Long-term prognostic importance of transient left ventricular dilation during pharmacologic stress echocardiography
Leopoldo Pérez de Isla1, José Zamorano, Carlos Almería
1Echocardiographic Laboratory, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Insights
Left ventricular transient ischemic dilation (TID) during stress echocardiography (SE) is a significant predictor of long-term prognosis. Identifying TID helps pinpoint patients with higher risks for adverse cardiac events.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Prognostic Biomarkers
Background:
- Transient ischemic dilation (TID) during stress echocardiography (SE) is associated with extensive coronary artery disease.
- Long-term prognostic implications of TID during SE have not been previously reported.
Purpose of the Study:
- To evaluate the prognostic significance of left ventricular (LV) TID in patients with a positive SE.
- To determine if TID is an independent predictor of long-term outcomes.
Main Methods:
- 99 consecutive patients with a positive SE were included.
- LV volumes were assessed using the modified Simpson's rule.
- TID was defined as an increase in LV end-diastolic volume during stress; patients were followed clinically.
Main Results:
- 32.3% of patients exhibited TID, with a higher mean age in the TID group (70.2 vs. 65.8 years).
- Mean follow-up was 21.4 months.
- TID was an independent predictor of long-term prognosis (RR=6.9, P=.042), with survival free of acute myocardial infarction being shorter in the TID group (39.7 vs. 47.28 months).
Conclusions:
- LV TID during SE is an easily assessed and independent prognostic marker.
- TID aids in identifying patients at increased risk for adverse cardiac events.
- This marker can help stratify patients for closer monitoring or intervention.
Objectives:
We sought to evaluate the prognostic significance of left ventricular (LV) transient ischemic dilation (TID) for patients with a positive stress echocardiogram (SE).
Background:
TID during SE has been related to the presence of extensive coronary artery disease, but its long-term prognostic implications have not been reported.
Methods:
In all, 99 consecutive patients with a positive SE comprised the study group. LV volumes were evaluated according to the modified Simpson's rule. TID during SE was defined as the presence of an increase in LV end-diastolic volume during the stress test. A clinical history was fulfilled for each patient and all of them were followed up.
Results:
Of 99 patients, 32 (32.3%) showed TID. Mean age was 65.8 +/- 9.8 years for non-TID group and 70.2 +/- 8.4 for TID group (P = .048). Baseline characteristics and subsequent treatment were similar in both groups. Mean follow-up was 21.4 +/- 15.8 months. In non-TID group the mean survival free of acute myocardial infarction was 47.28 months and 39.7 months in TID group (log rank = 0.012). In the univariate and multivariate analysis only TID and the wall motion score index were found as independent predictors related to long-term prognosis (risk ratio = 6.9; 95% confidence interval = 0.8-59.6; P = .042; and risk ratio = 0.4; 95% confidence interval = 0.18-0.89; P = .047, respectively).
Conclusions:
LV TID during SE is an easy and independent prognostic marker. It helps to select patients with increased risk.
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