Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Impact of an inconclusive exercise stress echocardiogram on cardiovascular outcomes
Session:
Posters - B. Imaging
Speaker:
Ana Filipa Abreu Cardoso
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
Ana Filipa Cardoso; Mário Rui Lourenço; Pedro Von Hafe; Geraldo Dias; Tamara Pereira; Mariana Tinoco; Marina Fernandes; Olga Azevedo; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Background: </strong>Exercise stress echocardiography (ESE) is used for the assessment of suspected or known coronary artery disease (CAD); however, a certain percentage of ESE studies are inconclusive. We aim to evaluate the prognostic impact of an inconclusive ESE on cardiovascular outcomes.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Methods: </strong>Single-center retrospective study of consecutive patients (pts) who performed an ESE between 2018 and 2019 for diagnosis or stratification of CAD. All pts performed a symptom-limited Bruce protocol. ESE was considered inconclusive when 85% of age-predicted maximum HR was not reached. Primary endpoint was a composite of admission for acute coronary syndrome (ACS), coronary revascularization and cardiovascular death during the follow-up.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Results: </strong>A total of<strong> </strong>141 pts were included (76% male; mean age 60±9 years). ESE was inconclusive in 51 (36%) pts, positive in 11 (8%) and negative in 79 (56%).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">The mean exercise time of pts with inconclusive ESE was 7±2 minutes and 76% had normal functional capacity. Fatigue (25 pts; 49%) and lower extremities pain (11 pts; 22%) were the main reasons for ESE stopping. Five pts (10%) complained of chest pain during exam. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">Pts with an inconclusive ESE were more diabetic (inconclusive 43%, positive 9%, negative 13%; p=.001), had more chronic obstructive pulmonary disease (COPD) (14%, 0%, 2.5%; p=.026), performed more frequently the exam under beta blocker (BB) therapy (59%, 27%, 18%; p=.041) and had less ST-segment depression fulfilling electrocardiographic criteria for ischemia (10%, 64%, 27%, p<.001). Their functional capacity was worse than negative ESE pts (p<.001).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">During a median follow up of 22 months (IQR 15-27), 13 (9.2%) pts had the primary endpoint, including 5 pts (3.5%) with ACS. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">Pts with an inconclusive ESE had a lower incidence of the primary outcome than pts with a positive ESE and a higher incidence of events than pts with negative results (figure).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">In multivariate analysis, after adjusting for functional capacity and electrocardiographic criteria for ischemia, an inconclusive ESE was an independent predictor of the primary endpoint (HR 9.7, IC95% 1.1-87,6 p= .042)</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Conclusions:</strong> The frequency of inconclusive ESE is not negligible (36%). These pts had more diabetes and COPD and performed the exam under BB therapy more frequently, highlighting the importance of proper patient selection. An inconclusive ESE was associated to a higher risk of cardiovascular events compared to negative ESE.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site