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Titolo:
CARDIAC IMAGING FOR RISK STRATIFICATION WITH DOBUTAMINE-ATROPINE STRESS-TESTING IN PATIENTS WITH CHEST PAIN - ECHOCARDIOGRAPHY, PERFUSION SCINTIGRAPHY, OR BOTH
Autore:
GELEIJNSE ML; ELHENDY A; VANDOMBURG RT; CORNEL JH; RAMBALDI R; SALUSTRI A; REIJS AEM; ROELANDT JRTC; FIORETTI PM;
Indirizzi:
THORAX CTR ROTTERDAM,BA 300,DR MOLEWATERPL 40 NL-3015 GD ROTTERDAM NETHERLANDS UNIV HOSP DIJKZIGT,DEPT NUCL MED ROTTERDAM NETHERLANDS ERASMUS UNIV ROTTERDAM ROTTERDAM NETHERLANDS
Titolo Testata:
Circulation
fascicolo: 1, volume: 96, anno: 1997,
pagine: 137 - 147
SICI:
0009-7322(1997)96:1<137:CIFRSW>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; ISCHEMIC-HEART-DISEASE; PROGNOSTIC VALUE; DIPYRIDAMOLE-ECHOCARDIOGRAPHY; MYOCARDIAL-ISCHEMIA; EXERCISE; MULTICENTER; INFUSION; SAFETY;
Keywords:
STRESS; TESTS; ECHOCARDIOGRAPHY; RADIOISOTOPES; PROGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
M.L. Geleijnse et al., "CARDIAC IMAGING FOR RISK STRATIFICATION WITH DOBUTAMINE-ATROPINE STRESS-TESTING IN PATIENTS WITH CHEST PAIN - ECHOCARDIOGRAPHY, PERFUSION SCINTIGRAPHY, OR BOTH", Circulation, 96(1), 1997, pp. 137-147

Abstract

Background Pharmacological stress echocardiography and myocardial perfusion scintigraphy are used frequently for risk stratification in patients with suspected myocardial ischemia. However, their relative prognostic strength has never been explored. Methods and Results Two hundred twenty consecutive patients with chest pain (mean age, 60+/-12 years; 124 men, 115 with previous myocardial infarction) were studied withdobu tamine-atropine stress echocardiography (ECHO) and simultaneous Te-99m sestamibi single photon emission computed tomography imaging (MIBI). Ischemia was defined as deterioration in left ventricular wall motion and reversible perfusion defects, respectively. ECHO was positive for ischemia in 76 and MIBI in 91 patients (agreement, 77%; kappa=.51). During follow-up of 31+/-15 months, 24 patients had hard cardiac events (nonfatal myocardial infarction or cardiac death). By univariateanalysis, age, history of congestive heart failure, and any abnormality or ischemia on ECHO or MIBI were associated with cardiac events. Multivariate analysis revealed that age, abnormal ECHO (odds ratio [OR],18.9; 95% CI, 2.5 to 146.0) or MIBI (OR, 12.8; 95% CI, 1.7 to 98.3), and ischemia on ECHO (OR, 4.0; 95% CI, 1.6 to 9.9) or MIBI (OR, 3.0; 95% CI, 1.2 to 7.4) had independent predictive values. When ECHO was used as a first option, the addition of MIBI to all nonischemic ECHO studies decreased the OR from 4.0 (95% CI, 1.6 to 9.9) to 3.8 (95% CI, 1.4 to 10.2). Addition of MIBI confined to nonischemic ECHO studies in which target heart rate was not attained (nondiagnostic studies) increased the OR to a maximal 5.7 (95% CI, 2.2 to 15.0). In contrast, the addition of ECHO to nondiagnostic MIBI studies was not useful. Conclusions Dobutamine-atropine ECHO and MIBI provide comparable prognostic information. The addition of MIBI to ECHO may be useful in patients with nondiagnostic ECHO studies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 00:51:40