Valor prognóstico da ecocardiografia sob estresse físico em portadores de bloqueio do ramo esquerdo

Vasconcelos, Francis de Lima; Santos, Bruno Fernandes de Oliveira; Santana, Nathalie de Oliveira; Faro, Gustavo Baptista de Almeida; Rocha, Romerito de Oliveira; Leal, Vinício Vieira; Barreto‐Filho, José Augusto; Sousa, Antônio Carlos Sobral; Oliveira, Joselina Luzia Menezes

doi:10.1590/s0066-782x2011005000098

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…During the follow-up of 609 patients with LBBB (average follow up of 4.6 ± 3.4 years), five-year mortality and cardiac events were twice as high in patients who had ischemia on SE 35 . In a study of a Brazilian population with LBBB, the SE was also a predictor of major cardiac events 36 .…”

Section: Discussionmentioning

confidence: 99%

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Calasans¹,

Santos²,

Silveira³

et al. 2013

Arquivos Brasileiros De Cardiologia

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BackgroundExercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. ObjectiveTo assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). ResultsG1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). ConclusionPositive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET.

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Section: Discussionmentioning

confidence: 99%

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Calasans¹,

Santos²,

Silveira³

et al. 2013

Arquivos Brasileiros De Cardiologia

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“…Among these are coronary atherosclerosis, which comprises a series of inflammatory responses at cellular and molecular level, of which reactions are further exacerbated in obese patients 18 , 19 . Physical stress echocardiography has been widely used in the noninvasive investigation of the CAD 20 . Physical exertion is the triggering agent of cardiovascular stress of choice for individuals with preserved physical capacity, as it results in greater increase in inotropism and provides physiological information about the presence, location and extent of ischemia 21 , 22 .…”

Section: Introductionmentioning

confidence: 99%

Assessment of myocardial ischemia in obese individuals undergoing physical stress echocardiography (PSE)

Silveira¹,

Sousa²,

Santos³

et al. 2015

Arquivos Brasileiros De Cardiologia

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BackgroundPhysical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m2) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group.ObjectiveTo assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences.Methods4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%).ResultsThere was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension.ConclusionObesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese.

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Resposta Exagerada da Pressão Arterial Sistólica ao Exercício e Isquemia Miocárdica à Ecocardiografia sob Estresse Físico

Martins-Santos,

Duarte,

Ferreira-Junior

et al. 2023

Arquivos Brasileiros De Cardiologia

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Valor prognóstico da ecocardiografia sob estresse físico em portadores de bloqueio do ramo esquerdo

Abstract: Background: The literature lacks studies about the prognostic value of exercise stress echocardiography (ESE) in patients with complete left bundle branch block (LBBB) of the bundle of His.

Cited by 4 publications

References 28 publications

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

Assessment of myocardial ischemia in obese individuals undergoing physical stress echocardiography (PSE)

Resposta Exagerada da Pressão Arterial Sistólica ao Exercício e Isquemia Miocárdica à Ecocardiografia sob Estresse Físico

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