Utility and limitation of treadmill exercise echocardiography for detecting significant coronary stenosis in infarct-related arteries in patients with healed myocardial infarction
This clinical study examines the diagnostic accuracy of exercise echocardiography for detecting significant coronary stenoses in infarct-related arteries in patients with healed myocardial infarction. Quantitative coronary angiography and exercise echocardiography using treadmill testing were perfor...
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| Veröffentlicht in: | The American journal of cardiology 2002-01, Vol.89 (2), p.159-163 |
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| creator | Nishioka, Toshihiko Mitani, Hideki Uehata, Akimi Takase, Bonpei Isojima, Kazushige Nagai, Tomoo Ohsuzu, Fumitaka Kurita, Akira Ohtomi, Shingo Siegel, Robert J |
| description | This clinical study examines the diagnostic accuracy of exercise echocardiography for detecting significant coronary stenoses in infarct-related arteries in patients with healed myocardial infarction. Quantitative coronary angiography and exercise echocardiography using treadmill testing were performed within 2 weeks of each other in 123 patients with a prior myocardial infarction. Coronary lumen diameter stenosis ≥50% by quantitative coronary angiography and the lack of a hyperdynamic response on exercise echocardiography was considered significant. For detection of infarct-related coronary lesions, treadmill exercise echocardiography was highly sensitive (91%) but less specific (59%) than for detection of non-infarct-related artery lesions. The 2 groups of patients with large and small infarct sites had similar sensitivity for detection of residual stenosis of the infarct-related artery (88% vs 96%, p = NS); however, the specificity of the small infarct sites for this purpose was significantly higher than that of the large infarct sites (86% vs 33%, p |
| doi_str_mv | 10.1016/S0002-9149(01)02193-2 |
| format | Article |
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Quantitative coronary angiography and exercise echocardiography using treadmill testing were performed within 2 weeks of each other in 123 patients with a prior myocardial infarction. Coronary lumen diameter stenosis ≥50% by quantitative coronary angiography and the lack of a hyperdynamic response on exercise echocardiography was considered significant. For detection of infarct-related coronary lesions, treadmill exercise echocardiography was highly sensitive (91%) but less specific (59%) than for detection of non-infarct-related artery lesions. The 2 groups of patients with large and small infarct sites had similar sensitivity for detection of residual stenosis of the infarct-related artery (88% vs 96%, p = NS); however, the specificity of the small infarct sites for this purpose was significantly higher than that of the large infarct sites (86% vs 33%, p <0.01). When remote ischemia was detected on exercise echocardiography, the specificity of exercise echocardiography was significantly lower (33% vs 70%, p <0.05) than when remote ischemia was not present. Thus, although there is high sensitivity, the specificity of treadmill exercise echocardiography for detecting infarct-related artery lesions is limited. However, high specificity is maintained when the infarct size is small and/or remote ischemia is not present.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(01)02193-2</identifier><identifier>PMID: 11792335</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Cardiology ; Cardiology. 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Quantitative coronary angiography and exercise echocardiography using treadmill testing were performed within 2 weeks of each other in 123 patients with a prior myocardial infarction. Coronary lumen diameter stenosis ≥50% by quantitative coronary angiography and the lack of a hyperdynamic response on exercise echocardiography was considered significant. For detection of infarct-related coronary lesions, treadmill exercise echocardiography was highly sensitive (91%) but less specific (59%) than for detection of non-infarct-related artery lesions. The 2 groups of patients with large and small infarct sites had similar sensitivity for detection of residual stenosis of the infarct-related artery (88% vs 96%, p = NS); however, the specificity of the small infarct sites for this purpose was significantly higher than that of the large infarct sites (86% vs 33%, p <0.01). When remote ischemia was detected on exercise echocardiography, the specificity of exercise echocardiography was significantly lower (33% vs 70%, p <0.05) than when remote ischemia was not present. Thus, although there is high sensitivity, the specificity of treadmill exercise echocardiography for detecting infarct-related artery lesions is limited. However, high specificity is maintained when the infarct size is small and/or remote ischemia is not present.</description><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Chi-Square Distribution</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - physiopathology</subject><subject>Coronary vessels</subject><subject>Echocardiography - methods</subject><subject>Exercise Test - instrumentation</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonic imaging</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkduKFDEQhhtR3HH0EZQgKHrRmnS6pztXIosnWPBC9zpUkspMlnQyJhl1nssXNHPQBW-EQAj5quqnvqZ5zOgrRtnq9RdKadcK1osXlL2kHRO87e40CzaNomWC8bvN4i9y0TzI-aY-GRtW95sLxkbRcT4sml_XxXlX9gSCId7NrkBxMZBoSUkIZnbeE_yJSbuMBPUmakjGxXWC7WZPbEzEYEFdXFiT7NbBWachFKJjigHSnuSCIWaXiQv1WEi6tAk9FDQEUsHk8Pi3rYMxlEx-uLIhGwRfgXl_mgf-T20N97C5Z8FnfHS-l831-3dfLz-2V58_fLp8e9Xqnk2lVZwCKK16wxWuOO1Wgho1WGMHPdphBKrsynLolFIjp4PSfScQhB0nw3FQfNk8P_Xdpvhth7nI2WWN3kPAuMtyZFxMw8Ar-PQf8CbuUqjZZMcpn6apX1VoOEE6xZwTWrlNbq4bkozKg1J5VCoPviRl8qi01i-bJ-fmOzWjua06O6zAszMAWYO3CUKVdcvxvu96ceDenDisO_vuMMms68Y1GpeqQGmi-0-U342Hw_A</recordid><startdate>20020115</startdate><enddate>20020115</enddate><creator>Nishioka, Toshihiko</creator><creator>Mitani, Hideki</creator><creator>Uehata, Akimi</creator><creator>Takase, Bonpei</creator><creator>Isojima, Kazushige</creator><creator>Nagai, Tomoo</creator><creator>Ohsuzu, Fumitaka</creator><creator>Kurita, Akira</creator><creator>Ohtomi, Shingo</creator><creator>Siegel, Robert J</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20020115</creationdate><title>Utility and limitation of treadmill exercise echocardiography for detecting significant coronary stenosis in infarct-related arteries in patients with healed myocardial infarction</title><author>Nishioka, Toshihiko ; Mitani, Hideki ; Uehata, Akimi ; Takase, Bonpei ; Isojima, Kazushige ; Nagai, Tomoo ; Ohsuzu, Fumitaka ; Kurita, Akira ; Ohtomi, Shingo ; Siegel, Robert J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-b30aabcb4d3be6302690db5fdf5c7f57a0bf6f3a2bbb7305bc429ea9f78d3e5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. 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Quantitative coronary angiography and exercise echocardiography using treadmill testing were performed within 2 weeks of each other in 123 patients with a prior myocardial infarction. Coronary lumen diameter stenosis ≥50% by quantitative coronary angiography and the lack of a hyperdynamic response on exercise echocardiography was considered significant. For detection of infarct-related coronary lesions, treadmill exercise echocardiography was highly sensitive (91%) but less specific (59%) than for detection of non-infarct-related artery lesions. The 2 groups of patients with large and small infarct sites had similar sensitivity for detection of residual stenosis of the infarct-related artery (88% vs 96%, p = NS); however, the specificity of the small infarct sites for this purpose was significantly higher than that of the large infarct sites (86% vs 33%, p <0.01). When remote ischemia was detected on exercise echocardiography, the specificity of exercise echocardiography was significantly lower (33% vs 70%, p <0.05) than when remote ischemia was not present. Thus, although there is high sensitivity, the specificity of treadmill exercise echocardiography for detecting infarct-related artery lesions is limited. However, high specificity is maintained when the infarct size is small and/or remote ischemia is not present.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11792335</pmid><doi>10.1016/S0002-9149(01)02193-2</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular disease Chi-Square Distribution Coronary Angiography Coronary heart disease Coronary Stenosis - diagnostic imaging Coronary Stenosis - physiopathology Coronary vessels Echocardiography - methods Exercise Test - instrumentation Female Heart Humans Male Medical sciences Middle Aged Myocardial Infarction - diagnostic imaging Myocardial Infarction - physiopathology Risk Factors Sensitivity and Specificity Ultrasonic imaging |
| title | Utility and limitation of treadmill exercise echocardiography for detecting significant coronary stenosis in infarct-related arteries in patients with healed myocardial infarction |
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