Prognostic value of supine bicycle exercise stress echocardiography in patients with known or suspected coronary artery disease

D’Andrea, Antonello; Severino, Sergio; Caso, Pio; Liccardo, Biagio; Forni, Alberto; Fusco, Angela; Piccolo, R. Lo; Scherillo, Marino; Mininni, N; Calabrò, Raffaele

doi:10.1016/j.euje.2004.11.001

Cited by 16 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies show that the extent and severity of ischemia induced by exercise are strong predictors of AMI and cardiac death 18,33,34 , which confirms the results of this study in which myocardial ischemia, estimated by ΔLVWMSI, has been a predictor of adverse cardiac events.…”

Section: Discussionsupporting

confidence: 89%

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Calasans¹,

Santos²,

Silveira³

et al. 2013

Arquivos Brasileiros De Cardiologia

View full text Add to dashboard Cite

BackgroundExercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. ObjectiveTo assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). ResultsG1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). ConclusionPositive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET.

show abstract

Section: Discussionsupporting

confidence: 89%

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Calasans¹,

Santos²,

Silveira³

et al. 2013

Arquivos Brasileiros De Cardiologia

View full text Add to dashboard Cite

show abstract

“…In such cases, it is crucial to rule out coronary artery disease (CAD) or congenital anomalies of the coronary arteries, both in terms of their origin and course [13]. For instance, CAD is diagnosed using ESE with moderate sensitivity and specificity (about 76 and 88%, respectively), comparing favorably with other stress-testing methods [14]. The choice between ESE and other third-line diagnostic modalities for the assessment of CAD in athletes is still a debated point in the literature (Table 2) [2].…”

Section: Exercise-induced Ischemiamentioning

confidence: 99%

Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges

Palermi,

Sperlongano,

Mandoli

et al. 2023

JCM

View full text Add to dashboard Cite

This comprehensive review explores the role of exercise stress echocardiography (ESE) in assessing cardiovascular health in athletes. Athletes often exhibit cardiovascular adaptations because of rigorous physical training, making the differentiation between physiological changes and potential pathological conditions challenging. ESE is a crucial diagnostic tool, offering detailed insights into an athlete’s cardiac function, reserve, and possible arrhythmias. This review highlights the methodology of ESE, emphasizing its significance in detecting exercise-induced anomalies and its application in distinguishing between athlete’s heart and other cardiovascular diseases. Recent advancements, such as LV global longitudinal strain (GLS) and myocardial work (MW), are introduced as innovative tools for the early detection of latent cardiac dysfunctions. However, the use of ESE also subsumes limitations and possible pitfalls, particularly in interpretation and potential false results, as explained in this article.

show abstract

“…Cardiovascular imaging during exercise, if feasible, has been favoured over pharmacologically induced stress imaging (Guazzi et al, 2017). However, despite the publication of various exercise CMR studies since 1995, implementation in clinical practice is still not established (Alonso‐Gonzalez et al, 2013; D'Andrea et al, 2005; Diller et al, 2005; Habert et al, 2018; Jaijee et al, 2018; La Gerche et al, 2011; Lau et al, 2016; Malhotra et al, 2016; Pellikka et al, 2007; Popovic et al, 2019; Roest et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Standardizing submaximal exercise intensities for use of supine push–pull exercise during cardiovascular magnetic resonance

Steenhorst

Hirsch

Berg

et al. 2022

Clin Physio Funct Imaging

View full text Add to dashboard Cite

Background Cardiovascular magnetic resonance (CMR) imaging during supine exercise at (sub)maximal oxygen consumption (VO2) offers unique diagnostic insights. However, maximal VO2 is not achievable in the supine position and standardizing submaximal exercise intensities remains challenging. Using heart rate or workload could be a viable option to translate VO2‐based submaximal exercise intensities. Aim To translate submaximal exercise intensities upright cycling exercise (UCE) to supine push–pull exercise (SPPE), by comparing heart rate or workload determined during UCE, with heart rate and workload during SPPE at similar exercise intensities. Methods and Results Sixteen healthy young adults (20.4 ± 2.2 years; 8 female) underwent cardiopulmonary UCE and SPPE testing [mean ± standard deviation maximal VO2: 3.2 ± 0.6 vs. 5 ± 0.3 L min−1, p < 0.001 and median (interquartile range) of the maximum workload: 310 (244, 361) vs. 98 (98, 100), p < 0.001, respectively]. Heart rate at 40% and 60% of maximal VO2, as determined by UCE, showed low bias (−3 and 0 bpm, respectively) and wide limits of agreement (±26 and ±28 bpm, respectively), in Bland–Altman analysis. VO2/Workload relation was exponential and less efficient during SPPE compared to UCE. Generalized estimated equation analysis predicted model‐based mean workload during SPPE, with acceptable 95% confidence interval. Conclusion Heart rate during UCE at submaximal exercise intensities can reasonably well be used to for SPPE in healthy subjects. Using workload, an ergometer specific, model‐based mean can be used to determine exercise intensities during SPPE. Individual variations in response to posture and movement change are high. During clinical interpretation of exercise CMR, individual exercise intensity has to be considered.

show abstract

Prognostic value of supine bicycle exercise stress echocardiography in patients with known or suspected coronary artery disease

Cited by 16 publications

References 30 publications

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges

Standardizing submaximal exercise intensities for use of supine push–pull exercise during cardiovascular magnetic resonance

Contact Info

Product

Resources

About