Background Restrictive Cardiomyopathies (R-CMP) represent a wide array of conditions characterized by diastolic heart failure with important impairment in left ventricle filling pressures. These entities require different treatments, rendering etiological diagnosis a key component during the evaluation of these patients. Purpose Report the mortality of a select group of patients with R-CMP referred to CMR in a tertiary care center in Latin-America. Methods We analyzed all patients with CMR performed in our institution, including hospitalized and ambulatory patients, between 2016 and 2021. We extracted data of patients diagnosed by CMR with amyloidosis, hypertrophic cardiomyopathy (HCM), and endomyocardial fibrosis (EMF). All-cause mortality was extracted from national census data and analyzed using Kaplan-Meier survival estimates and log-rank test. Results Between June 1st, 2016, and December 31st, 2021, 5000 CMRs were performed at our institution. Among these, 317 (6.3%) patients were diagnosed with R-CMP by CMR as follows: 52 patients (16.4%) had amyloidosis, 250 patients had HCM (78.9%) and 15 patients (4.7%) had EMF. Of these, 40.7% were female (n=129), the median age was 63 yar-old (IQR 51–71) and 64.7% (n=205) were out-patients. At a mean follow-up of 33.3 months, there was a statistically significant difference in mortality between patients with amyloidosis (49,0%) and those with HCM and EMF (7,1% and 13,3%, respectively; P<0.001), as described in Figure 1. Conclusions R-CMP represent a meaningful percentage of patients referred for CMR in our institution with different survival rates. Amyloidosis patients had a significantly higher mortality rate compared to HCM and EMF, at a relatively short follow-up. Increased access to CMR in our region for optimal diagnosis and early treatment may optimize prognosis in these types of patients. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Self funding
Introduction: During the COVID-19 pandemic, stratification of patients with chest pain with low-to-moderate probability of CAD (LMCP) became problematic due to fear of infection. We analyzed the impact in volume trends of modalities for stratification in these patients -including stress echocardiography (S-TTE), cardiac computed tomography (CCT), and single-photon emission CT (SPECT)- before, during, and after the pandemic Hypothesis: Usage of CCT increased during the COVID-19 pandemic due to the lower exposure of patients, during this test, to healthcare personnel. Methods: R etrospective chart review conducted between 2019 and 2021. We defined 3-time frames: pre-pandemic period (1/1/2019-12/31/2019), pandemic period (1/1/2020-12/31/2020), and post-pandemic period (1/1/2021-12/31/2021). The study included data of all 3 mentioned imaging modalities. Results: Our cohort included 19,637 LMCP patients evaluated using 1,369 CCTs (7%), 2,380 S-TTEs (13.6%) and 15,588 SPECTs (79.4%) -Fig 1a-. During the pre-pandemic period, CCT studies corresponded to 3.0%, while S-TTE and SPECT corresponded to 14.7% and 82.4%, respectively. In the post-pandemic period, CCT studies corresponded to 9.8%, while S-TTE and SPECT corresponded to 12.3% and 77.9%, respectively. An upward variation was observed regarding the utilization of CCT in the post-pandemic period compared to the pre-pandemic period (p<0.001), and a downward change was observed in S-TTE when the post-pandemic period was compared with the pre-pandemic period (p<0.001) -Fig 1b-. Conclusions: Since the beginning of the COVID-19 pandemic, the utilization of SPECT and s-TTE in LMCP patients decreased compared to the pre-pandemic period. In the post-pandemic period, both tests increased in use although their volumes are lower compared to the pre-pandemic period. Conversely, CCT had a linear increase since the beginning of the pandemic and this pattern has extended to the post-pandemic period.
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