Document Detail


Exercise echocardiography and thallium-201 single-photon emission computed tomography stress test for 5- and 10-year prognosis of mortality and specific cardiac events.
MedLine Citation:
PMID:  12415225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limited data suggest that stress myocardial perfusion imaging and stress echocardiography have similar prognostic value for composite cardiac events. However, it is not known whether exercise echocardiography and stress thallium are similar in their prediction of specific cardiac events, eg, death, sudden death, myocardial infarction, unstable angina, and congestive heart failure. A total of 206 patients undergoing stress echocardiography and thallium-201 single-photon emission computed tomography imaging during the same exercise test were followed-up for 5 and 10 years. Multivariate Cox regression analyses incorporating clinical, exercise stress test, echocardiographic, and nuclear imaging parameters were used to predict mortality and specific cardiac events. A moderate to large amount of ischemia (> or =4 segments on the basis of a 16-segment model) by exercise stress echocardiography was the strongest predictor of overall mortality (relative risk [RR] 6.2; P <.0001), cardiac death (RR 17.6; P =.01), congestive heart failure (RR 17.4; P =.0005) or sudden death (RR 26.8; P =.003), whereas a moderate to large fixed defect (> or =2 segments on the basis of a 6-segment model) by nuclear imaging was the strongest predictor of myocardial infarction (RR 8.1; P =.0002) or unstable angina (RR 3.0; P =.005) at 5 years. The heterogeneity in the prediction of these specific cardiac events by these 2 modalities was similarly observed at 10 years. The extent of ischemia by stress echocardiography is a better predictor of overall mortality, cardiac death, congestive heart failure, or sudden death, whereas the extent of a fixed defect by nuclear imaging is a better predictor of myocardial infarction or unstable angina.
Authors:
Azizul Hoque; Mohammed Maaieh; Rita A Longaker; Marcus F Stoddard
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  15     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2003-03-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1326-34     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, University of Louisville, Kentucky 40292, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Coronary Disease / mortality,  radionuclide imaging*,  ultrasonography*
Echocardiography, Stress / methods*
Exercise Test
Follow-Up Studies
Humans
Kentucky / epidemiology
Middle Aged
Prognosis
Proportional Hazards Models
Prospective Studies
Survival Rate
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

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


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