{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:01:23Z","timestamp":1768554083339,"version":"3.49.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,20]],"date-time":"2017-02-20T00:00:00Z","timestamp":1487548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Canadian Institutes of Health Research, University of British Columbia Division of Cardiology, AstraZeneca, Abbott Vascular, St. Jude Medical, and Servier"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Background<\/jats:title>Spontaneous healing of spontaneous coronary artery dissection (SCAD<\/jats:styled-content>) and left ventricular ejection fraction (LVEF<\/jats:styled-content>) recovery is frequently observed clinically. However, LVEF<\/jats:styled-content> on presentation and follow\u2010up imaging has not been described.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>We hypothesize that LV dysfunction improves at follow\u2010up after initial SCAD presentation.<\/jats:p><\/jats:sec>Methods<\/jats:title>We included patients with nonatherosclerotic SCAD<\/jats:styled-content> prospectively followed at Vancouver General Hospital, who had baseline assessment of LVEF<\/jats:styled-content> and wall\u2010motion abnormality (WMA<\/jats:styled-content>) during their index presentation. A subset of these patients had repeat assessment of their ventricular function at follow\u2010up. We compared the baseline LVEF<\/jats:styled-content> and WMA<\/jats:styled-content> with follow\u2010up assessments and correlated to long\u2010term cardiovascular outcomes.<\/jats:p><\/jats:sec>Results<\/jats:title>We included 277 SCAD<\/jats:styled-content> patients who had baseline ventricular assessment performed. The average age was 52.4\u2009\u00b1\u20099.4\u2009years, and 90.3% were female. All presented with myocardial infarction (24.2% STEMI<\/jats:styled-content>, 75.8% NSTEMI<\/jats:styled-content>). At baseline, the mean LVEF<\/jats:styled-content> was 55.6%\u2009\u00b1\u20099.1% and 72\/277 (26.0%) had LVEF<\/jats:styled-content> <50%. The presence of WMA<\/jats:styled-content> was observed in 237\/277 (85.6%) cases. Of 164 patients with repeat assessments, the baseline LVEF<\/jats:styled-content> was 54.6%\u2009\u00b1\u20099.2%, with improvement to 60.7%\u2009\u00b1\u20097.2% at follow\u2010up (P<\/jats:italic> < 0.001). Baseline LVEF<\/jats:styled-content> of <50% was observed in 29.9%, but only 6.7% had LVEF<\/jats:styled-content> <50% at follow\u2010up (P<\/jats:italic> < 0.001). Baseline WMA<\/jats:styled-content> was observed in 87.2% but decreased to 44.5% at follow\u2010up (P<\/jats:italic> < 0.001). Multivariable analysis showed that presentation with STEMI<\/jats:styled-content> (odds ratio [OR<\/jats:styled-content>]: 2.71, P<\/jats:italic> = 0.001), troponin I >50\u2009\u00b5g\/L (OR<\/jats:styled-content>: 1.02, P<\/jats:italic> = 0.005), and SCAD<\/jats:styled-content> involvement of the LAD<\/jats:styled-content> (OR<\/jats:styled-content>: 2.5, P<\/jats:italic> = 0.002) were independent predictors of baseline LVEF<\/jats:styled-content> <50%.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In our large, prospectively followed SCAD<\/jats:styled-content> cohort, the majority of patients presented with WMA<\/jats:styled-content> and had relatively normal LVEF<\/jats:styled-content>. Over half had subsequent normalization of WMA<\/jats:styled-content> and LVEF<\/jats:styled-content> on follow\u2010up assessment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22640","type":"journal-article","created":{"date-parts":[[2017,2,20]],"date-time":"2017-02-20T12:57:13Z","timestamp":1487595433000},"page":"149-154","source":"Crossref","is-referenced-by-count":35,"title":["Changes in left ventricular function after spontaneous coronary artery dissection"],"prefix":"10.1002","volume":"40","author":[{"given":"Christopher","family":"Franco","sequence":"first","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Starovoytov","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milad","family":"Heydari","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.B. John","family":"Mancini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eve","family":"Aymong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7027-984X","authenticated-orcid":false,"given":"Jacqueline","family":"Saw","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Vancouver General Hospital University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,20]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"133","article-title":"Spontaneous coronary artery dissection: novel insights on diagnosis and management","volume":"5","author":"Alfonso F","year":"2015","journal-title":"Cardiovasc Diagn Ther."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2012.12.018"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.10.023"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.017"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001760"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2013.12.002"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(01)01680-0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25293"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26022"},{"key":"e_1_2_6_11_1","article-title":"The angiographic definitions of the Bypass Angioplasty Revascularization Investigation","volume":"3","author":"Alderman EL","year":"1992","journal-title":"Coron Artery Dis."},{"issue":"1073","key":"e_1_2_6_12_1","first-page":"e5","article-title":"Spontaneous coronary artery dissection misdiagnosed as takotsubo cardiomyopathy: a case series","volume":"31","author":"Chou AY","year":"2015","journal-title":"Can J Cardiol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2008.00870.x"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22640","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22640","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T10:53:59Z","timestamp":1696589639000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,20]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1002\/clc.22640"],"URL":"https:\/\/doi.org\/10.1002\/clc.22640","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,20]]}}}