Comorbidities and cardiac symptoms can modify myocardial function regardless of ischemia: a cross-sectional study with PET/CT

Erick Alexanderson-Rosas, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez; PET/CT Ciclotron, Faculty of Medicine, National Autonomous University of Mexico; Department of Physiology, National Autonomous University of Mexico;
Neftali Eduardo Antonio-Villa, MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
Enrique C. Guerra, MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
Hector Gurrola-Luna, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Andrea Johana Barajas-Paulin, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Adrian Espejel-Guzman, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Valentina Prieto-Vargas, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
Alexis D. Aparicio- Ortiz, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Javier Serrano-Roman, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Aldo Cabello-Ganem, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Alejandro Bautista-Perez-Gavilan, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
Isabel Carvajal-Juárez, 1Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Enrique Solorzano-Pinot, Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
Nilda Espinola-Zavaleta, Departamento de Cardiología Nuclear, Instituto Nacional de Cardiología Ignacio Chávez; Departamento de Ecocardiografía, Centro Médico ABC. Ciudad de México, México

Objective: Associating comorbidities and cardiac symptoms that alter myocardial mechanical function could help clinicians to correctly identify at-risk population. Methods: We conducted a functional open population cross-sectional study of patients referred to a positron emission computed tomography/computed tomography unit in Mexico City for evaluation of myocardial function, perfusion, and coronary circulation. Ischemia was defined as a sum difference score (SDS) > 2. Association between comorbidities and cardiac symptoms was tested using logistic regression models and trend analysis. We performed an interaction analysis to evaluate the addition of any accompanying symptoms to comorbid conditions on impairment of myocardial function. Results: One thousand two hundred and seventy-three patients were enrolled, 66.1% male, with a mean age of 62.4 (? 12.7) years, 360 (28.7%) with ischemia, 925 (72.7%) with at least one comorbidity, and 676 (53.1%) had at least one associated cardiac symptom. Patients without ischemia, type 2 diabetes, arterial hypertension, and adverse cardiac symptoms were associated with adverse function, perfusion, and coronary flow parameters. We observed a trend of a cumulative number of comorbidities and cardiac symptoms with increased ischemia and decreased coronary flow. Only in decreased LVEF, we demonstrated an interaction effect between increased comorbidities and adverse symptoms. Conclusions: The high burden of comorbidities and symptoms in our population alter myocardial function regardless of the level of ischemia.

Palabras clave: Myocardial infarction. Nuclear cardiology. Ischemic heart disease. Traditional risk factors. Epidemiology.