Increased myocardial energy expenditure in cardiac syndrome X: More work, more pain
Mehmet Serkan Cetin, Elif Hande Ozcan Cetin, Mehmet Akif Erdol, Ozlem Ozcan Celebi, Ahmet Temizhan, Yesim Guray, Omac Tufekcioglu, Dursun Aras, Serkan Topaloglu, Sinan Aydogdu, Ugur Canpolat, Selahattin Aydin
article (Uluslararası, Hakemli) | Yazar(lar): Mehmet Serkan Cetin, Elif Hande Ozcan Cetin, Mehmet Akif Erdol, Ozlem Ozcan Celebi, Ahmet Temizhan, Yesim Guray, Omac Tufekcioglu, Dursun Aras, Serkan Topaloglu, Sinan Aydogdu, Ugur Canpolat, Selahattin Aydin | Yıl: 2018 | Dergi/Kurum: TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIV
Objective: The aim of this study was to assess the myocardial energy expenditure (MEE) in patients with cardiac syndrome X (CSX) and to examine its association with exercise electrocardiogram (ECG) parameters.
Methods: A total of 99 patients who underwent coronary angiography and who were diagnosed as having normal coronary arteries were included. The patients were divided into 2 groups based on symptoms and exercise ECG parameters: 56 CSX patients and 43 control patients with a negative stress test. MEE was calculated using transthoracic echocardiography-derived parameters: circumferential end-systolic stress, left ventricular ejection time, and stroke volume.
Results: In patients with CSX, the MEE at rest was 28% higher in than the control group (89.2 +/- 36.3 vs. 69.8 +/- 17.2 cal/minute). Correlation analysis revealed a moderately negative correlation between MEE and the Duke treadmill score (DTS) beta:-0.456; p<0.001). Receiver operating characteristic analysis with a cut-off value of 74.6 cal/minute for MEE had a sensitivity of 78.1% and a specificity of 75.3% for the prediction of CSX (area under the curve: 0.872; p<0.001). An extra 1 calorie spent per minute at rest increased the likelihood of CSX by about 86% (odds ratio: 1.863).
Conclusion: This study demonstrated that MEE was greater in CSX patients compared with a control group. Increased MEE was determined to be an independent predictor of CSX. DTS was inversely correlated with MEE. Increased MEE may have a crucial role in CSX pathophysiology.