Document Detail

Prediction of ischemic events by anatomic M-mode strain rate stress echocardiography.
MedLine Citation:
PMID:  18187305     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We assessed the prognostic value of anatomic M-mode strain rate stress echocardiography (SRSE) in patients with known or suspected coronary artery disease. Previous studies showing that M-mode SRSE may be an accurate method for detection of coronary artery disease suggest that this technique may be useful for risk stratification. METHODS: M-mode SRSE, using a color-coded display of strain rate (SR), was performed in 358 patients (48, dobutamine; 68, bicycle; 242, treadmill). SR was graded by visual assessment of the color-coded display in 12 apical segments. Abnormal rest SR was defined as SR more positive than -1/s (green-yellow). Ischemia was defined by the development of post-systolic shortening or lack of improvement of SR to more negative than -2/s (brown hue) with stress. Patients were followed for cardiac events. RESULTS: Twelve patients with early intervention for an abnormal two-dimensional stress echocardiogram or stress electrocardiogram were excluded. Follow-up (mean 10.7 months) was completed in 98% (338/346) of the remaining patients. Events occurred in 1.7% (4/230) of patients with normal SRSE compared with 10% (11/108) with abnormal SRSE (P = .002). The annualized hard event (infarction, death) rate in those with normal SRSE was 0.5% versus 7.2% in those with abnormal SRSE (P = .001). Smoking (P = .048, relative risk 2.91), nitrate use (P = .001, relative risk 7.81), and the severity of the abnormality on SRSE (P = .009, relative risk 1.75) independently predicted events. Wall motion assessment was not predictive. Patients with normal SRSE had better event-free survival compared with those with abnormal SRSE (P < .001). CONCLUSION: SRSE is an independent predictor of outcome. A normal SRSE predicts a low risk of infarction or death in short-term follow-up.
Ronald Mastouri; Jothiharan Mahenthiran; Masoor Kamalesh; Irmina Gradus-Pizlo; Harvey Feigenbaum; Stephen G Sawada
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-09
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-306     Citation Subset:  IM    
Department of Medicine, Indiana University Medical Center and the Krannert Institute of Cardiology, Indianapolis, Indiana, USA.
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MeSH Terms
Dobutamine / diagnostic use*
Echocardiography, Doppler, Color / methods*
Elasticity Imaging Techniques / methods*
Exercise Test / methods*
Image Enhancement / methods
Image Interpretation, Computer-Assisted / methods
Information Storage and Retrieval / methods*
Middle Aged
Myocardial Ischemia / complications,  ultrasonography*
Reproducibility of Results
Sensitivity and Specificity
Ventricular Dysfunction, Left / etiology,  ultrasonography*
Reg. No./Substance:
Comment In:
J Am Soc Echocardiogr. 2008 Apr;21(4):307-8   [PMID:  18394530 ]

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

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