Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy
Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise,...
Gespeichert in:
| Veröffentlicht in: | The American journal of cardiology 2010-11, Vol.106 (10), p.1423-1428 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1428 |
|---|---|
| container_issue | 10 |
| container_start_page | 1423 |
| container_title | The American journal of cardiology |
| container_volume | 106 |
| creator | Marshall, Andrew J., MB Hutchings, Fiona, BSc James, Alycia J., BSc Kelion, Andrew D., DM |
| description | Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise, with apparent incremental prognostic power above exercise testing alone. We compared exercise test and myocardial perfusion scintigraphic (MPS) findings and risk of hard cardiac events (median 4 years) in patients completing ≥9-minute treadmill exercise. Patients undergoing myocardial perfusion scintigraphy who completed a 9-minute Bruce protocol exercise were identified over a 2-year period. Follow-up was performed by telephone, with case-note review when necessary; this was 97% complete. Five hundred sixteen patients were identified (73% men, median age 53 year). One hundred eighty-one (35%) had known coronary disease. One hundred forty-nine (29%) had a “high-risk” exercise test result (limiting chest pain or ST-segment depression), and 69 (13%) had high-risk MPS findings (>10% myocardium ischemic or ejection fraction |
| doi_str_mv | 10.1016/j.amjcard.2010.06.074 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_763258995</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002914910014086</els_id><sourcerecordid>2195234281</sourcerecordid><originalsourceid>FETCH-LOGICAL-c476t-bbd6e667f8219ad2c5b2dff00a9d6bd1dfeb62b265b4292ac371e3414013fbc43</originalsourceid><addsrcrecordid>eNqFkl-L1DAUxYMo7uzqR1CCIPvUMUnTtHlRZPEf7OrAzvoa0uR2TG2TMWmF-famzLjCvvgUEn735txzLkIvKFlTQsWbfq3H3uho14zkNyLWpOaP0Io2tSyopOVjtCKEsEJSLs_QeUp9vlJaiafojFFSSV7SFXKbGHY-pMkZ_F0PM-DQYY2_Og_FjfPzBHgbQdvRDQPeQpqw83ijJwd-SvjOW4i74PwO3xzCosbpAW8gdnNyweNb4_zkdlHvfxyeoSedHhI8P50X6O7jh-3V5-L626cvV--vC8NrMRVtawUIUXcNo1JbZqqW2a4jREsrWkttB61gLRNVy5lk2pQ1hZJTTmjZtYaXF-jy2Hcfw685K1ajSwaGQXsIc1K1KFnVSFll8tUDsg9z9FmcakgtuagZyVB1hEwMKUXo1D66UceDokQtSahenZJQSxKKCJWTyHUvT83ndgR7X_XX-gy8PgE6GT10UXvj0j-urGQtJcvcuyMH2bTfDqJKJrtvwLoIZlI2uP9Kefuggxmcd_nTn3CAdD80VYkpom6XtVm2huZ94aQR5R8zG77N</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>807946720</pqid></control><display><type>article</type><title>Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Marshall, Andrew J., MB ; Hutchings, Fiona, BSc ; James, Alycia J., BSc ; Kelion, Andrew D., DM</creator><creatorcontrib>Marshall, Andrew J., MB ; Hutchings, Fiona, BSc ; James, Alycia J., BSc ; Kelion, Andrew D., DM</creatorcontrib><description>Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise, with apparent incremental prognostic power above exercise testing alone. We compared exercise test and myocardial perfusion scintigraphic (MPS) findings and risk of hard cardiac events (median 4 years) in patients completing ≥9-minute treadmill exercise. Patients undergoing myocardial perfusion scintigraphy who completed a 9-minute Bruce protocol exercise were identified over a 2-year period. Follow-up was performed by telephone, with case-note review when necessary; this was 97% complete. Five hundred sixteen patients were identified (73% men, median age 53 year). One hundred eighty-one (35%) had known coronary disease. One hundred forty-nine (29%) had a “high-risk” exercise test result (limiting chest pain or ST-segment depression), and 69 (13%) had high-risk MPS findings (>10% myocardium ischemic or ejection fraction <40%). Of 367 patients with a reassuring exercise test result, 38 (10.4%) had high-risk MPS findings. Of 149 with a high-risk exercise test, 118 (79%) had reassuring MPS findings. At median follow-up of 49 months, there were 8 cardiac events (1.6%). Only 2 patients with high-risk exercise test results (1.4%) and 1 with high-risk MPS findings (1.5%) had an event. In conclusion, for patients able to manage a 9-minute Bruce protocol, presence/absence of symptoms or electrocardiographic changes is a poor predictor of MPS findings. Irrespective of test findings, however, subsequent cardiac risk is extremely low. Ability to complete a 9-minute Bruce protocol treadmill exercise may itself provide adequate prognostic reassurance for most purposes.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.06.074</identifier><identifier>PMID: 21059431</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Coronary Artery Disease - diagnosis ; Electrocardiography ; Exercise ; Exercise Test ; Female ; Fitness equipment ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Perfusion Imaging ; Prognosis ; Retrospective Studies ; Time Factors</subject><ispartof>The American journal of cardiology, 2010-11, Vol.106 (10), p.1423-1428</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Nov 15, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-bbd6e667f8219ad2c5b2dff00a9d6bd1dfeb62b265b4292ac371e3414013fbc43</citedby><cites>FETCH-LOGICAL-c476t-bbd6e667f8219ad2c5b2dff00a9d6bd1dfeb62b265b4292ac371e3414013fbc43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914910014086$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23597992$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21059431$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marshall, Andrew J., MB</creatorcontrib><creatorcontrib>Hutchings, Fiona, BSc</creatorcontrib><creatorcontrib>James, Alycia J., BSc</creatorcontrib><creatorcontrib>Kelion, Andrew D., DM</creatorcontrib><title>Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise, with apparent incremental prognostic power above exercise testing alone. We compared exercise test and myocardial perfusion scintigraphic (MPS) findings and risk of hard cardiac events (median 4 years) in patients completing ≥9-minute treadmill exercise. Patients undergoing myocardial perfusion scintigraphy who completed a 9-minute Bruce protocol exercise were identified over a 2-year period. Follow-up was performed by telephone, with case-note review when necessary; this was 97% complete. Five hundred sixteen patients were identified (73% men, median age 53 year). One hundred eighty-one (35%) had known coronary disease. One hundred forty-nine (29%) had a “high-risk” exercise test result (limiting chest pain or ST-segment depression), and 69 (13%) had high-risk MPS findings (>10% myocardium ischemic or ejection fraction <40%). Of 367 patients with a reassuring exercise test result, 38 (10.4%) had high-risk MPS findings. Of 149 with a high-risk exercise test, 118 (79%) had reassuring MPS findings. At median follow-up of 49 months, there were 8 cardiac events (1.6%). Only 2 patients with high-risk exercise test results (1.4%) and 1 with high-risk MPS findings (1.5%) had an event. In conclusion, for patients able to manage a 9-minute Bruce protocol, presence/absence of symptoms or electrocardiographic changes is a poor predictor of MPS findings. Irrespective of test findings, however, subsequent cardiac risk is extremely low. Ability to complete a 9-minute Bruce protocol treadmill exercise may itself provide adequate prognostic reassurance for most purposes.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Electrocardiography</subject><subject>Exercise</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Fitness equipment</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Perfusion Imaging</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl-L1DAUxYMo7uzqR1CCIPvUMUnTtHlRZPEf7OrAzvoa0uR2TG2TMWmF-famzLjCvvgUEn735txzLkIvKFlTQsWbfq3H3uho14zkNyLWpOaP0Io2tSyopOVjtCKEsEJSLs_QeUp9vlJaiafojFFSSV7SFXKbGHY-pMkZ_F0PM-DQYY2_Og_FjfPzBHgbQdvRDQPeQpqw83ijJwd-SvjOW4i74PwO3xzCosbpAW8gdnNyweNb4_zkdlHvfxyeoSedHhI8P50X6O7jh-3V5-L626cvV--vC8NrMRVtawUIUXcNo1JbZqqW2a4jREsrWkttB61gLRNVy5lk2pQ1hZJTTmjZtYaXF-jy2Hcfw685K1ajSwaGQXsIc1K1KFnVSFll8tUDsg9z9FmcakgtuagZyVB1hEwMKUXo1D66UceDokQtSahenZJQSxKKCJWTyHUvT83ndgR7X_XX-gy8PgE6GT10UXvj0j-urGQtJcvcuyMH2bTfDqJKJrtvwLoIZlI2uP9Kefuggxmcd_nTn3CAdD80VYkpom6XtVm2huZ94aQR5R8zG77N</recordid><startdate>20101115</startdate><enddate>20101115</enddate><creator>Marshall, Andrew J., MB</creator><creator>Hutchings, Fiona, BSc</creator><creator>James, Alycia J., BSc</creator><creator>Kelion, Andrew D., DM</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>20101115</creationdate><title>Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy</title><author>Marshall, Andrew J., MB ; Hutchings, Fiona, BSc ; James, Alycia J., BSc ; Kelion, Andrew D., DM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-bbd6e667f8219ad2c5b2dff00a9d6bd1dfeb62b265b4292ac371e3414013fbc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Electrocardiography</topic><topic>Exercise</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Fitness equipment</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Perfusion Imaging</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marshall, Andrew J., MB</creatorcontrib><creatorcontrib>Hutchings, Fiona, BSc</creatorcontrib><creatorcontrib>James, Alycia J., BSc</creatorcontrib><creatorcontrib>Kelion, Andrew D., DM</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marshall, Andrew J., MB</au><au>Hutchings, Fiona, BSc</au><au>James, Alycia J., BSc</au><au>Kelion, Andrew D., DM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2010-11-15</date><risdate>2010</risdate><volume>106</volume><issue>10</issue><spage>1423</spage><epage>1428</epage><pages>1423-1428</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise, with apparent incremental prognostic power above exercise testing alone. We compared exercise test and myocardial perfusion scintigraphic (MPS) findings and risk of hard cardiac events (median 4 years) in patients completing ≥9-minute treadmill exercise. Patients undergoing myocardial perfusion scintigraphy who completed a 9-minute Bruce protocol exercise were identified over a 2-year period. Follow-up was performed by telephone, with case-note review when necessary; this was 97% complete. Five hundred sixteen patients were identified (73% men, median age 53 year). One hundred eighty-one (35%) had known coronary disease. One hundred forty-nine (29%) had a “high-risk” exercise test result (limiting chest pain or ST-segment depression), and 69 (13%) had high-risk MPS findings (>10% myocardium ischemic or ejection fraction <40%). Of 367 patients with a reassuring exercise test result, 38 (10.4%) had high-risk MPS findings. Of 149 with a high-risk exercise test, 118 (79%) had reassuring MPS findings. At median follow-up of 49 months, there were 8 cardiac events (1.6%). Only 2 patients with high-risk exercise test results (1.4%) and 1 with high-risk MPS findings (1.5%) had an event. In conclusion, for patients able to manage a 9-minute Bruce protocol, presence/absence of symptoms or electrocardiographic changes is a poor predictor of MPS findings. Irrespective of test findings, however, subsequent cardiac risk is extremely low. Ability to complete a 9-minute Bruce protocol treadmill exercise may itself provide adequate prognostic reassurance for most purposes.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21059431</pmid><doi>10.1016/j.amjcard.2010.06.074</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2010-11, Vol.106 (10), p.1423-1428 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_763258995 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Coronary Artery Disease - diagnosis Electrocardiography Exercise Exercise Test Female Fitness equipment Humans Male Medical sciences Middle Aged Myocardial Perfusion Imaging Prognosis Retrospective Studies Time Factors |
| title | Prognostic Value of a Nine-Minute Treadmill Test in Patients Undergoing Myocardial Perfusion Scintigraphy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T11%3A50%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20Value%20of%20a%20Nine-Minute%20Treadmill%20Test%20in%20Patients%20Undergoing%20Myocardial%20Perfusion%20Scintigraphy&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Marshall,%20Andrew%20J.,%20MB&rft.date=2010-11-15&rft.volume=106&rft.issue=10&rft.spage=1423&rft.epage=1428&rft.pages=1423-1428&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/j.amjcard.2010.06.074&rft_dat=%3Cproquest_cross%3E2195234281%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=807946720&rft_id=info:pmid/21059431&rft_els_id=S0002914910014086&rfr_iscdi=true |