Paul Apfaltrer MD, Presenter: Nothing to Disclose

Joseph Anwar Abro MA, Abstract Co-Author: Nothing to Disclose

U. Joseph Schoepf MD, Abstract Co-Author: Research Consultant, Bayer AG Research Grant, Bayer AG Research Consultant, Bracco Group Research Grant, Bracco Group Research Consultant, General Electric Company Research Grant, General Electric Company Research Consultant, Siemens AG Research Grant, Siemens AG

John William Nance MD, Abstract Co-Author: Nothing to Disclose

Fabian Bamberg MD, MPH, Abstract Co-Author: Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG Research Grant, Bayer AG Research Grant, Siemens AG

Rozemarijn Vliegenthart MD, PhD, Abstract Co-Author: Nothing to Disclose

Hypotheses to explain the higher rate of cardiac events in blacks versus whites include differences in coronary atherosclerosis and a higher rate of myocardial disease. We compared CT-derived myocardial measures between black and white patients with acute chest pain.

This retrospective analysis was peformed under an IRB waiver and in HIPAA compliance. The study population consisted of 333 patients (163 black - mean age 54.4±11.1 years; 52% men; 170 white - mean age 54.0±12.3 years; 56% men) who underwent cardiac dual-source CT for acute chest pain. Myocardial mass (MM), left ventricular (LV) ejection fraction (EF), LV-end systolic volume (LVESV) and LV-end diastolic volume (LVEDV) were quantified using an automated analysis algorithm. Septal wall thickness (SWT) and cardiac chamber diameters were measured. Measurements were compared by chi-square test and independent t-test and evaluated by linear regression analysis.

MM was larger for blacks compared to whites (174.4±57.8g versus 157.3±55.2g. [p<0.01]), while SWT was slightly higher (11.9±2.9mm versus 11.3±3.7mm [p<0.05]). These differences were mainly due to results in women. EF (67.5±13.3ml versus 69.0±10.2ml) and LVEDV (133.5±42.8ml versus 129.9±38.3ml) were not significantly different (p>0.05). LVESV and systolic LV diameter were higher in blacks compared to whites (47.2±36.6m versus 41.7±27.5ml and 32.1±9.1mm versus 30.4±6.2mm [p<0.05]). The relationship between race and myocardial parameters remained significant after adjusting for cardiovascular risk factors.

In patients with acute chest pain, CT-derived myocardial parameters were generally higher for blacks than for whites, suggesting myocardial disease as a possible substrate for the higher rate of cardiac events in blacks.

CT derived myocardial measures differ between symptomatic white and black patients, suggesting a differential relationship between myocardial adaptation and heart disease by race.

Apfaltrer, P, Abro, J, Schoepf, U, Nance, J, Bamberg, F, Vliegenthart, R, CT-derived Parameters of Myocardial Anatomy and Function in Black and White Patients with Acute Chest Pain.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12024687.html