Key result
Abnormal exercise echocardiography was independently associated with cardiac death or nonfatal myocardial infarction in patients with excellent exercise capacity (P=0.03).
Why the study?
Does treadmill exercise echocardiography improve risk stratification for hard events in patients with excellent exercise capacity?
Cohort (n=1,433)
Does treadmill exercise echocardiography improve risk stratification for hard events in patients with excellent exercise capacity?
Exercise echocardiography provides incremental prognostic value over standard clinical and exercise testing variables even in patients with excellent exercise capacity.
May aid stratification in excellent-capacity patients; hypothesis-generating and should not yet change practice.
BACKGROUND: The incremental value of exercise echocardiography (EE) has been demonstrated to be maximal in patients with moderate pretest probability for coronary artery disease, but there is a lack of data in patients with low pretest probability or patients with good functional capacity. METHODS: To investigate whether such incremental value is maintained in patients with excellent exercise capacity, we studied 1,433 patients who had excellent exercise capacity (>or=8 METs for women, >or=10 METs for men). RESULTS: During a follow-up of 2.3 +/- 1.5 years, 42 hard events occurred (cardiac death or nonfatal myocardial infarction). Variables independently associated to hard events were male gender (P = 0.04), % of the age-predicted maximum heart rate (P = 0.02), chronotropic reserve (P = 0.002), and abnormal EE (P = 0.03; incremental P value of EE = 0.03). CONCLUSIONS: EE has incremental value over clinical variables, resting echocardiography, and exercise testing variables in patients with excellent exercise capacity. EE may be preferable to ECG exercise testing even in patients expected to have good exercise capacity.
No takes yet. Share an insight, caveat, or question.
Peteiro et al. (2007) conducted a cohort in Coronary artery disease risk (n=1,433). Abnormal exercise echocardiography vs. Normal exercise echocardiography / clinical and resting variables was evaluated on Hard events (cardiac death or nonfatal myocardial infarction) (p=0.03). Abnormal exercise echocardiography was independently associated with cardiac death or nonfatal myocardial infarction in patients with excellent exercise capacity (P=0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: