Stress echocardiography: safety and tolerability

Fennich, Nada; Ellouali, Fédoua; Abdelali, S; Chaara, A; Berrada, A; Elhajjaji, Imane; Cherradi, R; Abir, S.; Doghmi, Nawal; Cherti, Mohammed

doi:10.1186/1476-7120-11-30

Cited by 9 publications

(13 citation statements)

References 18 publications

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“…In a Moroccan study with 311 patients, 206 of whom were submitted to ESE, no major or lethal events were registered. 33 According to Sicari et al 18 pharmacological stress from dobutamine triggers severe complications in 3 of 1,000 patients, and pharmacological stress from dipyridamole triggers severe complications in 1 of 1,000 patients.…”

Section: Discussionmentioning

confidence: 99%

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Low Prevalance of Major Events Adverse to Exercise Stress Echocardiography

Andrade¹,

Telino²,

Sousa³

et al. 2016

Arquivos Brasileiros De Cardiologia

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Background:Stress echocardiography is well validated for diagnosis and risk stratification of coronary artery disease. Exercise stress echocardiography (ESE) has been shown to be the most physiological among the modalities of stress, but its safety is not well established.Objective:To study the complications related to ESE and clinical and echocardiographic variables most commonly associated with their occurrence.Methods:Cross-sectional study consisting of 10250 patients submitted to ESE for convenience, from January 2000 to June 2014. Cardiac Arrhythmias (CA) were the most frequent complications observed during the examination. The volunteers were divided into two groups according to the occurrence of CA during ESE: G1 group, composed of patients who have CA, and G2 formed by individuals who did not show such complication. Results: Group G1, consisting of 2843 patients (27.7%), and Group G2 consisting of 7407 patients (72.3%). There was no death, acute myocardial infarction, ventricular fibrillation or asystole. Predominant CAs were: supraventricular extrasystoles (13.7%), and ventricular extrasystoles (11.5%). G1 group had a higher mean age, higher frequency of hypertension and smoking, larger aortic roots and left atrium (LA) and lower ejection fraction than G2. G1 group also had more ischemic changes (p < 0.001). The predictor variables were age (RR 1.04; [CI] 95% from 1.038 to 1.049) and LA (RR 1.64; [CI] 95% from 1.448 to 1.872).Conclusion:ESE proved to be a safe modality of stress, with non-fatal complications only. Advanced age and enlargement of the left atrium are predictive of cardiac arrhythmias.

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Section: Discussionmentioning

confidence: 99%

“…However, literature on the method's safety and its complications is scarce. 32 , 33 Therefore, the objective of this study is to analyse the complications related to ESE and the clinical and echocardiographical variables that are predictors of these events.…”

Section: Introductionmentioning

confidence: 99%

Low Prevalance of Major Events Adverse to Exercise Stress Echocardiography

Andrade¹,

Telino²,

Sousa³

et al. 2016

Arquivos Brasileiros De Cardiologia

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“…20,23,24 A cohort of 4,033 patients conducted by Mathias et al. 26 has shown a positive result in 37% of them, and inconclusive result in 10%.…”

Section: Discussionmentioning

confidence: 99%

Dobutamine Stress Echocardiography Safety in Chagas Disease Patients

Rassi¹,

Vieira²,

Furtado

et al. 2017

Arquivos Brasileiros De Cardiologia

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BackgroundA few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease.ObjectivesTo assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam.MethodsRetrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed.ResultsTheir mean age was 64±10 years and most patients were females (65.4%). No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%.ConclusionDSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found.

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“…Dobutamine is the agent most commonly used in pharmacological stress tests . Severe ventricular arrhythmias may occur during the test, but such events are rare, confirming that dobutamine is safe to be used in stress echocardiography …”

Section: Introductionmentioning

confidence: 97%

“…9 Severe ventricular arrhythmias may occur during the test, but such events are rare, confirming that dobutamine is safe to be used in stress echocardiography. [10][11][12] However, there is hesitation in clinical practice in using this test for patients with CD due to the arrhythmogenic potential of the drug in a population of patients more susceptible to arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Incidence and variables associated with arrhythmias during dobutamine–atropine stress echocardiography among patients with Chagas disease

et al. 2019

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Background Dobutamine stress echocardiography (DSE) is an important tool in the diagnosis of coronary artery disease. However, there is hesitation in clinical practice for using it in patients with Chagas disease (CD) due to the arrhythmogenic potential of this heart condition. This study aimed to evaluate the incidence and variables associated with arrhythmias during DSE in a population of patients with CD. Methods A population of 205 consecutive patients with CD and suspected coronary heart disease was assessed through a retrospective database analysis. CD was confirmed in all patients by serological testing. Results The mean age of the patients selected was 64 years, and 65.4% of the patients were female. Significant arrhythmias occurred as follows: nonsustained ventricular tachycardia in 7.3% of patients; supraventricular tachycardia and sustained ventricular tachycardia in 1%; and atrial fibrillation in 0.5%. Nonsignificant arrhythmias occurred as follows: premature ventricular contractions in 48% of patients and bigeminy in 4.4%. Values for the wall‐motion score index at rest greater than 1.12 and 1.18 were independently correlated with the occurrence of nonsignificant arrhythmias (odds ratio [OR] = 2.90, P < 0.001) and significant arrhythmias (OR = 4.23, P = 0.044), respectively. Conclusion DSE should be considered a safe examination in patients with CD despite the known increased risk of arrhythmias in this group of patients. The occurrence of arrhythmias was low in this study. Abnormal wall‐motion score index values at rest were associated with the occurrence of significant and nonsignificant arrhythmias during the test.

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Stress echocardiography: safety and tolerability

Cited by 9 publications

References 18 publications

Low Prevalance of Major Events Adverse to Exercise Stress Echocardiography

Low Prevalance of Major Events Adverse to Exercise Stress Echocardiography

Dobutamine Stress Echocardiography Safety in Chagas Disease Patients

Incidence and variables associated with arrhythmias during dobutamine–atropine stress echocardiography among patients with Chagas disease

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