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Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE)
BACKGROUND: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m(2)) the usefulness of pharmacological stress echocardiography has been demonstrated; how...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495454/ https://www.ncbi.nlm.nih.gov/pubmed/25714197 http://dx.doi.org/10.5935/abc.20150006 |
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author | Silveira, Mara Graziele Maciel Sousa, Antônio Carlos Sobral Santos, Marcos Antônio Almeida Tavares, Irlaneide da Silva Andrade, Stephanie Macedo Melo, Luiza Dantas de Andrade, Loren Suyane Oliveira Santos, Emmanuel Lima Almeida Oliveira, Joselina Luzia Menezes |
author_facet | Silveira, Mara Graziele Maciel Sousa, Antônio Carlos Sobral Santos, Marcos Antônio Almeida Tavares, Irlaneide da Silva Andrade, Stephanie Macedo Melo, Luiza Dantas de Andrade, Loren Suyane Oliveira Santos, Emmanuel Lima Almeida Oliveira, Joselina Luzia Menezes |
author_sort | Silveira, Mara Graziele Maciel |
collection | PubMed |
description | BACKGROUND: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m(2)) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group. OBJECTIVE: To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences. METHODS: 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%). RESULTS: There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension. CONCLUSION: Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese. |
format | Online Article Text |
id | pubmed-4495454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Sociedade Brasileira de Cardiologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-44954542015-07-08 Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE) Silveira, Mara Graziele Maciel Sousa, Antônio Carlos Sobral Santos, Marcos Antônio Almeida Tavares, Irlaneide da Silva Andrade, Stephanie Macedo Melo, Luiza Dantas de Andrade, Loren Suyane Oliveira Santos, Emmanuel Lima Almeida Oliveira, Joselina Luzia Menezes Arq Bras Cardiol Original Article BACKGROUND: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m(2)) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group. OBJECTIVE: To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences. METHODS: 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%). RESULTS: There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension. CONCLUSION: Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese. Sociedade Brasileira de Cardiologia 2015-05 /pmc/articles/PMC4495454/ /pubmed/25714197 http://dx.doi.org/10.5935/abc.20150006 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Silveira, Mara Graziele Maciel Sousa, Antônio Carlos Sobral Santos, Marcos Antônio Almeida Tavares, Irlaneide da Silva Andrade, Stephanie Macedo Melo, Luiza Dantas de Andrade, Loren Suyane Oliveira Santos, Emmanuel Lima Almeida Oliveira, Joselina Luzia Menezes Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE) |
title | Assessment of Myocardial Ischemia in Obese Individuals Undergoing
Physical Stress Echocardiography (PSE) |
title_full | Assessment of Myocardial Ischemia in Obese Individuals Undergoing
Physical Stress Echocardiography (PSE) |
title_fullStr | Assessment of Myocardial Ischemia in Obese Individuals Undergoing
Physical Stress Echocardiography (PSE) |
title_full_unstemmed | Assessment of Myocardial Ischemia in Obese Individuals Undergoing
Physical Stress Echocardiography (PSE) |
title_short | Assessment of Myocardial Ischemia in Obese Individuals Undergoing
Physical Stress Echocardiography (PSE) |
title_sort | assessment of myocardial ischemia in obese individuals undergoing
physical stress echocardiography (pse) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495454/ https://www.ncbi.nlm.nih.gov/pubmed/25714197 http://dx.doi.org/10.5935/abc.20150006 |
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