Document Detail


Relationship between coronary artery calcification detected by electron-beam computed tomography and abnormal stress echocardiography: association and prognostic implications.
MedLine Citation:
PMID:  17113002     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to compare the results and prognostic value of electron-beam computed tomography (EBCT) and exercise echocardiography. BACKGROUND: Although patients with elevated coronary artery calcium scores (CACS) might be referred for exercise echocardiography, the association of EBCT CACS with wall motion score index (WMSI) is not known. METHODS: Patients without known coronary artery disease who underwent both clinically indicated EBCT and exercise echocardiography within a 3-month period were identified. Exercise WMSI was based on a 16-segment model (normal = 1; abnormal >1). The EBCT CACS was derived with the Agatston scoring system. Follow-up was obtained for the combined end point of death and myocardial infarction. RESULTS: The study population included 556 patients (age 54 +/- 10 years; 65% male). Correlation between EBCT CACS and exercise WMSI was limited (r = 0.17, p < 0.0001) but statistically significant. The proportion of patients with abnormal exercise WMSI increased with increasing CACS severity (chi-square = 19.1, p < 0.001). However, even in those with CACS >400, 66% had normal exercise WMSI. Age, CACS, and chest pain were independently associated with abnormal exercise WMSI. Events occurred in 12 (2%) patients. Wall motion score index (risk ratio [RR] 3.7, p = 0.023) and age (RR 1.9, p = 0.019) were associated with events. CONCLUSIONS: Electron-beam computed tomography CACS was predictive of abnormal exercise WMSI, but the majority of patients with elevated CACS had normal WMSI. Wall motion score index and age were the best predictors of events. Prospective studies are indicated to establish the relative roles of these tests in risk stratification.
Authors:
Gautam Ramakrishna; Jerome F Breen; Sharon L Mulvagh; Robert B McCully; Patricia A Pellikka
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-10-31
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  48     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2006-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2125-31     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aging
Calcinosis / diagnosis*,  mortality,  physiopathology,  therapy
Chest Pain / etiology
Coronary Artery Disease / diagnosis*,  mortality,  physiopathology,  therapy
Echocardiography, Stress*
Female
Follow-Up Studies
Heart / physiopathology
Humans
Male
Middle Aged
Myocardial Infarction / etiology
Myocardial Revascularization
Prognosis
Tomography, X-Ray Computed*

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


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