Document Detail

Prognostic value of exercise stress test and dobutamine stress echo in patients with known coronary artery disease.
MedLine Citation:
PMID:  19017329     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to compare the feasibility of dobutamine stress echocardiography (DSE) and exercise stress test (EST) between patients in different age groups and to evaluate their proportional prognostic value in a population with established coronary artery disease (CAD). METHODS: The study sample included 323 subjects, subdivided in group 1 (G1), comprising 246 patients aged <75 years, and group 2 (G2), with 77 subjects aged >or=75 years. DSE and EST were performed before enrollment in a cardiac rehabilitation program; for prognostic assessment, end points were all-cause mortality and hard cardiac events (cardiac death or nonfatal myocardial infarction). RESULTS: During DSE, G2 patients showed worse wall motion score index (WMSI), but the test was stopped for complications in a comparable proportion of cases (54 G1 and 19 G2 patients, P = NS). EST was inconclusive in similarly high proportion of patients in both groups (76% in G1 vs. 84% in G2, P = NS); G2 patients reached a significantly lower total workload (6 +/- 1.6 METs in G1 vs. 5 +/- 1.2 METs in G2, P < 0.001). At multivariate analysis, a lower peak exercise capacity (HR 0.566, CI 0.351-0.914, P = 0.020) was associated with higher mortality, while a high-dose WMSI >2 (HR 5.123, CI 1.559-16.833, P = 0.007), viability (HR 3.354, CI 1.162-9.678, P = 0.025), and nonprescription of beta-blockers (HR 0.328, CI 0.114-0.945, P = 0.039) predicted hard cardiac events. CONCLUSION: In patients with known CAD, EST and DSE maintain a significant prognostic role in terms of peak exercise capacity for EST and of presence of viability and an extensive wall motion abnormalities at peak DSE.
Francesca Innocenti; Francesca Caldi; Irene Tassinari; Chiara Agresti; Costanza Burgisser; Francesco Fattirolli; Giorgio Jacopo Baldereschi; Niccolò Marchionni; Giulio Masotti; Riccardo Pini
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-11-01
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  26     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-07     Completed Date:  2009-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-9     Citation Subset:  IM    
Department of Critical Care Medicine and Surgery, Unit of Geriatric Cardiology, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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MeSH Terms
Age Factors
Aged, 80 and over
Coronary Artery Disease / diagnosis*,  mortality
Echocardiography, Stress*
Exercise Test*
Feasibility Studies
Follow-Up Studies
Middle Aged
Retrospective Studies
Treatment Outcome

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