Background: Myxomas are the most common primary cardiac tumors. Angiographically detectable neovascularity
(ADN) of myxoma is increasingly being reported as a result of the use of coronary
angiography (CAG) to detect coronary artery disease. However, the clinical significance
of these findings is not fully understood.
Methods: We enrolled 59 patients with cardiac myxoma who also underwent CAG between January
2013 and October 2018. Patients were followed up for a mean of 28.9 months (range
1–69 months). The clinical features, echocardiography measurements, pathological examination
findings, CAG results, and outcomes during follow-up were compared between patients
with ADN and patients without ADN.
Results: ADN was found in 25 patients (42.4%). The arteries feeding the ADN included the right
coronary artery (
n=15), the left circumflex coronary artery (
n=7), and both arteries (
n=3). The patients with ADN had a higher proportion of eosinophils (3.2% vs. 2.2%,
P=0.03) and higher low-density lipoprotein cholesterol level (2.7 mmol/L vs. 2.2 mmol/L,
P=0.02). Myxoma pedicles were more likely to be located in the interatrial septum
in patients with ADN (96% vs. 73.5%, P=0.02). No significant correlation was observed
between the groups in clinical manifestations, atrial arrhythmia, myxoma size, cardiac
chamber size, left ventricular ejection fraction, and the prevalence of complication
with coronary artery disease [16% in the ADN group (
n=4) vs. 20.6% in the non-ADN group (
n=7), P=0.66]. However, patients with ADN tended to have a lower incidence of major
adverse cardiac and cerebrovascular events on long-term follow-up (0% vs. 14.7%, P=0.07).
Conclusion: CAG-detected ADN in patients with cardiac myxoma is associated with a borderline
lower rate of major adverse cardiac and cerebrovascular events.
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