An expanded stress-echocardiography protocol with treadmill exercise provided additional diagnostic information about the nature of shortness of breath in 72.5% of patients.
Observational (n=243)
Does an expanded stress echocardiography protocol with treadmill exercise identify the etiology of dyspnea in outpatients?
An expanded stress echocardiography protocol with treadmill exercise provides additional diagnostic information regarding the etiology of dyspnea in 72.5% of patients without increasing study duration.
Aim To determine diagnostic capabilities of the expanded protocol for stress echocardiography (stress-EchoCG) with comprehensive evaluation of clinical and echocardiographic indexes in differential diagnosis of dyspnea.Material and methods This study included 243 patients (123 women and 120 men) who were referred to outpatient stress-EchoCG during one calendar month. For 80 patients complaining about shortness of breath, the expanded stress-EchoCG protocol with treadmill exercise was performed. During the exercise, E / e' and tricuspid regurgitation velocity were determined, and clinical features and possible nature of dyspnea were evaluated.Results Shortness of breath had an ischemic origin in 17.5 % of 80 patients; 13.8 % had criteria of elevated left ventricular end-diastolic pressure; 17.5 % of patients had clinical signs of bronco-pulmonary pathology; 5.0 % had moderate and severe mitral regurgitation; 20 % displayed signs of chronotropic insufficiency during exercise including on the background of beta-blocker therapy; 15.0 % of patients displayed a hypertensive response to exercise, which was associated with signs of chronotropic insufficiency in 50 % of them; and 1.3 % had signs of hyperventilation syndrome. In addition to diagnosis of transient ischemia, additional information about the nature of shortness of breath was obtained for 72.5 % of patients. Based on results of the test, objective causes for dyspnea were not identified for 10.0 % of patients.Conclusion The expanded stress-EchoCG protocol with exercise allows obtaining information about the nature of dyspnea for most patients with shortness of breath of a non-ischemic origin. For this patient category, expanding the stress-EchoCG protocol does not increase duration of the study and is economically beneficial for diagnosis of chronic heart failure and other causes for shortness of breath.
Карев et al. (Sun,) conducted a observational in Shortness of breath (dyspnea) (n=243). Expanded stress-echocardiography protocol with treadmill exercise was evaluated on Additional information obtained about the nature of shortness of breath. An expanded stress-echocardiography protocol with treadmill exercise provided additional diagnostic information about the nature of shortness of breath in 72.5% of patients.