Overview
Long-term prognostic value of macrovascular and microvascular coronary artery stenoses in each type of cardiomyopathy.
Description
Coronary artery imaging techniques have taken a central role in the assessment of cardiovascular (CV) diagnosis over the past two decades. Many patients with a cardiomyopathy are also found to have a bystander coronary artery disease, not responsible for their cardiomyopathy. However, the prognostic value of those bystander coronary artery diseases is not known.
Also, new imaging techniques have been developed to assess coronary microvascular disease, but the prognostic value of these findings is not known.
In this study, the investigators evaluate the incidence and the prognosis of bystander coronary artery disease and microvascular disease in patients with ischemic, hypertrophic, dilated and restrictive cardiomyopathies in 5 French centers.
Coronary angiography, cardiac magnetic resonance (CMR), tomographic coronary artery angiography, single-photon emission computed tomography (SPECT), rest and stress trans-thoracic echocardiography (TTE) results will be recorded.
Macrovascular coronary artery disease is defined by :
- a stenosis > 50 % in coronary angiography confirmed with myocardial ischemia (SPECT, stress echocardiography),
- a stenosis > 70 % (50% if it is the left main coronary artery)
- or a stenosis 30-70 % with a fractional flow reserve (FFR) < 0.8 Microvascular disease is defined by an index of microvascular resistance (IMR) >23 or myocardial perfusion heterogeneity imaging (MPHI) > 4 using SPECT or CMR.
Major adverse cardiovascular events (MACE) will be assessed 1 year, 2 years and 5 years after enrollment.
Eligibility
Inclusion Criteria:
- Ischemic
- Dilated
- Hypertrophic
- Restrictive cardiomyopathy.
Exclusion Criteria:
- Pregnant women
- Breastfeeding women
- Patients under legal protection