Comparison of Treadmill Exercise Echocardiography Before and After Exercise in the Evaluation of Patients with Known or Suspected Coronary Artery Disease |
| |
| Authors: | Jesus Peteiro MD Ramon Fabregas MD Lorenzo Montserrat MD Nemesio Alvarez MD Alfonso Castro-Beiras MD |
| |
| Institution: | 1. College of Civil Engineering, Hunan University, Changsha 410082, China;2. Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong;1. Department of Engineering Mechanics, AML, Tsinghua University, Beijing 100084, China;2. School of Naval Architecture and Ocean Engineering, Naval University of Engineering, Wuhan, Hubei Province 430033, China;1. Department of Medicine, Columbia University, New York City, New York;2. Department of Biostatistics, Columbia University, New York City, New York;3. Department of Neurology, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida;4. Departments of Neurology and Epidemiology, Columbia University, New York City, New York;5. Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, Florida;1. Department of Stomatology, Xi''an Central Hospital, Xi''an, Shaanxi, China;2. Department of Cariology and Endodontology, Shanghai Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;3. College of Stomatology, Shanghai Jiao Tong University, Shanghai, China;4. National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China |
| |
| Abstract: | OBJECTIVES: We sought to compare the feasibility and accuracy of peak treadmill exercise echocardiography versus postexercise echocardiography imaging. BACKGROUND: Although peak exercise echocardiography has been reported for both supine and orthostatic bicycle exercise and has shown higher sensitivity than postexercise imaging, acquiring images at peak exercise with treadmill has not been explored. METHODS: Peak and post-treadmill exercise echocardiography and coronary angiography were performed on 89 patients with known or suspected coronary artery disease. Positive exercise echocardiography was defined as necrosis or ischemic response. Positive coronary angiography was defined as >/=1 diseased vessels (>/=50% luminal narrowing). Images were analyzed in a blind manner by an expert observer. RESULTS: Postexercise images were acquired within 80 seconds after exercise (40 +/- 14). Mean heart rate (bpm) was 139 +/- 22 at peak versus 118 +/- 25 at postexercise imaging (P <.001). Interpretable peak and postexercise images were obtained for all 89 patients. Of the 72 classified as having positive exercise echocardiography, 23 had new regional wall motion abnormality at peak (21 with positive angiography), which resolved at postexercise imaging. Sensitivity was higher with peak than with postexercise imaging (94% vs 73%, P <.001). Specificity was similar (68% vs 79%), as was predictive positive value (92% vs 93%). Negative predictive value was again higher with peak imaging (76% vs 44%, P <.05). Total accuracy was higher with peak imaging (89% vs 74%, P <.05). CONCLUSIONS: Peak treadmill exercise echocardiography is technically feasible and has higher sensitivity and accuracy than post-treadmill exercise echocardiography. Therefore in the clinical setting peak exercise echocardiography should be performed to diagnose ischemia. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
