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Chronotropic incompetence and a higher frequency of myocardial ischemia in exercise echocardiography.
- Source :
-
Cardiovascular ultrasound [Cardiovasc Ultrasound] 2007 Nov 02; Vol. 5, pp. 38. Date of Electronic Publication: 2007 Nov 02. - Publication Year :
- 2007
-
Abstract
- Background: Exercise echocardiography (EE) is an established method to diagnose coronary artery disease (CAD). Chronotropic incompetence (CI) during the EE may be a marker of myocardial ischemia. The purpose of this investigation was to evaluate the additive value of CI during EE in CAD diagnosis.<br />Methods: Between 2000 and 2006, 4042 patients (1900 men with a mean age of 56 +/- 11 years) were evaluated by EE. Based on the heart rate (HR) reached during the exercise test, the subjects were divided into two groups: G1 group - 490 patients who failed to achieve 85% of the maximal age-predicted HR, and G2 group - 3552 patients who were able to achieve 85% of the maximal age-predicted HR. Clinical characteristics, left ventricular wall motion abnormalities - wall motion score index (WMSI) - and coronary angiography (CA) were the parameters compared between the two groups.<br />Results: The left ventricular wall motion abnormalities were more frequent in G1 group than in G2 group (54% versus 26%; P < 0.00001). WMSI was higher in G1 group than in G2 group, both at rest (1.06 +/- 0.17 versus 1.02 +/- 0.09; P < 0.0001) and after exercise (1.12 +/- 0.23 versus 1.04 +/- 0.21; P < 0.0001). In G1 group, 82% of the patients with positive EE for myocardial ischemia presented obstructive coronary, compared to 71% (P = 0.03) in G2 group.<br />Conclusion: CI is associated with a higher frequency of myocardial ischemia during EE, reinforcing the concept that CI is a marker of the severity of myocardial ischemia.
- Subjects :
- Brazil epidemiology
Comorbidity
Exercise Test methods
Female
Heart Rate
Humans
Incidence
Male
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Arrhythmias, Cardiac diagnostic imaging
Arrhythmias, Cardiac epidemiology
Echocardiography statistics & numerical data
Exercise Test statistics & numerical data
Myocardial Ischemia diagnostic imaging
Myocardial Ischemia epidemiology
Risk Assessment methods
Subjects
Details
- Language :
- English
- ISSN :
- 1476-7120
- Volume :
- 5
- Database :
- MEDLINE
- Journal :
- Cardiovascular ultrasound
- Publication Type :
- Academic Journal
- Accession number :
- 17980022
- Full Text :
- https://doi.org/10.1186/1476-7120-5-38