Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease

Peteiro, Jesús; Bouzas‐Mosquera, Alberto; Broullón, Francisco J.; García-Campos, Ana; Pazos, Pablo; Castro‐Beiras, Alfonso

doi:10.1093/eurheartj/ehp427

Cited by 63 publications

(47 citation statements)

References 30 publications

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“…On the other hand, our data confirms previous reports observing the small number of cardiac events in patients with a normal ExE [1,2] as only one patient of our cohort died of suspected cardiac causes (sudden death) and only 1 had a myocardial infarction during followup. Mortality was dramatically high but it was mainly due to lung disease.…”

Section: Discussionsupporting

confidence: 92%

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Exercise Echocardiography Findings and Outcome in Patients with Right Ventricular Dilation not Related to Left-Sided Heart Disease

Peteiro¹,

Bouzas‐Mosquera²,

Yáñez³

et al. 2017

J Cardiovasc Dis Diagn

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Objective: Symptoms may be similar in patients with heart or lung disease. Thus, patients with lung disease are occasionally referred for evaluation by exercise echocardiography (ExE). We aimed to study the clinical, ExE data and outcome of patients with right ventricular (RV) dilation not explained by left ventricular (LV) heart disease. Methods:Retrospective analysis of RV dysfunctional data in absence of LV heart disease in patients submitted to an ExE.Results: Data on RV dilation in absence of LV heart disease were found in 21 of 18,400 ExE studies (0.11%). In 4 of the 21 patients (19%) RV function and systolic pulmonary artery pressure were normal at rest. However, exercise induced RV dysfunction and/or elevated systolic pulmonary artery pressure in all of these 4 patients. During follow-up of 5.2 ± 5.7 years 11 patients died (52%), most of them of respiratory causes (73%), being pulmonary thromboembolism (PTE) (38%) the most frequent final diagnosis. Conclusion:RV dysfunction in absence of LV disease is rare among patients referred for ExE. ExE is of value as sometimes abnormalities on RV function arise only with exercise

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Section: Discussionsupporting

confidence: 92%

“…Echocardiography was performed from the apical long-axis, apical four and two-chambers, parasternal long-axis, and parasternal shortaxis views at rest, peak and post-exercise, as described [2,3]. Images at rest were taken in the decubitus lateral position, at peak exercise with the patient still exercising on the treadmill.…”

Section: Methodsmentioning

confidence: 99%

Exercise Echocardiography Findings and Outcome in Patients with Right Ventricular Dilation not Related to Left-Sided Heart Disease

Peteiro¹,

Bouzas‐Mosquera²,

Yáñez³

et al. 2017

J Cardiovasc Dis Diagn

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“…Feasibility of peak treadmill exercise imaging has been previously assessed by our group. 11,12 In 1 study, the feasibility was 99% and the percentage of patients in whom ≤13 segments were adequately visualized was 3%. 11 Previously reported intra-and interobserver agreement by our group was 100% (κ=1.0±0) and 96% (κ=0.90±0.09), respectively, for resting wall motion abnormalities (WMAs), and 92% (κ=0.83±0.16) and 96% (κ=0.91±0.09), respectively, for exercise-induced WMAs.…”

Section: Exe and Echocardiographic Analysismentioning

confidence: 99%

“…Echocardiography was performed in 3 apical views (long-axis, 4-, and 2-chamber) and 2 parasternal views (long-and short-axis) at baseline, peak exercise, 11,12 and in the immediate postexercise period.…”

Section: Exe and Echocardiographic Analysismentioning

confidence: 99%

Value of an Exercise Workload ≥10 Metabolic Equivalents for Predicting Inducible Myocardial Ischemia

Peteiro

Bouzas‐Mosquera

Broullón

et al. 2013

Circ: Cardiovascular Imaging

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Background-We sought to identify extensive ischemia on exercise echocardiography (ExE) relative to workload in patients without known coronary artery disease and to investigate whether ExE is useful in predicting outcomes in those with high exercise capacity (≥10 metabolic equivalents [METs]) plus a maximal test (≥85% of their maximal age-predicted heart rate [MAPHR]). Methods and Results-The analysis was performed on 4269 patients who underwent ExE, of whom 3995 achieved ≥85% of their MAPHR. These patients were divided according to the reached workload (<7, 7-9, or ≥10 METs) and compared for ExE results. Outcomes in the group achieving ≥10 METs plus ≥85% of their MAPHR (n=2221) were specifically assessed. Ischemia was defined as new/worsening wall motion abnormalities with exercise. ExE results were different between groups because the METs were lower. Still, among patients achieving ≥10 METs plus ≥85% of their MAPHR, 9.3% had extensive ischemia and 6% multiterritory disease. During follow-up in this subgroup, 108 patients died and 42 had a major cardiac event. Annualized mortality and major cardiac event rates were 0.84% and 0.32% in patients without ischemia versus 2.26% and 0.84% in those with ischemia, respectively (P<0.001 and P=0.002, respectively). Ischemia was an independent predictor of mortality (hazard ratio,

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“…Also, we must point out that a lower percentage of complications could result from an approach based on peak imaging as it is performed in our center. [8] Peak imaging may allow for premature cessation of the exercise in case of extensive ischemia that could be neglected if a postexercise imaging approach was just the only way to examine the patients.…”

Section: Introductionmentioning

confidence: 99%

Complications of Exercise Echocardiography. Analysis of a Cohort of 19,239 patients

Peteiro¹,

Bouzas‐Mosquera²

2017

ICFJ

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Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease

Abstract: Peak treadmill EE provides significant incremental information over post-EE for predicting outcome in patients with known or suspected CAD.

Cited by 63 publications

References 30 publications

Exercise Echocardiography Findings and Outcome in Patients with Right Ventricular Dilation not Related to Left-Sided Heart Disease

Exercise Echocardiography Findings and Outcome in Patients with Right Ventricular Dilation not Related to Left-Sided Heart Disease

Value of an Exercise Workload ≥10 Metabolic Equivalents for Predicting Inducible Myocardial Ischemia

Complications of Exercise Echocardiography. Analysis of a Cohort of 19,239 patients

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