallah, MD

Attending Physician
Spectrum Health
Grand Rapids, Michigan, United States
DM

David A. McNamara, MD

Attending Physician
Spectrum Health/Michigan State University College of Human Medicine
Grand Rapids, United States

Background: Cardiac MRI (CMR) is a robust tool for assessing myocardial viability. However, the role of CMR-derived viability and its associations with mortality in patients with complex CAD referred to a Heart Team (HT) remain unknown.

Methods: Patients ≥18yo referred to a quaternary center HT for CAD between Jan 2015-Mar 2021 with a CMR in the preceding 6 months were included; those with moderate-severe valvular disease were excluded. Baseline comorbidities, labs, CMR findings, treatment recommendations, and mortality rates (Michigan Death Registry) were stratified based on the total number of non-viable segments [none, moderate (1-5 non-viable segments), and high ( > 6 non-viable segments)].

Results: Of 2030 patients referred to HT, 229 patients (11.3%) were included for analysis with a mean left ventricular systolic function of 31%±11 and left ventricular end diastolic volume of 259mL±79. 161 (70%) patients demonstrated at least 1 non-viable segment. Only minor differences were noted in baseline comorbidities and labs with no differences noted in biventricular function and volumes between groups (Figure a). High 2-year mortality (16%) rates were observed in the entire cohort that did not differ when stratified by the number of non-viable segments on CMR (Figure b/c).

Conclusion: In a large quaternary complex CAD HT, no differences in mortality were observed in patients when stratified by CMR-derived myocardial viability, although the power to detect this difference was low.