ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary Article*1A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to update the 1997 guidelines for the clinical application of echocardiography)

Cheitlin, M.D.; Armstrong, William F.; Aurigemma, Gerard P.; Beller, George A.; Bierman, Fredrick Z.; Davis, Jack L.; Douglas, Pamela S.; Faxon, David P.; Gillam, Linda D.; Kimball, Thomas R.; Kussmaul, William G.; Pearlman, Alan S.; Philbrick, John T.; Rakowski, Harry; Thys, Daniel M.; Antman, Elliott M.; Smith, Sidney C.; Alpert, Joseph S.; Gregoratos, Gabriel; Anderson, Jeffrey L.; Hiratzka, Loren F.; Hunt, Sharon A.; Fuster, Valentín; Jacobs, Alice K.; Gibbons, Raymond J.; Russell, Richard O.

doi:10.1016/s0894-7317(03)00685-0

Cited by 738 publications

(778 citation statements)

References 253 publications

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“…Second, most other published data are from healthcare systems fundamentally different to the publicly funded service provided within New Zealand and this may therefore lead to both differing mechanisms of referral and thresholds for investigation. Published consensus expert guidelines in general advocate a risk-based approach to investigation of suspected cardiac chest pain (1)(2)(3)(4). Patients considered at low risk of CAD are usually observed, while those at moderate to high risk require further risk stratification often achieved by cardiac catheterisation.…”

Section: Discussionmentioning

confidence: 99%

“…However, for those at significant risk of CAD (or where evidence of myocardial necrosis is evident), direct referral for cardiac catheterisation is appropriate. This risk-based approach to investigation aims to maximise the diagnostic yield of cardiac catheterisation and is a strategy, which is supported by various international consensus guidelines (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

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The utility of a ‘non-significant’ coronary angiogram

Wang

Samaranayake

et al. 2015

Int J Clin Pract

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Summary Background Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this ‘non‐significant’ result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography. Method All patients undergoing coronary angiography at Auckland City Hospital during July 2010–October 2011 were reviewed (n = 2983). Of these, 12.3% (n = 366) underwent coronary angiography for evaluation of chest pain and were found to have absent or mild CAD. These patients were followed up for 2.3 ± 0.6 years. Results Mean age was 60.0 ± 12.3 years, 56.1% were female. The ECG was abnormal in 55.0% of patients. Stress testing for inducible ischaemia was undertaken in 40.7% of patients and was abnormal in 57.7%. Following angiography, 43.2% had no changes to cardiac medications. Additional drug therapy (aspirin, statin, beta‐blockers, ACE‐inhibitor) was commenced in around 14.2–22.1% of cases. These drugs were discontinued in 4.1–8.2% of patients. Rates of major adverse cardiovascular events and readmissions with chest pain were 0.3% (1) and 1.9% (7) respectively at 30 days, and 1.9% (7) and 6.0% (22) at 1 year. Conclusion Although even non‐obstructive atheroma may justify medical therapy to limit disease progression, our findings may suggest that in these cases, invasive coronary angiography, may not lead to the patient/physician reassurance justified by historical data.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The utility of a ‘non-significant’ coronary angiogram

Wang

Samaranayake

et al. 2015

Int J Clin Pract

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“…Each patient underwent complete resting M-mode two-dimensional echocardiography using a Sonos ultrasound system (HewlettPackard, Palo Alto, CA, USA). The examination was performed in the supine left-lateral position according to the standards of the American Society of Echocardiography [14]. M-mode measurements, including left-ventricular enddiastolic and end-systolic diameters, and leftventricular ejection fraction, were calculated from the two-dimensional images.…”

Section: Methodsmentioning

confidence: 99%

Impact of Inspiratory Muscle Training Versus Resistance Training on Ventricular Dysfunction in Patients With Dilated Cardiomyopathy: A Randomized Controlled Trial

Elsayed¹,

Atya²

2017

IJPR

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Background: Dilated cardiomyopathy is a common cardiac dysfunction affecting patient's functional activities. Inspiratory muscle training retains the progression of the disease and improve cardiac functions.Objectives: To investigate the effect of inspiratory muscle training versus resistance training on left-ventricular dysfunction in patients with dilated cardiomyopathy. Materials and Methods:Thirty male patients with ischemic dilated cardiomyopathy were randomly assigned to either the Inspiratory Muscle Training (n = 15) or Resistance Training (n = 15) Groups. The Inspiratory Muscle Training Group received supervised aerobic training plus inspiratory muscle training at 40% of the maximal inspiratory pressure for 28 min once daily 3 days a week for 16 weeks. The Resistance Training Group received aerobic training plus resistance training (50-60% of the one-repetition maximum) in three sets per session 3 days a week for 16 weeks.Main measures: Left-ventricular end-diastolic and end-systolic diameters via echocardiography, left-ventricular ejection fraction, aerobic capacity, inspiratory muscle strength, and N-terminal prohormone of brain natriuretic peptide levels were assessed at baseline, after 16 weeks of training-based intervention, and at a 24-week followup.Results: The Inspiratory Muscle Training Group exhibited significantly greater improvements in left-ventricular end-diastolic and end-systolic diameters, left-ventricular ejection fraction, aerobic capacity, respiratory muscle strength, and N-terminal prohormone of brain natriuretic peptide levels than the Resistance Training Group (p > 0.05). These significant gains were maintained at a 24-week follow-up. Conclusion:Inspiratory muscle training has more significant effect in eliminating the left ventricular dysfunction than resistance training for patients with dilated cardiomyopathy.

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“…Measurements were made according to the guidelines laid down by the American Society of Echocardiography [26]. The left atrial dimension (LAD) and left ventricular end-diastolic (LVEdD) and end-systolic dimension (LVEsD) were assessed by M-mode echocardiography in a standard fashion.…”

Section: Bnp Hcm and Atrial Fibrillationmentioning

confidence: 99%