title: Clinical and angiographic correlates of left ventricular dysfunction in patients with three vessel coronary disease.
abstract: BACKGROUND
  Among patients with advanced multivessel coronary disease, left ventricular (LV) function is widely variable, and clinical and angiographic correlates of ventricular dysfunction remain to be defined.
  
  
  METHODS
  Among 73 339 patients undergoing diagnostic cardiac catheterization at a single center in China, patients with left ventriculographic assessment were identified with three-vessel coronary disease with or without left main involvement. Clinical and angiographic characteristics were examined among patients with normal or varying extent of LV dysfunction, and predictors of LV impairment (ejection fraction (EF): < 25%, 25% - 40% or > 40%) were determined.
  
  
  RESULTS
  Among 11 950 patients identified with three-vessel coronary disease, the sample distribution of LVEF was > 40%, n = 10 776; 25% - 40%, n = 948; < 25%, n = 226. Patients with reduced LV function (< 40%) more commonly were male and had a history of myocardial infarction (MI), diabetes or unstable angina. Hypertension was more frequent in those with LVEF ≥ 40%. In a multivariate Logistic regression analysis, prior MI (odds ratio (OR), 3.37; 95% confidence interval (CI), 2.96 - 3.84) was most predictive of LVEF < 40%, followed by male gender, diabetes, and presentation with unstable angina. For LVEF < 25%, only prior MI was identified as a significant correlate of severe LV dysfunction (OR 4.06, 95%CI 3.06 - 5.39). Following exclusion of patients with previous MI (n = 7416), male gender and diabetes were predictive of LVEF < 40%, yet presentation with unstable angina was the only factor significantly associated with LVEF < 25%.
  
  
  CONCLUSIONS
  Among individuals identified with three-vessel coronary disease with or without left main involvement, previous MI was the most significant risk factor of LV dysfunction.
authors.affiliation: Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Gao
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Yue-Jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: David E
authors.initials: DE
authors.lastname: Kandzari
authors.forename: Jin-Qing
authors.initials: JQ
authors.lastname: Yuan
authors.forename: Jue
authors.initials: J
authors.lastname: Chen
authors.forename: Ji-Lin
authors.initials: JL
authors.lastname: Chen
authors.forename: Shu-Bin
authors.initials: SB
authors.lastname: Qiao
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Wu
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Yan
authors.forename: Xue-Wen
authors.initials: XW
authors.lastname: Qin
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Dai
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: Si-Yong
authors.initials: SY
authors.lastname: Teng
authors.forename: Run-Lin
authors.initials: RL
authors.lastname: Gao
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000473:pathology* / Q000503:physiopathology