Long-Term Prognostic Value of Dobutamine-Atropine Stress Echocardiography in 1737 Patients With Known or Suspected Coronary Artery Disease

Poldermans, Don; Fioretti, P.; Boersma, Eric; Bax, Jeroen J.; Thomson, Ian R.; Roelandt, Jos R.T.C.; Simoons, Maarten L.

doi:10.1161/01.cir.99.6.757

Cited by 158 publications

(68 citation statements)

References 19 publications

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“…At least 2 large studies with pharmacological stress with dobutamine, which is commonly used during SE for wall motion assessment, have shown hard event rates varying between 1.1% to 1.3%, which is lower (though only marginally) than that seen in this study for wall motion assessment. 9,10 Nevertheless, normal perfusion in this study portended a reassuring Ͻ1% annual event rate mark (low-risk group). Another intriguing issue in this study was the lack of predictive value of multivessel ischemia for both perfusion and wall motion assessment.…”

Section: Article See P 1217mentioning

confidence: 59%

Myocardial Contrast Echocardiography for Simultaneous Assessment of Function and Perfusion in Real Time

Senior

Shah

2012

Circulation

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Section: Article See P 1217mentioning

confidence: 59%

Myocardial Contrast Echocardiography for Simultaneous Assessment of Function and Perfusion in Real Time

Senior

Shah

2012

Circulation

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“…Although DSE is an established method for the diagnosis of CAD, 12 as well as risk stratification and determination of prognosis, 11,[13][14][15][16] its accuracy may be decreased by the suboptimal endocardial border delineation that is encountered in 10-30% of an unselected population undergoing DSE. 6 Harmonic imaging and intravenous contrast agents have been shown to improve endocardial border delineation, and potentially improving the diagnostic accuracy of DSE.…”

Section: Discussionmentioning

confidence: 99%

Effects of Gender on Prognosis of Patients With Known or Suspected Coronary Artery Disease Undergoing Contrast-Enhanced Dobutamine Stress Echocardiography

Wake

Takeuchi

Yoshikawa

et al. 2007

Circ J

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CE-DSEOur protocol for CE-DSE is described elsewhere. 7-10 Briefly, noncontrast-enhanced parasternal long-and shortaxis views and CE apical 4-and 2-chamber views were obtained after injection of intravenous contrast agent Circ J 2007; 71: 1060 -1066 (Received February 8, 2007 revised manuscript received April 8, 2007; accepted April 11, 2007) Department of Cardiology and Internal Medicine, Osaka City University Effects of Gender on Prognosis of Patients With Known or Suspected Coronary Artery Disease Undergoing Contrast-Enhanced Dobutamine Stress EchocardiographyRyotaro Wake, MD; Masaaki Takeuchi, MD*; Junichi Yoshikawa, MD**; Minoru Yoshiyama, MD Background Gender differences in the predictors of outcome among patients with known or suspected coronary artery disease (CAD) undergoing contrast-enhanced dobutamine stress echocardiography (CE-DSE) have not been completely determined. Methods and ResultsFollow-up (30±17 months) data for 581 men and 309 women with known or suspected CAD who underwent CE-DSE (mean age: 66 years) were obtained. Hard cardiac events included cardiac death and nonfatal myocardial infarction. Total cardiac events included hard cardiac events, unstable angina, congestive heart failure, and late revascularization (>3 months). Cardiac events occurred in 123 male and 50 female patients. Positive results for CE-DSE were associated with worse prognosis in both men and women (2-year total event free rate: 73.5% vs 88.2% in men, p<0.0001, 80.3% vs 91.3% in women, p<0.01). Addition of CE-DSE results, including abnormal left ventricular end-systolic volume response and left ventricular ejection fraction at peak stress <50%, to the clinical and rest echocardiography model provided incremental information for predicting total cardiac events (increase in chi-square value for the model from 60 to 72, p<0.001) in men and (increase in chi-square value for the model from 17 to 32, p<0.001) in women. Conclusions CE-DSE provides incremental information for predicting future cardiac events in both men and women. (Circ J 2007; 71: 1060 -1066

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“…Although DSE is an established method for diagnosing CAD 11 and for risk stratification and determination of prognosis, [11][12][13][14][15][16][23][24][25][26][27] its accuracy may be limited by suboptimal endocardial border delineation, which is observed in 10-30% of unselected patients undergoing stress echocardiography. 18,[27][28][29] Harmonic imaging and intravenous injection of contrast agents have been shown to improve endocardial border delineation, and have enhanced the diagnostic accuracy of DSE.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Dobutamine stress echocardiography (DSE) has been established as a safe and feasible method for the diagnosis of CAD [9][10][11] and the prediction of cardiac events in patients with suspected CAD. [12][13][14][15][16] However, few findings have been obtained regarding the incremental value of DSE in the risk stratification of diabetic patients. 5,17 The use of intravenous ultrasound contrast agents during stress echocardiography has been shown to improve diagnostic accuracy in the detection of CAD, 18 as well as its prognostic value.…”

mentioning

confidence: 99%

Quantitative Assessment of Left Ventricular Function During Contrast-Enhanced Dobutamine Stress Echocardiography Predicts Future Cardiac Events in Diabetic Patients

Wake

Takeuchi

Yoshiyama

et al. 2006

Circ J

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Background Non-invasive diagnosis and risk stratification of coronary artery disease are important for the selection and optimization of therapeutic interventions in diabetic patients, which may improve survival. The aim of this study was to determine the incremental value of contrast-enhanced dobutamine stress echocardiography (CE-DSE) for risk stratification. Methods and Results CE-DSE was performed in 326 patients with diabetes mellitus (mean age; 66±10 years, 223 men). All patients were followed up for a mean of 29 months (1-61 months). Dobutamine was infused in a standard protocol with an intravenous contrast agent. The primary endpoints for hard cardiac events included cardiac death and nonfatal myocardial infarction. The primary endpoints for total cardiac events included hard cardiac events, unstable angina pectoris, congestive heart failure, and late coronary revascularization (>3 months). Cardiac events occurred in 74 patients. The addition of the CE-DSE results, including abnormal left ventricular end-systolic volume response and left ventricular ejection fraction at peak stress <50%, to the clinical and rest echocardiography model provided incremental information in predicting total cardiac events (increase in chisquare value for the model from 17 to 24, p<0.05) and hard cardiac events (increase in chi-square value for the model from 18 to 24, p<0.05). Conclusions Quantitative assessment of left ventricular function during CE-DSE provides incremental prognostic information in predicting cardiac events in diabetic patients. (Circ J 2006; 70: 868 -874)

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Long-Term Prognostic Value of Dobutamine-Atropine Stress Echocardiography in 1737 Patients With Known or Suspected Coronary Artery Disease

Abstract: In a large group of patients, DSE has an added value for predicting late cardiac events during long-term follow-up, improving the separation between high- risk and very-low-risk patients.

Cited by 158 publications

References 19 publications

Myocardial Contrast Echocardiography for Simultaneous Assessment of Function and Perfusion in Real Time

Myocardial Contrast Echocardiography for Simultaneous Assessment of Function and Perfusion in Real Time

Effects of Gender on Prognosis of Patients With Known or Suspected Coronary Artery Disease Undergoing Contrast-Enhanced Dobutamine Stress Echocardiography

Quantitative Assessment of Left Ventricular Function During Contrast-Enhanced Dobutamine Stress Echocardiography Predicts Future Cardiac Events in Diabetic Patients

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