Practical applications in stress echocardiography

Yao, Siu Sun; Qureshi, Ehtasham; Sherrid, Mark V.; Chaudhry, Farooq A.

doi:10.1016/s0735-1097(03)00923-9

Cited by 111 publications

(16 citation statements)

References 32 publications

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“…Similar results have been reported using other stress echo modalities [6,7,8,9,10,11] and in selected patients with known coronary anatomy [21]; as the first among these stress echocardiography studies, we extend these observations to a relatively large cohort of patients, sufficient to evaluate the prognostic value using only ‘hard’ endpoints, such as total and cardiac-related death.…”

Section: Discussionsupporting

confidence: 78%

“…Although the present study does not add specific information about the prognostic importance of inducible ischemia in predicting mortality, we could obtain prognostic information by analyzing only total and cardiac death rates during a long period of follow-up, without including surrogate or composite endpoints [6, 10] in a population smaller than that of other studies [7, 9, 12], which are often multicentric or use different stressors [10, 12]. …”

Section: Discussionmentioning

confidence: 99%

“…In this context, stress echocardiography is a well-validated technique for both the diagnosis and the risk stratification of CAD [2,3,4,5], and much data exist on the prediction of out- come, mainly using exercise echocardiography [6, 7] or pharmacologic agents like dobutamine [8,9,10] and dipyridamole [11, 12]. On the other hand, little information exists about the mid- or long-term prognostic value of transesophageal atrial pacing stress echocardiography (TAPSE).…”

Section: Introductionmentioning

confidence: 99%

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Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Anselmi¹,

Pilati²,

Golia³

et al. 2008

Cardiology

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Objectives: It was the aim of this study to investigate the long-term value of transesophageal atrial pacing in predicting death in patients with known or suspected coronary artery disease. Background: Exercise, dobutamine and dipyridamole stress echocardiography are all effective in predicting cardiac death. Transesophageal atrial pacing stress echocardiography (TAPSE) is a safe alternative to pharmacologic tests, but no information is available on prognosis with TAPSE. Methods: One thousand and ten TAPSE were performed in 975 consecutive patients. TAPSE was feasible in 970 tests (96%); after exclusion of the 35 patients with more than 1 TAPSE and those 42 lost at follow-up (mean 4.5 ± 3.7 years, median 6 years), the final population consisted of 857 patients (675 males, 58 ± 9 years old). The Cox model was used to analyze the association of clinical, resting and TAPSE variables with cardiac death. Results: TAPSE was abnormal in 281 (32%) patients. There were 46 cardiac-related deaths (5%), 25 among the 281 patients with an abnormal test (8.9%) and 21 among the 576 patients with a normal test (3.6%). The predictors of cardiac death were age, previous revascularization, resting wall motion score index and its variation during TAPSE. Abnormal TAPSE significantly increases the value of models predicting cardiac death. Moreover, cardiac mortality increased progressively with the extent of the induced ischemia. Conclusions: TAPSE is a useful tool in predicting death in patients with known or suspected coronary artery disease and might be considered an alternative to pharmacologic stressors.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Anselmi¹,

Pilati²,

Golia³

et al. 2008

Cardiology

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“…The published research on stress echocardiography commonly indicates that the wall motion score index includes a very high risk threshold of >1.5 or >1.7 (17,35–39) with an annual CAD mortality rate of >7% and a significantly elevated hazard for death of 6 (36,37). This high-risk wall motion score index is rarely observed in clinical practice.…”

Section: Published Evidence Of Elevated Risk Associated With Moderatementioning

confidence: 99%

Comparative Definitions for Moderate-Severe Ischemia in Stress Nuclear, Echocardiography, and Magnetic Resonance Imaging

Shaw¹,

Berman²,

Picard³

et al. 2014

JACC: Cardiovascular Imaging

181

131

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The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with ≥10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that ≥10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, ≥3 newly dysfunctional segments portend a median rate of CAD death or MI of 4.5%/year (interquartile range: 3.8% to 5.9%). Although imprecisely delineated, moderate-severe ischemia on cardiac magnetic resonance may be indicated by ≥4 of 32 stress perfusion defects or ≥3 dobutamine-induced dysfunctional segments. Risk-based thresholds can define equivalent amounts of ischemia across the stress imaging modalities, which will help to translate a common understanding of patient risk on which to guide subsequent management decisions.

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“…Ischemic burden has repeatedly been identified as a powerful prognostic factor among patients referred for stress testing using nuclear imaging 13–20 echocardiography 21–24 and, more recently, cardiac MRI (CMR). 25–27 …”

Section: Why Has Ischemia Burden Been Suggested As a Methods Of Targetmentioning

confidence: 99%

Does Ischemia Burden in Stable Coronary Artery Disease Effectively Identify Revascularization Candidates?

Reynolds

Picard

Hochman

2015

Circ: Cardiovascular Imaging

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Practical applications in stress echocardiography

Cited by 111 publications

References 32 publications

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Comparative Definitions for Moderate-Severe Ischemia in Stress Nuclear, Echocardiography, and Magnetic Resonance Imaging

Does Ischemia Burden in Stable Coronary Artery Disease Effectively Identify Revascularization Candidates?

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