TY - JOUR
T1 - Long-term prognostic value of dobutamine stress echocardiography in patients with atrial fibrillation
AU - Poldermans, D.
AU - Bax, J. J.
AU - Elhendy, A.
AU - Sozzi, F.
AU - Boersma, E.
AU - Thomson, I. R.
AU - Jordaens, L. J.
PY - 2001
Y1 - 2001
N2 - Study objective: To assess the long-term prognostic value of dobutamine stress echocardiography (DSE) for cardiac events (cardiac death, myocardial infarction, and late revascularization) in patients with atrial fibrillation (AF). Methods: Baseline ECGs were studied in patients undergoing DSE between 1989 and 1998. Sixty-nine patients had AF before DSE. Prognostic value of DSE in these patients was compared with a control group who had sinus rhythm (n = 1,664). The presence of stress-induced ischemia was noted for every patient. The mean follow-up period was 35 months (range, 6 to 84 months). Data are presented as hazards ratio (HR) with 95% confidence interval (CI). Results: Heart rate at rest was higher in patients with AF (77 ± 15 beats/min vs 73 ± 14 beats/min; p = 0.04); however, double product at peak stress was not different between patients with AF and sinus rhythm (17,602 vs 17,169, respectively; p = 0.46). In patients with AF, target heart rate was achieved at a lower dobutamine dose (33 ± 8 μg/kg/min vs 35 ± 9 μg/kg/min; p = 0.01). Cardiac arrhythmias occurred more frequently (12% vs 5%; p = 0.001) in patients with AF during DSE. During a follow-up period of 7 years, cardiac death occurred in 5 patients, myocardial infarction in 2 patients, and late revascularization in 10 patients. Prognostic value of DSE for all late cardiac events was similar in patients with AF (HR, 3.0; 95% CI, 0.9 to 9.5) and sinus rhythm (HR, 3.4; 95% CI, 2.7 to 4.3; p = 0.85). Conclusion: The prognostic value of DSE for late cardiac events is maintained in patients with AF.
AB - Study objective: To assess the long-term prognostic value of dobutamine stress echocardiography (DSE) for cardiac events (cardiac death, myocardial infarction, and late revascularization) in patients with atrial fibrillation (AF). Methods: Baseline ECGs were studied in patients undergoing DSE between 1989 and 1998. Sixty-nine patients had AF before DSE. Prognostic value of DSE in these patients was compared with a control group who had sinus rhythm (n = 1,664). The presence of stress-induced ischemia was noted for every patient. The mean follow-up period was 35 months (range, 6 to 84 months). Data are presented as hazards ratio (HR) with 95% confidence interval (CI). Results: Heart rate at rest was higher in patients with AF (77 ± 15 beats/min vs 73 ± 14 beats/min; p = 0.04); however, double product at peak stress was not different between patients with AF and sinus rhythm (17,602 vs 17,169, respectively; p = 0.46). In patients with AF, target heart rate was achieved at a lower dobutamine dose (33 ± 8 μg/kg/min vs 35 ± 9 μg/kg/min; p = 0.01). Cardiac arrhythmias occurred more frequently (12% vs 5%; p = 0.001) in patients with AF during DSE. During a follow-up period of 7 years, cardiac death occurred in 5 patients, myocardial infarction in 2 patients, and late revascularization in 10 patients. Prognostic value of DSE for all late cardiac events was similar in patients with AF (HR, 3.0; 95% CI, 0.9 to 9.5) and sinus rhythm (HR, 3.4; 95% CI, 2.7 to 4.3; p = 0.85). Conclusion: The prognostic value of DSE for late cardiac events is maintained in patients with AF.
KW - Atrial fibrillation
KW - Dobutamine stress echocardiography
KW - Long-term prognostic value
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U2 - 10.1378/chest.119.1.144
DO - 10.1378/chest.119.1.144
M3 - Article
C2 - 11157596
AN - SCOPUS:0035129275
VL - 119
SP - 144
EP - 149
JO - Chest
JF - Chest
SN - 0012-3692
IS - 1
ER -