Key result
Exercise echocardiography provided incremental prognostic value over resting echocardiography for hard events (P=0.02), and exercise-induced MR worsening independently predicted cardiac death (P=0.04).
Why the study?
Does exercise echocardiography with assessment of mitral regurgitation worsening improve prognostic prediction for hard events and cardiac death compared to resting echocardiography in patients with left ventricular dysfunction?
Cohort (n=323)
Does exercise echocardiography with assessment of mitral regurgitation worsening improve prognostic prediction for hard events and cardiac death compared to resting echocardiography in patients with left ventricular dysfunction?
p-value: p=0.02
Exercise echocardiography, particularly the assessment of exercise-induced mitral regurgitation worsening, provides independent prognostic value for cardiac death in patients with left ventricular dysfunction.
May enhance risk stratification in LV dysfunction; hypothesis-generating and should not yet change practice.
AIMS: The value of exercise echocardiography (EE) over resting echocardiography when this last incorporates information on mitral regurgitation (MR) is only partially known. Furthermore, limited data exist regarding the value of MR worsening during exercise in patients with left ventricular (LV) dysfunction. We investigate whether EE has incremental value over a resting echo-Doppler study; and whether post-exercise MR increments the value of EE for predicting outcome in patients with LV dysfunction. METHODS AND RESULTS: Three hundred and twenty-three consecutive patients with LV dysfunction (LV ejection fraction < or =45%) referred for EE were followed for 1.7 +/- 1.5 years. There were 43 hard events (myocardial infarction in 9 and cardiac death in 34). Resting MR, peak heart rate x blood pressure, and number of involved territories at exercise were independently associated to hard events (incremental P-value of EE =0.02). Independent variables associated to cardiac death were resting MR, peak heart rate x blood pressure, peak wall motion score index, and MR worsening (incremental P-value of MR worsening = 0.04). CONCLUSIONS: EE maintains its prognostic value over resting echocardiography even when this last incorporates information on MR. Exercise-induced MR worsening has independent prognostic value for cardiac death in patients with LV dysfunction.
No takes yet. Share an insight, caveat, or question.
PETEIRO et al. (2007) conducted a cohort in Left ventricular dysfunction (n=323). Exercise echocardiography and exercise-induced mitral regurgitation worsening vs. Resting echocardiography was evaluated on Hard events (myocardial infarction and cardiac death) (p=0.02). Exercise echocardiography provided incremental prognostic value over resting echocardiography for hard events (P=0.02), and exercise-induced MR worsening independently predicted cardiac death (P=0.04).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: