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Treadmill exercise echocardiography as a predictor of events in patients with left ventricular hypertrophy

Jesús Peteiro1, Alberto Bouzas-Mosquera, Francisco Broullón

  • 1Department of Cardiology, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain. pete@canalejo.org

American Journal of Hypertension
|April 10, 2010
PubMed

Insights

Exercise echocardiography (EE) effectively predicts outcomes in patients with coronary artery disease (CAD) and left ventricular hypertrophy (LVH). EE identifies ischemia, a key factor in mortality and major adverse cardiac events (MACE) for this population.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Clinical Outcomes

Background:

  • Exercise echocardiography (EE) is recommended for patients with known or suspected coronary artery disease (CAD) and electrocardiogram (ECG) abnormalities.
  • Left ventricular hypertrophy (LVH) is linked to poorer outcomes and often presents with resting ECG abnormalities.
  • The study aimed to evaluate EE's predictive value for outcomes in patients with known/suspected CAD and LVH.

Purpose of the Study:

  • To assess the prognostic value of exercise echocardiography (EE) in patients with known or suspected coronary artery disease (CAD) and left ventricular hypertrophy (LVH).
  • To determine if EE can predict all-cause mortality and major adverse cardiac events (MACE) in this specific patient group.

Main Methods:

  • Retrospective analysis of 1,058 patients undergoing EE, categorized by the presence or absence of LVH.
  • Evaluation of resting and exercise wall motion score index (WMSI) and identification of ischemia based on new/worsening wall motion abnormalities (WMA).
  • Endpoints included all-cause mortality and MACE, with a median follow-up of 4.6 years.

Main Results:

  • Patients with exercise-induced ischemia showed significantly higher 5-year mortality (15.3%) and MACE rates (13.6%) compared to those without (6.4% and 7.1%, respectively).
  • Left ventricular (LV) mass (HR 1.03) and DeltaWMSI (HR 1.94) were independent predictors of mortality in multivariable analysis.
  • DeltaWMSI independently predicted MACE in the overall population and in patients with LVH.

Conclusions:

  • Left ventricular mass is an independent predictor of mortality, even when considering EE data.
  • EE provides crucial prognostic information for predicting adverse events in patients with LVH and known/suspected CAD.
Abstract

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