Ruolo dell'ecocardiografia da sforzo nella valutazione di pazienti sottoposti a rivascolarizzazione miocardica

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F. Acquistapace, L. Sormani, L. Menicanti

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Abstract

Correlating with coronary angiography, it is well established that exercise echocardiography improves sensitivity and diagnostic accuracy of exercise electrocardiography In the detection of inducible myocardial ischemia. The use of stress echocardiography after cardiac surgical revascularization is still poorly defined. From May 1993 to January 1995, 320 patients underwent myocardial revascularization by coronary artery bypass grafting (CABG) and were evaluated by exercise echocardiography. Echocardiographic images were obtained within 60-90 s after maximal, symptom-limited, upright bicycle exercise, and compared with rest images. The test was positive because of the appearance or worsening of segmentary asynergies in 45/320 patients (14%); 17/320 patients (5.3%) were positive for ECG standards and 5/320 patients (2.2%) were positive for appearance of typical symptoms; 120/320 patients (37.5%) showed Improvement of persisting asynergies in already ischemic and revascularized regions or in regions not previously interested by known ischemic events. In conclusion, exercise echocardiography was successful in revealing signs of inadequate coronary perfusion after CABG when other markers of ischemia were absent. It was also capable of assessing myocardial viability with a physiologic inotropic stimulus, by identifying functional myocardial abnormalities and predicting their reversibility or irreversibility. Exercise echocardiography plays a leading role in the prognostic stratification of revascularized patients and in the short- and mid-term follow-up.

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Original languageItalian
Pages (from-to)245-250
Number of pages6
JournalCardiovascular Imaging
Volume8
Issue number2
Publication statusPublished - 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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