Long-term prognostic value of dobutamine stress echocardiography in patients with atrial fibrillation

D. Poldermans, J. J. Bax, A. Elhendy, F. Sozzi, E. Boersma, I. R. Thomson, L. J. Jordaens

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)144-149
Number of pages6
JournalChest
Volume119
Issue number1
DOIs
Publication statusPublished - 2001

Keywords

  • Atrial fibrillation
  • Dobutamine stress echocardiography
  • Long-term prognostic value

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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