Archives of the Turkish Society of Cardiology
Increased Myocardial Energy Expenditure in Cardiac Syndrome X: More Work More Pain [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-76967

Increased Myocardial Energy Expenditure in Cardiac Syndrome X: More Work More Pain

Mehmet Serkan Çetin1, Elif Hande Özcan Çetin2, Uğur Canpolat3, Mehmet Akif Erdöl2, Selahattin Aydın4, Özlem Özcan Çelebi2, Ahmet Temizhan2, Yeşim Akın2, Omaç Tüfekçioğlu2, Dursun Aras2, Serkan Topaloğlu2, Sinan Aydoğdu2
1Bülent  Ecevit  University Faculty  of  Medicine, Cardiology  Department,  Zonguldak, TURKEY
2Turkey Yuksek Ihtisas Education and  Research Hospital,  Cardiology Department, Ankara, TURKEY
3Hacettepe University Faculty  of  Medicine, Cardiology  Department, Ankara, TURKEY
4Balıkesir Atatürk State Hospital, Balıkesir, Turkey

We aimed to assess the myocardial energy expenditure (MEE) in patients with Cardiac Syndrome X (CSX) and to reveal its association with exercise ECG parameters.
99 patients who were performed coronary angiography and diagnosed as normal coronary arteries were included. Based on the patients’ symptoms and exercise ECG parameters, patients were divided into two groups: 56 CSX patients and 43 control patients with negative stress test. MEE was calculated with transthoracic echocardiography derived parameters; circumferential end-systolic stress, left ventricular ejection time and stroke volume.
In patients with CSX, MEE(min) at rest was 28% higher than the control group (89.2±36.3 vs 69.8±17.2). In correlation analysis, a moderately negative correlation between MEE and Duke treadmill score was determined (β: -0.456, p<0.001). In ROC analysis, a cut-off value of 74.6 cal/min for MEE had 78.1% sensitivity and 75.3% specificity for prediction of CSX (AUC: 0.872, p<0.001). An extra 1 calorie spent per minute at rest increased the likelihood of a CSX by about 86% (OR: 1.863).
Our study demonstrated that MEE was increased in CSX patients compared with control groups. Increased MEE was determined to be an independent predictor of CSX. DTS, which is a indicator of poor prognosis, reversely correlated with MEE. Increased MEE may have a crucial role in CSX pathophysiology.

Keywords: Myocardial Energy Expenditure, Cardiac Syndrome X, Duke score

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Corresponding Author: Elif Hande Özcan Çetin, Türkiye
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