Detection and clinical usefulness of a biphasic response during exercise echocardiography early after myocardial infarction

Lancellotti, Patrizio; Hoffer, E; Piérard, Luc

doi:10.1016/s0735-1097(03)00049-4

Cited by 34 publications

(18 citation statements)

References 20 publications

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“…None of our patients developed regional wall motion abnormalities during dobutamine stress echocardiography testing, which is a sensitive and specific method for the detection of myocardial ischemia (16,17 ). Accordingly, IMA concentrations remained unchanged compared with baseline.…”

Section: Discussionmentioning

confidence: 67%

Ischemia-Modified Albumin Concentrations in Patients with Peripheral Vascular Disease and Exercise-Induced Skeletal Muscle Ischemia

Roy¹,

Quiles²,

Sharma³

et al. 2004

Clinical Chemistry

102

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Background: Ischemia-modified albumin (IMA) is a new marker of myocardial ischemia, there is concern that IMA concentrations may be affected by ischemia occurring in tissues other than the myocardium. Methods: We assessed 23 consecutive patients (15 males; mean age, 67 years) with typical leg claudication and documented peripheral vascular disease (PVD). All patients underwent both treadmill-exercise stress testing to induce leg ischemia and dobutamine stress echocardiography 1 week apart for the assessment of myocardial ischemia. Blood samples for IMA measurements were obtained at baseline, immediately after peak exercise/stress, and 1 h after exercise/stress. Statistical analysis was performed with the ANOVA repeated-measures test. Results: Compared with baseline, mean (SD) IMA was significantly lower after the induction of skeletal muscle ischemia and returned to baseline values at 1 h: baseline, 74.6 (15.6) kilounits/L; peak stress, 69.5 (14.0) kilounits/L (P <0.0001 vs baseline); 1 h after stress, 75.9 (15.7) kilounits/L (P <0.0001 vs peak stress; P ‫؍‬ 0.3 vs baseline). Baseline, peak stress, and 1-h poststress IMA concentrations were inversely correlated with the anklebrachial index after exercise (r ‫؍‬ ؊0.4; P <0.05). None of the patients showed regional wall motion abnormalities during dobutamine stress echocardiography, and IMA concentrations remained unchanged from baseline. There were no differences in baseline [74.6 (15.6) vs 72.7 (11.5) kilounits/L; P ‫؍‬ 0.6], peak stress, or poststress

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Section: Discussionmentioning

confidence: 67%

Ischemia-Modified Albumin Concentrations in Patients with Peripheral Vascular Disease and Exercise-Induced Skeletal Muscle Ischemia

Roy¹,

Quiles²,

Sharma³

et al. 2004

Clinical Chemistry

102

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“…Mitral and tricuspid valves were regarded as restrictive if leaflet stiffening and retraction towards the apex was identified. Mitral valvular tenting area -a marker of the apical displacement of mitral leafletswas obtained from the parasternal long axis view at midsystole and measured the area enclosed between the annular plane and the mitral leaflets [15,16]. The aortic valve was judged as being restrictive if the valve opened with visibly evident doming of the leaflets.…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

Prospective, long-term study of the effect of cabergoline on valvular status in patients with prolactinoma and idiopathic hyperprolactinemia

et al. 2016

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Since the 1990's cabergoline has been the treatment of choice in prolactinoma, as it permits rapid and effective hormonal and tumor control in most cases. Evidence of cardiac valvulopathy was demonstrated in Parkinson's disease patients treated with dopamine agonists. Retrospective studies in prolactinoma patients treated with cabergoline at lower doses did not show such an effect. However, few prospective data with long-term follow-up are available. The aim of this study was to assess the safety of cabergoline regarding cardiac valvular status during prospective follow-up in patients treated for prolactinoma or idiopathic hyperprolactinemia. We report here a series of 100 patients (71F; median age at diagnosis: 41.5 years) treated with cabergoline for endocrine diseases (prolactinoma n = 89, idiopathic hyperprolactinemia n = 11). All patients underwent complete transthoracic echocardiographic studies at baseline and during long-term prospective surveillance using the same equipment and performed by the same technicians. The median interval between baseline and last follow-up echocardiographic studies while on cabergoline was 62.5 months (interquartile range: 34.75-77.0). The median total duration of cabergoline treatment was 124.5 months (interquartile range: 80.75-188.75) and the median cumulative total dose of cabergoline was 277.8 mg (interquartile range :121.4-437.8 mg) at last follow-up. We found no clinically relevant alterations in cardiac valve function or valvular calcifications with cabergoline treatment. Our data suggest that findings from retrospective analyses are correct and that cabergoline is a safe chronic treatment at the doses used typically in endocrinology.

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“…17,103 At lower doses (2.5-5 lg/kg/minute) dobutamine stimulates a contractile response in hypoperfused segments that are dysfunctional at rest, but still viable, by increasing myocardial blood flow without precipitating further ischemia. 104,105 Such a response is highly sensitive for the presence of myocardial viability.…”

Section: Myocardial Viabilitymentioning

confidence: 99%

“…106 Another potential means by which dobutamine improves contractility is peripheral vasodilation, which reduces LV afterload and end systolic wall stress, improving contractility for the same amount of myocardial blood flow. 107 Augmentation of contractility of viable segments can also be appreciated during low-level 103 To demonstrate the presence of myocardial viability an improvement by at least one grade in two or more segments with dobutamine is recommended. 5 At higher doses of dobutamine (C20 lg/kg/minute) the myocardial oxygen demand increases and segments supplied by diseased arteries will become ischemic and develop worsening of contractile function.…”

Section: Myocardial Viabilitymentioning

confidence: 99%

“…113 The biphasic response can also accurately detect the presence of residual infarct-related artery stenosis following acute MI. 103,114 For patients with a known history of CAD (including those with ischemic cardiomyopathy), detection of viable hibernating myocardium has important implications for management. Hibernation has been described as the presence of regional wall motion dysfunction in the presence of reduced perfusion at rest.…”

Section: Myocardial Viabilitymentioning

confidence: 99%

See 1 more Smart Citation

Stress echocardiography for the detection and assessment of coronary artery disease

Fine

Pellikka

2011

Journal of Nuclear Cardiology

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Detection and clinical usefulness of a biphasic response during exercise echocardiography early after myocardial infarction

Abstract: A biphasic response can be detected during exercise. Exercise echocardiography is an accurate tool for detecting IRA stenosis and predicting functional improvement early after AMI.

Cited by 34 publications

References 20 publications

Ischemia-Modified Albumin Concentrations in Patients with Peripheral Vascular Disease and Exercise-Induced Skeletal Muscle Ischemia

Ischemia-Modified Albumin Concentrations in Patients with Peripheral Vascular Disease and Exercise-Induced Skeletal Muscle Ischemia

Prospective, long-term study of the effect of cabergoline on valvular status in patients with prolactinoma and idiopathic hyperprolactinemia

Stress echocardiography for the detection and assessment of coronary artery disease

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