Risk Stratification by Treadmill Exercise Echocardiography

Peteiro, Jesús; Monserrat, Lorenzo; Bouzas, Alberto; Piñón, Pablo; Mariñas, Javier; Bouzas, Beatriz; Castro‐Beiras, Alfonso

doi:10.1016/j.echo.2006.01.022

Cited by 10 publications

(3 citation statements)

References 25 publications

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“…Peteiro et al reported lower peak double product in patients with cardiac events during the follow-up period after undergoing ESE. 33 Van der Sijde et al found increased RPP max as a univariate but not multivariate predictor of long-term cardiac death in a sample of patients with both positive and negative DSE. 34 However, in the study of Mccully et al RPP max was not associated with the adverse outcome in patients with normal ESE 21 .…”

Section: Discussionmentioning

confidence: 96%

The value of negative stress echocardiography in predicting cardiovascular events among adults with no known coronary disease

Samiei

Parsaee

Pourafkari

et al. 2019

J Cardiovasc Thorac Res

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Introduction: Stress echocardiography is a safe and cost-effective method of evaluating the patients with suspected coronary artery disease (CAD). However, the risk factors of an adverse cardiovascular event after a normal exercise (ESE) or dobutamine (DSE) stress echocardiography are not well established. Methods: A cohort of 705 patients without previous history of CAD and a negative ESE/DSE was studied. All studies were performed in a high-volume echocardiologic laboratory and interpreted by two experienced echocardiography-trained cardiologists. Patients with inconclusive studies and those with an evidence of myocardial ischemia were excluded. Demographic, echocardiographic and hemodynamic findings were recorded. Patients were followed for at least 2 years. Independent predictors of major adverse cardiovascular events (MACE) were determined by regression analysis. Results: During a period of 55.7±17.5 months, MACE occurred in 35 (5.0%) of patients. Negative predictive value (NPV) of DSE was 89.2%, which was significantly less than 96.5% for ESE in predicting the occurrence of MACE (P = 0.001). MACE occurred more frequently among older (≥65 years) men with preexisting diabetes, hypertension, and/or hyperlipidemia. During ESE, a higher maximum blood pressure*heart rate product for the achieved level of metabolic equivalent (METS) of tasks was also an independent predictor of MACE. Conclusion: Inability of patients to undergo traditional ESE that led to the choice of using DSE alternative reduces the NPV of the stress echocardiography among patients without previous history of CAD. A modest rise of heart rate and blood pressure in response to increased level of activity serves as favorable prognostic value and improves the NPV of stress echocardiography.

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Section: Discussionmentioning

confidence: 96%

The value of negative stress echocardiography in predicting cardiovascular events among adults with no known coronary disease

Samiei

Parsaee

Pourafkari

et al. 2019

J Cardiovasc Thorac Res

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“…ESE also allows a better stratification of patients with low-risk Duke treadmill score, aiding in the decision whether to perform coronary angiography [26] . Several studies have shown that gender, functional capacity, rate-pressure product, resting LV function, and ischemia are independently associated with cardiac events [26,27] , and that ESE has incremental predictive value in patients with different pre-test probabilities of CAD [27] . Patients with WMA involving the territories of the 3 coronary arteries, patients with peak wall motion score index > 1.5, and patients with ischemia at a distance are at higher risk for cardiac events [28] .…”

Section: Prognostic Value Of Exercise Echocardiographymentioning

confidence: 99%

“…There are further advantages of ESE over these other techniques, including: safety (approximately 1 event/7000 in ESE, 1/700 in pharmacological stress echocardiography) [60,61] ; relatively high diagnostic accuracy (sensitivity 80% and specificity 86%) [54] , comparable to that of nuclear imaging but higher than that of exercise ECG [53] ; solid prognostic data (less that 1% events/year in patients with a negative stress echocardiogram) [22,25,27,62] ; and the fact that it is a green technology (compared to nuclear myocardial perfusion imaging and coronary computed tomographic angiography that may expose the patient to radiation levels equivalent to as many as 600 plain chest X-rays) [63] . In addition, the cost of stress echocardiography is lower than that of other noninvasive imaging techniques.…”

Section: The Competitorsmentioning

confidence: 99%

Exercise echocardiography

Peteiro

Bouzas‐Mosquera²

2010

WJC

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Exercise echocardiography has been used for 30 years. It is now considered a consolidated technique for the diagnosis and risk stratification of patients with known or suspected coronary artery disease (CAD). Of the stress echocardiography techniques, it represents the first choice for patients who are able to exercise. Given that the cost-effectiveness and safety of stress echocardiography are higher than those of other imaging techniques, its use is likely to be expanded further. Recent research has also proposed this technique for the evaluation of cardiac pathology beyond CAD. Although the role of new technology is promising, the assessment of cardiac function relies on good quality black and white harmonic images.

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Exercise Echocardiography

Piérard¹

2015

Stress Echocardiography

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Risk Stratification by Treadmill Exercise Echocardiography

Cited by 10 publications

References 25 publications

The value of negative stress echocardiography in predicting cardiovascular events among adults with no known coronary disease

The value of negative stress echocardiography in predicting cardiovascular events among adults with no known coronary disease

Exercise echocardiography

Exercise Echocardiography

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