Document Detail

Predischarge exercise echocardiography in patients with unstable angina who respond to medical treatment.
MedLine Citation:
PMID:  1352191     Owner:  NLM     Status:  MEDLINE    
The diagnostic and prognostic value of predischarge exercise echocardiography (echo) was assessed prospectively in 36 patients with unstable angina soon after stabilization on medical treatment. Two-dimensional echo was performed at rest and immediately after a symptom-limited exercise test. Patients with previous myocardial infarction, coronary revascularization, left bundle-branch block and dilated cardiomyopathy were excluded. Left ventricular regional wall motion was analyzed visually and a wall motion score index (WMSI) was derived. Patients were followed prospectively for an average period of 26 months (range 16-34 months). The study end points were a new cardiac event defined as acute myocardial infarction or a need for coronary revascularization because of a recurrence of severe medically refractory angina. Sixteen patients (44%) had positive exercise electrocardiography (ECG), while exercise echo was positive in 22 patients (61%). Of 28 patients undergoing coronary angiography, 23 had significant coronary artery disease (CAD). The sensitivity of exercise ECG in detecting CAD was 61% while the corresponding result was 83% for exercise echo. Cardiac events occurred in 21 patients (58%). Exercise ECG was positive in 12 of these patients (57%), while a positive exercise echo was found in 17 patients (81%). There were significantly more patients with positive exercise echo among patients experiencing cardiac events than among those without cardiac events (p less than 0.01). In patients with CAD, WMSI decreased significantly after exercise (p less than 0.05). Exercise WMSI was also significantly lower in patients with CAD than in those without CAD (p less than 0.02). Exercise WMSI also discriminated patients with cardiac events from those without such events (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
A M Amanullah; K Lindvall
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  15     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-07-31     Completed Date:  1992-07-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  417-23     Citation Subset:  IM    
Department of Medicine 1, Karolinska Institute, South Hospital, Stockholm, Sweden.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angina, Unstable / drug therapy*,  ultrasonography
Aspirin / therapeutic use
Calcium Channel Blockers / therapeutic use
Cardiovascular Agents / therapeutic use*
Echocardiography / drug effects*
Exercise Test / drug effects*
Follow-Up Studies
Hemodynamics / drug effects*
Middle Aged
Myocardial Contraction / drug effects
Myocardial Infarction / ultrasonography
Nitrates / therapeutic use
Patient Discharge
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Calcium Channel Blockers; 0/Cardiovascular Agents; 0/Nitrates; 50-78-2/Aspirin

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