Related Experiment Videos

Risk stratification by accelerated high-dose dipyridamole stress echocardiography in patients over 70 years of age

Liz Andréa Villela Baroncini1, Leonardo Brandão Précoma1, Cintia Doná Busato2

  • 1Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901 Curitiba, Paraná, Brazil.

International Journal of Cardiology
|June 28, 2011
PubMed

Insights

Accelerated high-dose dipyridamole stress echocardiography is feasible for assessing coronary artery disease risk in older adults. A positive stress echo response, coronary artery disease, and dyslipidemia predict cardiovascular events, while male gender and positive stress echo predict death.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Geriatric Medicine

Background:

  • Non-invasive prognostic assessment of coronary artery disease (CAD) is crucial in patients over 70.
  • Accurate risk stratification in this elderly population is a significant clinical challenge.

Purpose of the Study:

  • To evaluate the feasibility, predictive values, and accuracy of accelerated high-dose dipyridamole stress echocardiography.
  • To assess its utility in patients aged 70 years and older.

Main Methods:

  • Retrospective analysis of 379 patients (mean age 75.9 years) undergoing dipyridamole stress echocardiography.
  • Follow-up data for 313 patients over a mean of 21 months.
  • Statistical analysis including logistic regression and Cox regression models.

Main Results:

  • High feasibility (97%) of the procedure in elderly patients.
  • Excellent negative predictive values (96.7-97.7%) and accuracy (94.9-95.5%) for cardiovascular events.
  • Positive predictive values of 30% (6 months) and 40% (12 months).
  • Independent predictors of cardiovascular events included dyslipidemia, CAD, and positive stress echo response.
  • Male gender and positive stress echo response predicted mortality.

Conclusions:

  • Accelerated high-dose dipyridamole stress echocardiography is a feasible method for risk stratification in patients over 70.
  • Positive stress echo response, CAD, and dyslipidemia are significant predictors of cardiovascular events.
  • Male gender and positive stress echo response are significant predictors of death in this cohort.
Abstract

Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...