Value of exercise echocardiography for predicting mortality in elderly patients

Abstract

ExEcho is feasible in elderly patients with suspected or known coronary artery disease and provides useful information for risk stratification in these patients.

Exercise Standards for Testing and Training

“…298 Exercise echocardiography in 2159 patients >70 years (mean 75 years) with known or suspected CAD showed that the change in LV wall motion score (based on a 4-point dyskinesis ranking in each of 16 segments) from rest to peak exercise was a potent independent predictor of both death and major cardiac events. 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.…”

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

“…Although the majority of investigations have focused on prognosis by markers of ischemia in the elderly, the results generally reveal a similar accuracy of testing when compared with younger individuals presenting with SIHD. [1152][1153][1154][1155] Baseline ECG changes, arrhythmias, and LV hypertrophy, which are more common in older adults who have accumulated cardiac comorbidities, also limit the value of stress testing. 1156,1157 The higher prevalence of SIHD in older adults results in more tests that are falsely negative, and the prognostic value of the Duke treadmill score in older adults might be limited.…”

Research update for articles published in EJCI in 2010

“…Peak treadmill exercise echocardiography -the technique employed in our study [51] -has recently shown to be more sensitive than bicycle stress echocardiography, at least for detecting multivessel coronary artery disease [52]; this may be particularly relevant in elderly patients, in whom bicycle stress echocardiography is often inconclusive owing to premature interruption of exercise and ⁄ or problems of coordination.…”

“…Other n = 2 [42] FGF21 levels are increased in patients with nonalcoholic fatty liver disease and chiefly mirror the extent of hepatic steatosis X [46] Echocardiographic evaluation of the AVinterval in patients with cardiac resyn chronisation therapy was independently associated with improved clinical outcome, impacting on daily clinical practice of heart failure patient care X [51] Exercise echocardiography is feasible in elderly patients with suspected or known coronary artery disease X Exercise echocardiography in elderly patients with suspected or known coronary artery disease provides useful information for risk stratification in these patients X [55] Good CPAP compliance results in a significant C-reactive protein reduction X To achieve the best positive impact on cardiovascular morbidity and mortality, a time period of at least 6 months of CPAP use is required X [60] Acetyl-L-carnitine attenuates aortic stiffening and cardiac hypertrophy, possibly through its decrease of lipid oxidation-derived MDA ⁄ TBARS in the rats with insulin deficiency X Oxfenicine does not attenuate aortic stiffening and cardiac hypertrophy X [62] We found significant reductions in the ratios of serum functional MBL levels to oligomer mannose-binding lectin levels in hemodialysis patients compared with healthy subjects X We found significant reductions in the ratios of serum functional MBL levels to oligomer mannose-binding lectin levels in pre-hemodialysis patients compared with healthy subjects X…”