TY - JOUR
T1 - Usefulness of High Functional Capacity in Patients With Exercise-Induced ST-Depression to Predict a Negative Result on Exercise Echocardiography and Low Prognostic Risk
AU - Bhat, Amogh
AU - Desai, Amish
AU - Amsterdam, Ezra A
PY - 2008/6/1
Y1 - 2008/6/1
N2 - Although exercise electrocardiography (ExECG) is commonly used to detect coronary artery disease, the diagnostic accuracy and reliability of positive (ischemic) results of ExECG in low- and intermediate-risk populations are limited. Accordingly, many patients with positive results of ExECG undergo secondary evaluation using noninvasive stress imaging such as exercise echocardiography. Functional capacity is a strong predictor of prognosis and, indirectly, of high-risk coronary artery disease. It was hypothesized that high functional capacity in patients with positive results of ExECG would predict (1) negative results on subsequent exercise echocardiography and (2) a low risk for late mortality. Results were analyzed in 104 consecutive patients (79 men, 25 women; mean age 49 years, range 27 to 76) referred for exercise echocardiography after positive results of ExECG with a treadmill workload of ≥10 METs. Late all-cause mortality was also determined in these patients. Exercise echocardiographic results were negative in 93% of patients (97 of 104; 92% of men [73 of 79] and 100% of women [25 of 25]) and positive in 7% (7 of 104). During a mean follow-up period of 7.2 ± 1.9 years, there was 1 death. In conclusion, high functional capacity in patients with positive results of ExECG is associated with negative exercise echocardiographic results in most patients and very low late mortality. Patients with ischemic ST-segment response on ExECG who achieve workloads of ≥10 METs infrequently require additional noninvasive or invasive evaluation.
AB - Although exercise electrocardiography (ExECG) is commonly used to detect coronary artery disease, the diagnostic accuracy and reliability of positive (ischemic) results of ExECG in low- and intermediate-risk populations are limited. Accordingly, many patients with positive results of ExECG undergo secondary evaluation using noninvasive stress imaging such as exercise echocardiography. Functional capacity is a strong predictor of prognosis and, indirectly, of high-risk coronary artery disease. It was hypothesized that high functional capacity in patients with positive results of ExECG would predict (1) negative results on subsequent exercise echocardiography and (2) a low risk for late mortality. Results were analyzed in 104 consecutive patients (79 men, 25 women; mean age 49 years, range 27 to 76) referred for exercise echocardiography after positive results of ExECG with a treadmill workload of ≥10 METs. Late all-cause mortality was also determined in these patients. Exercise echocardiographic results were negative in 93% of patients (97 of 104; 92% of men [73 of 79] and 100% of women [25 of 25]) and positive in 7% (7 of 104). During a mean follow-up period of 7.2 ± 1.9 years, there was 1 death. In conclusion, high functional capacity in patients with positive results of ExECG is associated with negative exercise echocardiographic results in most patients and very low late mortality. Patients with ischemic ST-segment response on ExECG who achieve workloads of ≥10 METs infrequently require additional noninvasive or invasive evaluation.
UR - http://www.scopus.com/inward/record.url?scp=43549108299&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43549108299&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2008.01.039
DO - 10.1016/j.amjcard.2008.01.039
M3 - Article
C2 - 18489930
AN - SCOPUS:43549108299
VL - 101
SP - 1541
EP - 1543
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 11
ER -