| Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease. | |
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MedLine Citation:
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PMID: 19825812 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Although peak may have higher sensitivity than post-treadmill exercise echocardiography (EE) for the detection of coronary artery disease (CAD), its prognostic value remains unknown. We sought to assess the relative values of peak and post-EE for predicting outcome in patients with known/suspected CAD. METHODS AND RESULTS: We studied 2947 patients who underwent EE. Wall motion score index (WMSI) was evaluated at rest, peak, and post-exercise. Ischaemia was defined as the development of new or worsening wall motion abnormalities with exercise. Separate analyses for all-cause mortality and major cardiac events (MACE) were performed. Ischaemia developed in 544 patients (18.5%). Among them, ischaemia was detected only at peak exercise in 124 patients (23%), whereas 414 (76%) had ischaemia at peak plus post-exercise imaging and six patients (1%) had ischaemia only at post-exercise. During follow-up, 164 patients died. The 5-year mortality rate was 3.5% in patients without ischaemia, 15.3% in patients with peak ischaemia alone, and 14% in patients with post-exercise ischaemia (P < 0.001 normal vs. ischaemic groups). In the multivariate analysis, post-exercise WMSI was an independent predictor of MACE [hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.09-2.19, P = 0.02]. Peak exercise WMSI was an independent predictor of MACE (HR 2.19, 95% CI 1.30-3.69, P = 0.003) and mortality (HR 1.58, 95% CI 1.07-2.35, P = 0.02). The addition of peak EE results to clinical, resting echocardiography, exercise variables, and post-EE provided incremental prognostic information for MACE (P = 0.04) and mortality (P = 0.04). CONCLUSION: Peak treadmill EE provides significant incremental information over post-EE for predicting outcome in patients with known or suspected CAD. |
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Authors:
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Jesús Peteiro; Alberto Bouzas-Mosquera; Francisco J Broullón; Ana Garcia-Campos; Pablo Pazos; Alfonso Castro-Beiras |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-10-12 |
Journal Detail:
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Title: European heart journal Volume: 31 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-15 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 187-95 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Complejo Hospitalario Universitario de A Coruña, As Xubias 84, A Coruña, Spain. pete@canalejo.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Disease / mortality*, ultrasonography Echocardiography, Stress / mortality Electrocardiography Exercise / physiology* Exercise Test / methods Female Follow-Up Studies Humans Male Middle Aged Myocardial Ischemia / mortality, ultrasonography Observer Variation Prognosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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