Document Detail

Prognostic value of dobutamine stress echocardiography in patients with diabetes.
MedLine Citation:
PMID:  12663576     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in patients with diabetes. The role of pharmacologic stress echocardiography in the risk stratification of diabetic patients has not been well defined. RESEARCH DESIGN AND METHODS: We studied 396 diabetic patients (mean age 61 +/- 11 years, 252 men [64%]) with limited exercise capacity who underwent DSE for evaluation of known or suspected coronary artery disease (CAD). End points were hard cardiac events (cardiac death and nonfatal myocardial infarction) and all causes of mortality. RESULTS: During a median follow-up of 3 years, 97 patients (24%) died (55 cardiac deaths), and 27 patients had nonfatal myocardial infarction. In an incremental multivariate analysis model, clinical predictors of hard cardiac events were history of congestive heart failure, previous myocardial infarction, hypercholesterolemia, and ejection fraction at rest. The percentage of ischemic segments was incremental to the clinical model in the prediction of hard cardiac events (chi(2) = 37 vs. 18, P < 0.05). Clinical predictors of all causes of mortality were history of congestive heart failure, age, hypercholesterolemia, and ejection fraction at rest. Wall motion score index at peak stress was incremental to the clinical model in the prediction of mortality (chi(2) = 52 vs. 43, P < 0.05). CONCLUSIONS: DSE provides incremental data for the prediction of mortality and hard cardiac events in patients with diabetes who are unable to perform an adequate exercise stress test.
Fabiola B Sozzi; Abdou Elhendy; Jos R T C Roelandt; Ron T van Domburg; Arend F L Schinkel; Eleni C Vourvouri; Jeroen J Bax; Johan De Sutter; Alberico Borghetti; Don Poldermans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes care     Volume:  26     ISSN:  0149-5992     ISO Abbreviation:  Diabetes Care     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-28     Completed Date:  2003-10-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1074-8     Citation Subset:  IM    
Erasmus Medical Centre, Rotterdam, The Netherlands.
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MeSH Terms
Adrenergic beta-Agonists / diagnostic use*
Coronary Disease / mortality,  physiopathology,  ultrasonography*
Diabetic Angiopathies / mortality,  physiopathology*,  ultrasonography*
Disease-Free Survival
Dobutamine / diagnostic use*
Echocardiography / methods
Exercise Test / methods*
Follow-Up Studies
Heart Failure / epidemiology
Hypercholesterolemia / epidemiology
Image Processing, Computer-Assisted
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Survival Analysis
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine

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