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[Prognostic value of treadmill exercise echocardiography]
Jesús Peteiro-Vázquez1, Lorenzo Monserrrat-Iglesias, Javier Mariñas-Davila
1Servicio de Cardiología, Hospital Juan Canalejo, A Coruña, Spain. pete@canalejo.org
Revista Espanola De Cardiologia
|August 2, 2005
Summary
Exercise echocardiography (EE) significantly improves risk stratification for cardiac events in patients with coronary artery disease. Abnormal EE results, along with clinical factors, independently predict serious cardiovascular events.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Preventive Medicine
Background:
- Exercise echocardiography (EE) is established for diagnosing coronary artery disease.
- Its role in risk stratification beyond diagnosis is not well-defined.
Purpose of the Study:
- To evaluate if EE data enhances risk prediction for cardiac events when combined with clinical and exercise testing data.
- To determine if the extent and exercise response of abnormal echocardiographic regions impact risk stratification.
Main Methods:
- A cohort of 2,436 patients undergoing EE was followed for a median of 2.1 years.
- Serious cardiovascular events (myocardial infarction, cardiovascular death) were recorded before revascularization.
- Multivariate analysis assessed predictors of cardiac events.
Main Results:
- Abnormal EE results were observed in 49% of patients, correlating with a higher event rate (7.3% vs. 2.5%).
- Independent predictors of serious events included male sex, lower metabolic equivalents (METs), peak heart rate x blood pressure, resting wall motion score index, and number of abnormal regions.
- The number of abnormal regions at peak exercise was a significant independent predictor of risk.
Conclusions:
- Exercise echocardiography provides valuable data that supplements clinical information and results from exercise testing and resting echocardiography.
- EE is a crucial tool for risk stratification in patients with known or suspected coronary artery disease.