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Titolo:
Stress echocardiography for assessment of cardiac allograft vasculopathy
Autore:
Spes, CH; Angermann, CE;
Indirizzi:
Univ Munich, Lehrkrankenhaus, Krankenhaus Munchen Neuperlach, D-81737 Munich, Germany Univ Munich Munich Germany D-81737 n Neuperlach, D-81737 Munich, Germany Univ Munich, Klin Innenstadt, Kardiol Abt, D-80336 Munich, Germany Univ Munich Munich Germany D-80336 Kardiol Abt, D-80336 Munich, Germany
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
, volume: 89, anno: 2000, supplemento:, 9
pagine: 50 - 53
SICI:
0300-5860(2000)89:<50:SEFAOC>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-TRANSPLANT RECIPIENTS; CORONARY-ARTERY DISEASE; INTRAVASCULAR ULTRASOUND; NONINVASIVE ASSESSMENT; DOBUTAMINE; ANGIOGRAPHY; EVENTS;
Keywords:
stress echocardiography; cardiac transplantation; allograft vasculopathy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Spes, CH Univ Munich, Lehrkrankenhaus, Krankenhaus Munchen Neuperlach, Oskar Maria Graf Ring 51, D-81737 Munich, Germany Univ Munich Oskar Maria GrafRing 51 Munich Germany D-81737 many
Citazione:
C.H. Spes e C.E. Angermann, "Stress echocardiography for assessment of cardiac allograft vasculopathy", Z KARDIOL, 89, 2000, pp. 50-53

Abstract

Invasive methods as coronary angiography and intravascular ultrasound (IVUS) are still the routine tools for diagnosis of cardiac allograft vasculopathy (CAV). Nevertheless, invasive tests are expensive and not free of risk. Dobutamine stress echocardiography (DSE) emerged as a useful non-invasive tool for assessment of cardiac allograft vasculopathy (CAV). In our study, echocardiographic wall motion abnormalities (WMA) at rest had a sensitivityof 57 % (specificity ss %) to detect CAV defined by IVUS and angiography, which was significantly (p < 0.0001) improved to 72 % (specificity 88 %) bystress testing. Additional M-mode analysis of systolic wall thickening improved the sensitivity of the resting echocardiogram to 72 % (specificity 85%), the combined M- mode and 2D-analysis during stress had a sensitivity of 85 % (p < 0.0001; specificity 82 %). DSE was also useful to predict prognosis: 1.9 % of patients with normal, but 27.3 % of patients with abnormal 2D-DSE developed cardiac events (heart failure, infarction, death, re-HTX, PTCA) between annual studies (p < 0.0002). No change in serial DSE studies was associated with a low event rate (4 %), compared to serial DSE deterioration (29 %, p < 0.0014). Based on our experience, we postpone invasive studies for 12-24 months, if DSE is normal or remains unchanged in serial studies. Angiography is used in patients with abnormal or deteriorating DSE. In conclusion, noninvasive DSE provides useful diagnostic and prognostic information. It appears safe to use DSE as a first step of CAV monitoring.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 18:10:23