TY - JOUR
T1 - Prediction of cardiac events after uncomplicated myocardial infarction by cross-sectional echocardiography during transesophageal atrial pacing
AU - Iliceto, Sabino
AU - Caiati, Carlo
AU - Ricci, Antonio
AU - Amico, Antonio
AU - D'Ambrosio, Gaetano
AU - Ferri, Giovanni M.
AU - Izzi, Michele
AU - Lagioia, Rocco
AU - Rizzon, Paolo
PY - 1990
Y1 - 1990
N2 - Atrial pacing can safely be utilized shortly after myocardial infarction. To evaluate the prognostic value of wall motion abnormalities induced by such pacing 83 consecutive patients with recent uncomplicated myocardial infarction underwent transthoracic corss-sectional echocardiography during transesophageal atrial pacing and upright bicycle exercise stress test. Patients were followed-up for 14 ± 5 months. During the atrial pacing and the echocardiography, patients were defined at high risk if abnormalities of wall motion were detected in left ventricular regions remote from the infarcted area. Then, during the exercise stress test, high risk patients were those with ST segment depression ≥ 1 mm. On the other hand, patients were considered to be at low risk if they had no abnormalities of wall motion during atrial pacing in remote regions or, in the case of the stress test, if they did not develop ST depression ≥ 1 mm. Of the 83 patients, 21 had major cardiac events during the period of follow-up. Cardiac events occurred in 15 23 (65%) and 5 60 (8%, P <0.001) patients assigned to the groups adjudged to be at high and low risk, respectively, on the basis of echocardiographic results. Exercise testing was less reliable in identifying patients at risk of future cardiac events. Major events occurred in only 6 of the 19 patients with a positive stress test (32%, P <0.05 vs positive stress echocardiography) and in 14 of the 64 patients with a negative exercise stress test (22%, P = NS vs positive exercise stress test, P <0.05 vs negative atrial pacing echocardiography).
AB - Atrial pacing can safely be utilized shortly after myocardial infarction. To evaluate the prognostic value of wall motion abnormalities induced by such pacing 83 consecutive patients with recent uncomplicated myocardial infarction underwent transthoracic corss-sectional echocardiography during transesophageal atrial pacing and upright bicycle exercise stress test. Patients were followed-up for 14 ± 5 months. During the atrial pacing and the echocardiography, patients were defined at high risk if abnormalities of wall motion were detected in left ventricular regions remote from the infarcted area. Then, during the exercise stress test, high risk patients were those with ST segment depression ≥ 1 mm. On the other hand, patients were considered to be at low risk if they had no abnormalities of wall motion during atrial pacing in remote regions or, in the case of the stress test, if they did not develop ST depression ≥ 1 mm. Of the 83 patients, 21 had major cardiac events during the period of follow-up. Cardiac events occurred in 15 23 (65%) and 5 60 (8%, P <0.001) patients assigned to the groups adjudged to be at high and low risk, respectively, on the basis of echocardiographic results. Exercise testing was less reliable in identifying patients at risk of future cardiac events. Major events occurred in only 6 of the 19 patients with a positive stress test (32%, P <0.05 vs positive stress echocardiography) and in 14 of the 64 patients with a negative exercise stress test (22%, P = NS vs positive exercise stress test, P <0.05 vs negative atrial pacing echocardiography).
KW - Atrial pacing
KW - Echocardiography
KW - Myocardial infarction
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=0025369259&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025369259&partnerID=8YFLogxK
U2 - 10.1016/0167-5273(90)90013-U
DO - 10.1016/0167-5273(90)90013-U
M3 - Article
C2 - 2365537
AN - SCOPUS:0025369259
VL - 28
SP - 95
EP - 103
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -