As the ACC Middle East 2025 Together With 16th Emirates Cardiac Society Conference winds down in Dubai, UAE, the three winners of the conference's abstract competition were announced and invited to present at ACC.26 in New Orleans, LA. The winning abstracts covered a wide range of topics: non-HDL-C levels in Middle Eastern patients with atherosclerotic cardiovascular disease (ASCVD), the effect of left ventricle mass index (LVMI) on right ventricle (RV) impairment, and comparative efficacy of imaging agents in detecting coronary artery disease (CAD).

Non-HDL-C in Middle Eastern Patients

The first study, conducted by Osama Alkouri et al., used data from the Jordan SMuRF-less study and six Middle Eastern cardiovascular registries and found that out of 2,763 patients with ASCVD, the 54% that had high non-HDL-C tended to be younger (55 years vs. 60 years, p<0.001) and more likely to smoke (52.6% vs. 43.1%). They more commonly had dyslipidemia (90.8% vs. 75.8%), acute coronary syndrome (88.1% vs. 83.7%), and both worse LDL-C (141.3 vs. 81.1 mg/dL) and triglycerides (221.4 vs. 140.9 mg/dL) – but were less likely to have hypertension (51.0% vs. 64.2%) and heart failure (15.4% vs. 25.0%). Age <60 years (OR=0.45), hypertension (OR=0.74) and heart failure (OR=0.61) were all inversely associated with high non-HDL-C (p<0.01). "These findings support [non-HDL-C]'s use as a secondary lipid target and call for region-specific guidelines and early intervention strategies," write Alkouri and colleagues.

LVMI and LV Geometric Pattern on RV Impairment

In the next winning study, out of Egypt, Loay Solima, MSC, et al., found RV dysfunction (Right Ventricular Ejection Fraction <42%) present in half of 150 patients with hypertension undergoing CT angiography, which correlated with both higher LVMI and abnormal LV geometry. LV geometry and relative wall thickness were independent predictors of RV dysfunction (p<0.001). "Hypertension, a major cardiovascular risk factor, primarily affects the left ventricle (LV), while its impact on the right ventricle (RV) is often under-recognized," write Soliman et al. Furthermore, LVMI was negatively correlated with RVEF (r=–0.635) and tricuspid annular plane systolic excursion (TAPSE) (r=–0.500) and positively correlated with RV end-systolic volume (RVESV) and RV end-diastolic volume (RVEDV). Across LV geometry groups, there were significant differences in all four: RVEF, TAPSE, RVEDV and RVEDV.

Flurpiridaz F 18 PET MPI vs. SPECT MPI

Lastly, a metanalysis by Beyzanur Güney et al., out of Turkey, found that flurpiridaz F 18 (Flyrcado) PET myocardial profusion imaging (MPI) agent had superior diagnostic performance compared to SPECT MPI in detecting significant CAD in adults with known or suspected CAD – particularly in terms of sensitivity (0.762 vs. 0.609) and overall diagnostic accuracy, including diagnostic ratio (7.878 vs. 4.575). PET also had comparable specificity (0.711 vs. 0.744), a slightly higher positive likelihood ratio (2.611 vs. 2.367), and notably lower negative likelihood ratio (2.611 vs. 2.367). While 49% of patients reported adverse events, only a pooled rate of 3% across studies were found to be related to the drug. "While general adverse events were common, the low rate of radiotracer-related events supports a favorable safety profile for clinical use," write Güney and colleagues.

Clinical Topics: Noninvasive Imaging, Nuclear Imaging

Keywords: Myocardial Perfusion Imaging, Ventricular Function, Right, Heart Disease Risk Factors