Document Detail


Treadmill exercise echocardiography as a predictor of events in patients with left ventricular hypertrophy.
MedLine Citation:
PMID:  20379141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exercise echocardiography (EE) is recommended for patients with known/suspected coronary artery disease (CAD) and electrocardiogram (ECG) abnormalities. Left ventricular hypertrophy (LVH) is associated with worse outcome and patients with LVH have frequently resting ECG abnormalities. We sought to assess the value of EE for predicting outcome in patients with known/suspected CAD and LVH.
METHODS: Retrospective analysis over 1,058 patients, classified according to the presence (n = 557) or absence (n = 501) of LVH (LV mass > or =163 g for women, > or =225 g for men) who underwent EE. Wall motion score index (WMSI) was evaluated at rest and with exercise. Ischemia was defined as the development of new or worsening wall motion abnormalities (WMA) with exercise. The endpoints were all-cause mortality and major cardiac events (MACE). Overall, 352 patients (33%) developed new/worsening WMA.
RESULTS: During a follow-up of 4.6 +/- 4.0 years, 178 patients died and 129 had a MACE. The 5-year mortality and MACE rates were 6.4 and 7.1% in patients without ischemia vs. 15.3 and 13.6% in those with ischemia, respectively (P < 0.001). In the multivariable analysis, LV mass (hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.02-1.04, P = 0.008) and DeltaWMSI (HR 1.94, 95% CI 1.12-3.35, P = 0.02) were independent predictors of mortality. DeltaWMSI was also an independent predictor of MACE in the overall population (P = 0.002) and in patients with LVH (P = 0.04).
CONCLUSION: LV mass independently predicts mortality, even when EE data are considered. EE provides significant information for predicting events in patients with LVH and known/suspected CAD.
Authors:
Jesús Peteiro; Alberto Bouzas-Mosquera; Francisco Broullón; Pablo Pazos; Rodrigo Estevez-Loureiro; Alfonso Castro-Beiras
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-08
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-09-23     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  794-801     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain. pete@canalejo.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Echocardiography, Stress*
Endpoint Determination
Exercise Test
Female
Humans
Hypertrophy, Left Ventricular / mortality*,  ultrasonography*
Male
Middle Aged
Predictive Value of Tests
Prognosis
Comments/Corrections
Comment In:
Am J Hypertens. 2010 Jul;23(7):706   [PMID:  20559291 ]

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


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