Exercise electrocardiography combined with stress echocardiography for predicting myocardial ischemia in adults

Huang, Qiong; Wang, Junhong; Li, Dianfu; Zhao, Jianhua; Feng, Xiangjun; Zhou, Ningtian

doi:10.3892/etm.2020.9562

Cited by 4 publications

(1 citation statement)

References 23 publications

(42 reference statements)

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“…Among patients with a positive test, group I was dominated by patients with clinical criteria of a positive test -63 % (n = 12), which may be due to the peculiarity of cardiac nociception in such patients. It is assumed that severe angina pain is of great importance in the management of patients with no obstructive CAD and requires the appointment of additional anti-ischemic drugs [19]. DP reflects myocardial oxygen consumption, load on the cardiovascular system at different times of the day and at different physical exercise.…”

Section: Discussionmentioning

confidence: 99%

Results of bicycle exercise stress test in patients with stable coronary heart disease depending on the angiographic signs of atherosclerotic lesions of coronary arteries

Tseluyko

Pylova

2021

Eureka: HS

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The aim. To identify features of exercise response in coronary heart disease (CHD) patients depending on coronary artery condition and to identify factors associated with a positive test in patients with no obstructive coronary artery disease (INOCA). Materials and methods. The study included 105 patients diagnosed with stable coronary artery disease (CAD) who were hospitalized at the City Clinical Hospital No. 8 of the Kharkiv City Council. The criteria for diagnosis of ischemia with no obstructive coronary artery disease (INOCA) were met by 53 patients who formed group I. Group II included 52 patients who were consistently hospitalized in the period from June to December 2020, and had obstructive CAD for more than 50 % according to their coronary angiography (CAG). Results. According to the results of bicycle exercise stress test, a positive test was significantly more often registered in group II – n=30 (57.7 %) patients compared to group I – n=19 (35.8 %) patients (p=0.0249). The duration of the test in patients of group I was significantly longer than 420 seconds [290–540], compared with group II – 300.0 [210.0–540.0] (р=0.0352). Also, in patients in group II, the maximum volume of the test performed was probably lower than in group I (p=0.0324). When calculating the double product, it was also found that in group I its value was significantly higher compared to group II (p=0.0292). In group I there was a significantly higher rate of chronotropic reserve (44.0 [26.0–60.0]), compared with group II (p=0.0168). Elevated total cholesterol (above 5 mmol/l) is a statistically significant and independent factor of a positive exercise test in patients with INOCA (OR, 1.98 [0.9992-3.926], p=0.05). A correlation was found between the level of exercise tolerance and smoking in INOCA-patients (r =-0.388975, p=0.010899). Patients who underwent MINOCA also showed reduced tolerance to exercise (r=-0.3104, p=0.042721) Conclusions. The sensitivity of bicycle exercise stress test in patients with CAD depends on the presence and severity of atherosclerotic lesions of the coronary arteries (63 % in stenotic atherosclerosis, 36 % in no obstructive coronary arteries. It was found that exercise test duration, double product, chronotropic and inotropic reserve of the heart in patients with a positive exercise test with INOCA were significantly higher compared with patients with obstructive CAD. Independent factors associated with a positive exercise test in patients with no obstructive CAD are an increase in total cholesterol (multivariate regression logistic analysis).

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Section: Discussionmentioning

confidence: 99%

Results of bicycle exercise stress test in patients with stable coronary heart disease depending on the angiographic signs of atherosclerotic lesions of coronary arteries

Tseluyko

Pylova

2021

Eureka: HS

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Quantitative evaluation of myocardial perfusion in coronary heart disease by myocardial contrast and dobutamine stress echocardiography

Guo,

Zhang,

Wen

et al. 2024

J of Clinical Ultrasound

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ObjectiveWe aimed to investigate how combining myocardial contrast echocardiography (MCE) with dobutamine stress echocardiography (DSE) could help evaluate myocardial perfusion in coronary heart disease patients and understand changes in microcirculation across different levels of coronary artery blockage.MethodsWe conducted MCE and DSE tests on 53 coronary heart disease patients, categorizing ischemic myocardium into four groups: A (<50%), B (50%–69%), C (70%–89%), and D (≥90%). Dynamic myocardial perfusion images were captured during rest and peak dobutamine stress from various angles, analyzing parameters like plateau value A, slope β, and the product A × β, reflecting different aspects of myocardial blood flow.ResultsParametric values of myocardial perfusion (PVMPs) were significantly lower in group D at rest compared with other groups (p < 0.001). PVMPs increased notably at peak dobutamine stress in groups A, B, and C (p < 0.001). Groups A and B had higher PVMPs than groups C and D, with group D significantly lower (p < 0.001). β reserve values decreased gradually from group A to D, with significantly lower values of A and A × β in groups C and D compared with A and B (p < 0.001). Sensitivity and specificity for predicting >70% coronary artery blockage was 80%, 66%, and 74%, 80%, respectively, using specific thresholds.ConclusionCombining MCE with DSE is highly sensitive and accurate in diagnosing obstructive coronary artery blockages. It also helps assess myocardial microcirculation perfusion and left ventricular reserve function, which decline with increasing severity of coronary artery blockage.

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Stress Echocardiography for Chronic Coronary Syndrome: Clinical Practice Guidelines (2023)

ZHANG,

TIAN,

ZHU

et al. 2024

Journal of Geriatric Cardiology

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Exercise electrocardiography combined with stress echocardiography for predicting myocardial ischemia in adults

Cited by 4 publications

References 23 publications

Results of bicycle exercise stress test in patients with stable coronary heart disease depending on the angiographic signs of atherosclerotic lesions of coronary arteries

Results of bicycle exercise stress test in patients with stable coronary heart disease depending on the angiographic signs of atherosclerotic lesions of coronary arteries

Quantitative evaluation of myocardial perfusion in coronary heart disease by myocardial contrast and dobutamine stress echocardiography

Stress Echocardiography for Chronic Coronary Syndrome: Clinical Practice Guidelines (2023)

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