European Heart Journal Advance Access published online on November 28, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl393
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Outcomes after normal dobutamine stress echocardiography and predictors of adverse events: long-term follow-up of 3014 patients
1 Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
2 Department of Biostatistics, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
Received 27 December 2005; revised 24 October 2006; accepted 7 November 2006.
* Corresponding author. Tel: +1 507 266 0676; fax: +1 507 284 3968. E-mail address: pellikka.patricia{at}mayo.edu
Aims Normal exercise echocardiography predicts a good prognosis. Dobutamine stress echocardiography (DSE) is generally reserved for patients with comorbidities which preclude exercise testing. We evaluated predictors of adverse events after normal DSE.
Methods and results We studied 3014 patients (1200 males, 68±12 years) with normal DSE, defined as the absence of wall motion abnormality at rest or with stress. During median follow-up of 6.3 years, all-cause mortality and cardiac events, defined as myocardial infarction and coronary revascularization, occurred in 920 (31%) and 231 (7.7%) patients, respectively. Survival and cardiac event-free probabilities were 95 and 98% at 1 year, 78 and 93% at 5 years, and 56 and 89% at 10 years, respectively. Age, diabetes mellitus, and failure to achieve 85% age-predicted maximal heart rate were independent predictors of mortality and cardiac events. Patients with all three of these characteristics had a 13% probability of cardiac events within the first year and higher risk throughout follow-up.
Conclusion Prognosis after normal DSE is not necessarily benign, but depends on patient and stress test characteristics. Careful evaluation, using clinical and stress data, is required to identify patients with normal DSE who are at increased risk of adverse outcomes during long-term follow-up.
Key Words: Dobutamine • Ischaemic heart disease • Prognosis • Stress echocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
 |
|
 A. E. Weyman The Year in Echocardiography J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1221 - 1229. [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]
|
|
|
|
 |
|
 S. Gang, M. Dabhi, and M. M. Rajapurkar Ischaemia imaging in type 2 diabetic kidney transplant candidates is coronary angiography essential? Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2334 - 2338. [Abstract] [Full Text] [PDF]
|
|