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End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography
Background. A maximal negative stress echo identifies a low-risk subset for coronary events. However, the potentially prognostically relevant information on cardiovascular hemodynamics for heart-failure-related events is unsettled. Aim of this study was to assess the prognostic value of stress-induc...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760182/ https://www.ncbi.nlm.nih.gov/pubmed/24024185 http://dx.doi.org/10.1155/2013/235194 |
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author | Bombardini, Tonino Costantino, Marco Fabio Sicari, Rosa Ciampi, Quirino Pratali, Lorenza Picano, Eugenio |
author_facet | Bombardini, Tonino Costantino, Marco Fabio Sicari, Rosa Ciampi, Quirino Pratali, Lorenza Picano, Eugenio |
author_sort | Bombardini, Tonino |
collection | PubMed |
description | Background. A maximal negative stress echo identifies a low-risk subset for coronary events. However, the potentially prognostically relevant information on cardiovascular hemodynamics for heart-failure-related events is unsettled. Aim of this study was to assess the prognostic value of stress-induced variation in cardiovascular hemodynamics in patients with negative stress echocardiography. Methods. We enrolled 891 patients (593 males mean age 63 ± 12, ejection fraction 48 ± 17%), with negative (exercise 172, dipyridamole 482, and dobutamine 237) stress echocardiography result. During stress we assessed left ventricular end-systolic elastance index (E (LV)I), ventricular arterial coupling (VAC) indexed by the ratio of the E (LV)I to arterial elastance index (E (a)I), systemic vascular resistance (SVR), and pressure-volume area (PVA). Changes from rest to peak stress (reserve) were tested as predictors of main outcome measures: combined death and heart failure hospitalization. Results. During a median followup of 19 months (interquartile range 8–36), 50 deaths and 84 hospitalization occurred. Receiver-operating-characteristic curves identified as best predictors E (LV)I reserve for exercise (AUC = 0.871) and dobutamine (AUC = 0.848) and VAC reserve (AUC = 0.696) for dipyridamole. Conclusions. Patients with negative stress echocardiography may experience an adverse outcome, which can be identified by assessment of E (LV)I reserve and VAC reserve during stress echo. |
format | Online Article Text |
id | pubmed-3760182 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-37601822013-09-10 End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography Bombardini, Tonino Costantino, Marco Fabio Sicari, Rosa Ciampi, Quirino Pratali, Lorenza Picano, Eugenio Biomed Res Int Clinical Study Background. A maximal negative stress echo identifies a low-risk subset for coronary events. However, the potentially prognostically relevant information on cardiovascular hemodynamics for heart-failure-related events is unsettled. Aim of this study was to assess the prognostic value of stress-induced variation in cardiovascular hemodynamics in patients with negative stress echocardiography. Methods. We enrolled 891 patients (593 males mean age 63 ± 12, ejection fraction 48 ± 17%), with negative (exercise 172, dipyridamole 482, and dobutamine 237) stress echocardiography result. During stress we assessed left ventricular end-systolic elastance index (E (LV)I), ventricular arterial coupling (VAC) indexed by the ratio of the E (LV)I to arterial elastance index (E (a)I), systemic vascular resistance (SVR), and pressure-volume area (PVA). Changes from rest to peak stress (reserve) were tested as predictors of main outcome measures: combined death and heart failure hospitalization. Results. During a median followup of 19 months (interquartile range 8–36), 50 deaths and 84 hospitalization occurred. Receiver-operating-characteristic curves identified as best predictors E (LV)I reserve for exercise (AUC = 0.871) and dobutamine (AUC = 0.848) and VAC reserve (AUC = 0.696) for dipyridamole. Conclusions. Patients with negative stress echocardiography may experience an adverse outcome, which can be identified by assessment of E (LV)I reserve and VAC reserve during stress echo. Hindawi Publishing Corporation 2013 2013-08-19 /pmc/articles/PMC3760182/ /pubmed/24024185 http://dx.doi.org/10.1155/2013/235194 Text en Copyright © 2013 Tonino Bombardini et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Bombardini, Tonino Costantino, Marco Fabio Sicari, Rosa Ciampi, Quirino Pratali, Lorenza Picano, Eugenio End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title | End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title_full | End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title_fullStr | End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title_full_unstemmed | End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title_short | End-Systolic Elastance and Ventricular-Arterial Coupling Reserve Predict Cardiac Events in Patients with Negative Stress Echocardiography |
title_sort | end-systolic elastance and ventricular-arterial coupling reserve predict cardiac events in patients with negative stress echocardiography |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760182/ https://www.ncbi.nlm.nih.gov/pubmed/24024185 http://dx.doi.org/10.1155/2013/235194 |
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