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Ischemia induced by transesophageal atrial pacing stress echocardiography predicts long-term mortality

Maurizio Anselmi1, Mara Pilati, Giorgio Golia

  • 1Department of Biomedical and Surgical Sciences, Section of Cardiology, University of Verona, Verona, Italy. maurizio.anselmi@univr.it

Cardiology
|April 1, 2008
PubMed

Insights

Transesophageal atrial pacing stress echocardiography (TAPSE) effectively predicts cardiac death in patients with coronary artery disease. An abnormal TAPSE result significantly increases the risk, showing its long-term prognostic value.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Clinical Prediction

Background:

  • Pharmacologic stress echocardiography is established for cardiac death prediction.
  • Transesophageal atrial pacing stress echocardiography (TAPSE) offers a safe alternative.
  • Prognostic data for TAPSE was previously unavailable.

Purpose of the Study:

  • To evaluate the long-term predictive value of TAPSE for mortality.
  • To assess TAPSE's utility in patients with known or suspected coronary artery disease.

Main Methods:

  • 1010 TAPSE procedures were performed in 975 patients.
  • A final cohort of 857 patients with a mean follow-up of 4.5 years was analyzed.
  • Cox regression models identified predictors of cardiac death.

Main Results:

  • Abnormal TAPSE was observed in 32% of patients, correlating with higher cardiac mortality (8.9% vs 3.6%).
  • Predictors of cardiac death included age, prior revascularization, and resting/induced wall motion abnormalities.
  • Abnormal TAPSE significantly improved cardiac death prediction models.

Conclusions:

  • TAPSE is a valuable tool for predicting mortality in coronary artery disease patients.
  • TAPSE can serve as an alternative to pharmacologic stress testing for risk stratification.
Abstract

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