Document Detail


Usefulness of high functional capacity in patients with exercise-induced ST-depression to predict a negative result on exercise echocardiography and low prognostic risk.
MedLine Citation:
PMID:  18489930     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although exercise electrocardiography (ExECG) is commonly used to detect coronary artery disease, the diagnostic accuracy and reliability of positive (ischemic) results of ExECG in low- and intermediate-risk populations are limited. Accordingly, many patients with positive results of ExECG undergo secondary evaluation using noninvasive stress imaging such as exercise echocardiography. Functional capacity is a strong predictor of prognosis and, indirectly, of high-risk coronary artery disease. It was hypothesized that high functional capacity in patients with positive results of ExECG would predict (1) negative results on subsequent exercise echocardiography and (2) a low risk for late mortality. Results were analyzed in 104 consecutive patients (79 men, 25 women; mean age 49 years, range 27 to 76) referred for exercise echocardiography after positive results of ExECG with a treadmill workload of > or =10 METs. Late all-cause mortality was also determined in these patients. Exercise echocardiographic results were negative in 93% of patients (97 of 104; 92% of men [73 of 79] and 100% of women [25 of 25]) and positive in 7% (7 of 104). During a mean follow-up period of 7.2 +/- 1.9 years, there was 1 death. In conclusion, high functional capacity in patients with positive results of ExECG is associated with negative exercise echocardiographic results in most patients and very low late mortality. Patients with ischemic ST-segment response on ExECG who achieve workloads of > or =10 METs infrequently require additional noninvasive or invasive evaluation.
Authors:
Amogh Bhat; Amish Desai; Ezra A Amsterdam
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1541-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of California, Davis, Medical Center, Sacramento, California, USA.
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MeSH Terms
Descriptor/Qualifier:
California / epidemiology
Coronary Disease / diagnosis*,  epidemiology,  physiopathology
Disease Progression
Echocardiography, Stress / methods*
Electrocardiography*
Exercise Test / adverse effects*,  methods
Exercise Tolerance / physiology*
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Predictive Value of Tests
Prognosis
Reproducibility of Results
Retrospective Studies
Risk Factors
Survival Rate / trends

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


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