This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sicari, R. Search for Related Content PubMed PubMed Citation Articles by Sicari, R.

CLINICAL STUDY: STRESS ECHOCARDIOGRAPHY

Stress echo results predict mortality: a large-scale multicenter prospective international study

^* National Council of Research, Institute of Clinical Physiology, Pisa, Italy

Manuscript received June 4, 2002; revised manuscript received August 29, 2002, accepted September 20, 2002.

^* Reprint requests and correspondence: Dr. Rosa Sicari, CNR, Institute of Clinical Physiology, Via G. Moruzzi, 1, 56125 Pisa, Italy.
rosas{at}ifc.cnr.it

OBJECTIVES: The purpose of this study was to assess the long-term value of pharmacologic stress echocardiography with either dipyridamole or dobutamine (DET) for prediction of cardiac death in patients with proven or suspected coronary artery disease (CAD).

BACKGROUND: Stress echocardiography is an established, cost-effective technique for the detection of CAD.

METHODS: From the Echo Persantine International Cooperative–Echo Dobutamine International Cooperative data bank, 7,333 patients (5,452 males; 59 ± 10 years) underwent pharmacologic stress echocardiography with either high-dose dipyridamole (0.84 mg/kg over 10 min) (n = 4,984) or high-dose dobutamine (up to 40 µg/kg/3 min) (n = 2,349) for diagnostic purposes. Patients were followed up for a mean of 2.6 years (range 1 to 206 months).

RESULTS: The DET was positive for myocardial ischemia in 2,854 (35%) patients and negative in 4,479 (61%) patients. During the follow-up there were 161 cardiac deaths (sudden death and fatal myocardial infarction) (2.1% of the total population). Kaplan-Meier survival estimates showed a significantly better outcome for those patients with a negative pharmacologic stress echocardiography test compared with those with a positive test (92 vs. 71.2%, p = 0.0000).

CONCLUSIONS: Pharmacologic stress echocardiography with either dipyridamole or dobutamine is effective in predicting cardiac death during a long-term follow-up. A negative stress echocardiography test result is related to a favorable outcome.

Abbreviations and Acronyms   CAD   coronary artery disease   CI   confidence interval   DET   pharmacologic stress echocardiography with either dobutamine or dipyridamole   ECG   electrocardiograph/electrocardiographic   RR   relative risk   WMSI   wall motion score index

This article has been cited by other articles:

				K. H. Schuleri, M. Centola, R. T. George, L. C. Amado, K. S. Evers, K. Kitagawa, A. L. Vavere, R. Evers, J. M. Hare, C. Cox, et al. Characterization of peri-infarct zone heterogeneity by contrast-enhanced multidetector computed tomography: a comparison with magnetic resonance imaging. J. Am. Coll. Cardiol., May 5, 2009; 53(18): 1699 - 1707. [Abstract] [Full Text] [PDF]

				S. M. Bierig and A. Jones Accuracy and Cost Comparison of Ultrasound Versus Alternative Imaging Modalities, Including CT, MR, PET, and Angiography Journal of Diagnostic Medical Sonography, May 1, 2009; 25(3): 138 - 144. [Abstract] [PDF]

				R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress Echocardiography Expert Consensus Statement--Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur. Heart J., February 1, 2009; 30(3): 278 - 289. [Full Text] [PDF]

				R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur J Echocardiogr, July 1, 2008; 9(4): 415 - 437. [Abstract] [Full Text] [PDF]

				S. E. Karagiannis, H. H.H. Feringa, A. Elhendy, R. van Domburg, M. Chonchol, R. Vidakovic, J. J. Bax, G. Karatasakis, G. Athanasopoulos, D. V. Cokkinos, et al. Prognostic significance of renal function in patients undergoing dobutamine stress echocardiography Nephrol. Dial. Transplant., February 1, 2008; 23(2): 601 - 607. [Abstract] [Full Text] [PDF]

				F. Rigo, R. Sicari, S. Gherardi, A. Djordjevic-Dikic, L. Cortigiani, and E. Picano The additive prognostic value of wall motion abnormalities and coronary flow reserve during dipyridamole stress echo Eur. Heart J., January 1, 2008; 29(1): 79 - 88. [Abstract] [Full Text] [PDF]

				P. A. Pellikka and R. B. McCully Stress Echocardiography: So Much to Do, So Little Time J. Am. Coll. Cardiol., November 13, 2007; 50(20): 1990 - 1991. [Full Text] [PDF]

				A H Gershlick, M de Belder, J Chambers, D Hackett, R Keal, A Kelion, S Neubauer, D J Pennell, M Rothman, M Signy, et al. Role of non-invasive imaging in the management of coronary artery disease: an assessment of likely change over the next 10 years. A report from the British Cardiovascular Society Working Group Heart, April 1, 2007; 93(4): 423 - 431. [Abstract] [Full Text] [PDF]

				C. B. Ingul, E. Rozis, S. A. Slordahl, and T. H. Marwick Incremental Value of Strain Rate Imaging to Wall Motion Analysis for Prediction of Outcome in Patients Undergoing Dobutamine Stress Echocardiography Circulation, March 13, 2007; 115(10): 1252 - 1259. [Abstract] [Full Text] [PDF]

				Z. Vered, M. Leitman, and R. Krakover Better, (perhaps) cheaper, but is it best? Eur. Heart J., January 16, 2007; (2007) ehl432v1. [Full Text] [PDF]

				N. Chaowalit, R. B. McCully, M. J. Callahan, F. Mookadam, K. R. Bailey, and P. A. Pellikka Outcomes after normal dobutamine stress echocardiography and predictors of adverse events: long-term follow-up of 3014 patients Eur. Heart J., December 2, 2006; 27(24): 3039 - 3044. [Abstract] [Full Text] [PDF]

				E. Eroglu, J. D'hooge, L. Herbots, D. Thijs, C. Dubois, P. Sinnaeve, J. Dens, J. Vanhaecke, and F. Rademakers Comparison of real-time tri-plane and conventional 2D dobutamine stress echocardiography for the assessment of coronary artery disease Eur. Heart J., July 2, 2006; 27(14): 1719 - 1724. [Abstract] [Full Text] [PDF]

				L. J. Shaw, C. N. Bairey Merz, C. J. Pepine, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, S. Mankad, B. L. Sharaf, et al. Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender Differences in Traditional and Novel Risk Factors, Symptom Evaluation, and Gender-Optimized Diagnostic Strategies J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S4 - S20. [Abstract] [Full Text] [PDF]

				T. H. Marwick Ischaemia and outcome with normal coronary arteries Eur. Heart J., October 2, 2005; 26(20): 2077 - 2078. [Full Text] [PDF]

				E. Biagini, A. Elhendy, A. F. L. Schinkel, V. Rizzello, J. J. Bax, F. B. Sozzi, M. D. Kertai, R. T. van Domburg, B. J. Krenning, A. Branzi, et al. Long-Term Prediction of Mortality in Elderly Persons by Dobutamine Stress Echocardiography J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2005; 60(10): 1333 - 1338. [Abstract] [Full Text] [PDF]

				T. H. Marwick Contrast Stress Echocardiography: Completing the Picture From Image Enhancement to Improved Accuracy and Prognostic Insight Circulation, September 6, 2005; 112(10): 1382 - 1383. [Full Text] [PDF]

				W. F. Armstrong and W. A. Zoghbi Stress Echocardiography: Current Methodology and Clinical Applications J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1739 - 1747. [Abstract] [Full Text] [PDF]

				E Biagini, A F L Schinkel, J J Bax, V Rizzello, R T van Domburg, B J Krenning, M Bountioukos, C Pedone, E C Vourvouri, C Rapezzi, et al. Long term outcome in patients with silent versus symptomatic ischaemia during dobutamine stress echocardiography Heart, June 1, 2005; 91(6): 737 - 742. [Abstract] [Full Text] [PDF]

				R Senior, M Monaghan, H Becher, J Mayet, and P Nihoyannopoulos Stress echocardiography for the diagnosis and risk stratification of patients with suspected or known coronary artery disease: a critical appraisal. Supported by the British Society of Echocardiography Heart, April 1, 2005; 91(4): 427 - 436. [Abstract] [Full Text] [PDF]

				L. J. Shaw, C. Vasey, S. Sawada, C. Rimmerman, and T. H. Marwick Impact of gender on risk stratification by exercise and dobutamine stress echocardiography: long-term mortality in 4234 women and 6898 men Eur. Heart J., March 1, 2005; 26(5): 447 - 456. [Abstract] [Full Text] [PDF]

				R. Sicari, L. Cortigiani, R. Bigi, P. Landi, M. Raciti, E. Picano, and for the Echo-Persantine International Cooperative Prognostic Value of Pharmacological Stress Echocardiography Is Affected by Concomitant Antiischemic Therapy at the Time of Testing Circulation, May 25, 2004; 109(20): 2428 - 2431. [Abstract] [Full Text] [PDF]

				A. E. Weyman The year in echocardiography J. Am. Coll. Cardiol., January 7, 2004; 43(1): 140 - 148. [Full Text] [PDF]