Exercise echocardiography provided incremental prognostic value over clinical and rest models for predicting cardiac events (P<0.0001) and cardiac death (P=0.004) in patients ≥65 years.
Cohort (n=2,632)
Does exercise echocardiography improve the prediction of cardiac events and cardiac death in patients ≥65 years of age?
Exercise echocardiography provides significant incremental prognostic value over clinical and rest echocardiographic data for predicting cardiac events and mortality in elderly patients.
p-value: p=<0.0001
OBJECTIVES: We sought to determine the prognostic value of exercise echocardiography in the elderly. BACKGROUND: Limited data exist regarding the prognostic value of exercise testing in the elderly, a population which may be less able to exercise and is at increased risk of cardiac death. METHODS: Follow-up (2.9 +/- 1.7 years) was obtained in 2,632 patients > or = 65 years who underwent exercise echocardiography. RESULTS: There were 1,488 (56%) men and 1,144 (44%) women (age 72 +/- 5 years). The rest ejection fraction was 56 +/- 9%. Rest wall motion abnormalities were present in 935 patients (36%). The mean work load was 7.7 +/- 2.3 metabolic equivalents (METs) for men and 6.5 +/- 1.9 METs for women. New or worsening wall motion abnormalities developed with stress in 1,082 patients (41%). Cardiac events included cardiac death in 68 patients and nonfatal myocardial infarction in 80 patients. The addition of the exercise electrocardiogram to the clinical and rest echocardiographic model provided incremental information in predicting both cardiac events (chi-square = 77 to chi-square = 86, p = 0.003) and cardiac death (chi-square = 71 to chi-square = 86, p or = 65 years of age. The best model included clinical, exercise testing and exercise echocardiographic variables.
Arruda et al. (Thu,) conducted a cohort in Patients ≥65 years of age (n=2,632). Exercise echocardiography vs. Clinical and rest echocardiographic model was evaluated on Cardiac events and cardiac death (p=<0.0001). Exercise echocardiography provided incremental prognostic value over clinical and rest models for predicting cardiac events (P<0.0001) and cardiac death (P=0.004) in patients ≥65 years.