Document Detail


Clinical applicability of echocardiographically detected regional wall-motion abnormalities provoked by upright treadmill exercise.
MedLine Citation:
PMID:  10149875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exercise electrocardiography is the time-honored screening test for coronary artery disease but has serious limitations in many patient subgroups. A number of adjunctive modalities have been coupled to exercise ECG to increase the diagnostic accuracy of noninvasive testing, including thallium scintigraphy and gated blood pool radioventriculography. Exercise echocardiography has more recently emerged as a tool that can detect exercise-induced regional wall-motion abnormalities as an indicator of provoked myocardial ischemia. While there are conceptual advantages to performing echocardiography during maximal exercise, we have found that regional wall-motion analysis performed with echocardiograms obtained before and immediately after upright treadmill exercise allows highly accurate prediction of the extent and distribution of coronary artery disease as detected by angiography. This monograph summarizes our experience with this form of exercise echocardiography in three important patient groups: (1) patients being screened for the presence or absence of coronary artery disease; (2) patients who have undergone previous coronary artery bypass surgery and who are being evaluated for graft failure and/or progression of native-vessel disease; and (3) patients who have undergone coronary angioplasty and are at risk for restenosis and/or progression of disease. We believe, based on our experience and that of other investigators, that exercise echocardiography is a uniquely valuable tool in these and other patients for assessing the status of the coronary vascular anatomy. Not only can the presence or absence of obstructive disease be assessed, but the extent and distribution of disease can be accurately predicted, and other, noncoronary causes of chest pain such as aortic stenosis, mitral valve prolapse, hypertrophic cardiomyopathy, and pericardial disease can readily be identified.
Authors:
L J Crouse; P H Kramer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  9     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-08-27     Completed Date:  1992-08-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  97-106     Citation Subset:  T    
Affiliation:
Mid-America Cardiology Associates, Mid-America Heart Institute, St. Luke's Hospital, Kansas City, Missouri.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Coronary Disease / physiopathology,  ultrasonography*
Echocardiography / methods*
Exercise Test / methods*
Humans
Posture
Recurrence
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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