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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
15:45

Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice

Published on: February 10, 2013

Long term outcome in patients with silent versus symptomatic ischaemia during dobutamine stress echocardiography

E Biagini1, A F L Schinkel, J J Bax

  • 1Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands.

Heart (British Cardiac Society)
|May 17, 2005
PubMed

Insights

Patients with silent ischemia during dobutamine stress echocardiography (DSE) had similar ischemia extent but higher cardiac events. They received less treatment, indicating a need for improved management strategies for silent ischemia.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Clinical Prognosis

Background:

  • Dobutamine stress echocardiography (DSE) is crucial for assessing myocardial ischemia.
  • Distinguishing between silent and symptomatic ischemia is important for long-term patient outcomes.

Purpose of the Study:

  • To compare the long-term prognosis of patients with silent versus symptomatic myocardial ischemia identified during DSE.
  • To evaluate differences in treatment and cardiac event rates between these patient groups.

Main Methods:

  • Observational study involving 931 patients with stress-induced myocardial ischemia during DSE.
  • Analysis of cardiac death and non-fatal infarction rates over a mean follow-up of 5.5 years.
  • Multivariable Cox regression to identify independent predictors of cardiac events.

Main Results:

  • Silent ischemia was present in 69% of patients and was an independent predictor of cardiac death and myocardial infarction (HR 1.7).
  • Patients with silent ischemia had a higher annual cardiac event rate (4.6%) compared to symptomatic patients (3.0%).
  • Symptomatic patients received more cardioprotective therapy and coronary revascularisation (50% vs. 27%).

Conclusions:

  • Silent ischemia during DSE predicts a worse long-term prognosis compared to symptomatic ischemia.
  • Patients with silent ischemia experience higher cardiac event rates despite similar ischemia severity.
  • Under-treatment of silent ischemia highlights a critical area for therapeutic intervention and improved patient management.
Abstract

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