Prognostic value of exercise echocardiography in 2,632 patients ≥65 years of age

Abstract

Exercise echocardiography provides incremental prognostic information in patients > or = 65 years of age. The best model included clinical, exercise testing and exercise echocardiographic variables.

Stress Echocardiography Positivity Predicts Cancer Death

“…As expected and in keeping with previous extensive evidences,6, 7, 8, 9, 10, 11, 12, 13 a negative SE was associated with a significantly lower death rate compared with patients with positive SE. However, the 25‐year mortality difference between patients with SE positive versus those with SE negative results, albeit significant because of the large sample size, was modest: 70% versus 60% for all‐cause death and 40% versus 31% for cardiovascular death.…”

“…The prognostic value of SE was shown initially for cumulative end points, mainly consisting of soft end points such as recurrence of angina or coronary revascularization,5, 6, 7, 8 later for hard end points such as myocardial infarction (MI)9, 10 and—as data matured—for all‐cause death and cardiac death 11, 12, 13. The clinical meaning of the prognostic stratification is based not only on statistical but also on biological plausibility 14.…”

Exercise Standards for Testing and Training

“…206,299 This confirmed data in a series of 335 octogenarians in whom LV wall motion score stratified patients into low-and high-risk groups with annualized event rates of 1.2% and 5.8% per year, respectively, 300 and an earlier study of patients whose mean age was 72 years. 301 Exercise radionuclide imaging has also shown prognostic utility in this age group. 302 The use of exercise testing for risk stratification, exercise prescription, and assessment of therapeutic intervention in this "older old" population will continue to increase with changing demographics.…”

Stress Testing and Its Role in Coronary Artery Disease

“…In three reviews, exercise echocardiography (compared to coronary angiography) had a sensitivity of 79 to 85 percent and a specificity of 72 to 87 percent for the diagnosis of coronary artery disease (Fleischmann, 1998) (Kim, 2001) (Arruda, 2001). False negative results are more likely with sub-maximal exercise, single vessel disease, and moderate (50 to 70 percent) stenoses (Marwick, 1992).…”