TY - JOUR
T1 - Prognostic value of dipyridamole stress echocardiography in hypertensive patients with left ventricular hypertrophy, chest pain and resting electrocardiographic repolarization abnormalities
AU - Mondillo, S.
AU - Agricola, E.
AU - Ammaturo, T.
AU - Guerrini, F.
AU - Barbati, R.
AU - Focardi, M.
AU - Picchi, A.
AU - Ballo, P.
AU - Nami, R.
PY - 2001
Y1 - 2001
N2 - Background: Hypertension is a major cardiovascular risk factor in the development of coronary artery disease (CAD); therefore, evaluating the presence of CAD is a primary clinical goal. However, the noninvasive tests that are commonly used have poor diagnostic specificity, particularly in patients with left ventricular hypertrophy. Objectives: To assess the prognostic value of dipyridamole stress echocardiography (DET) for ischemic events in a subset of patients with hypertension with left ventricular hypertrophy, chest pain and resting electrocardiographic repolarization abnormalities. Patients and methods: Eighty-two patients (48 men and 34 women; average age 65±7.2 years with left ventricular hypertrophy documented echocardiographically (left ventricular mass index greater than 50 g/h
2.7), and resting ST segment shift of 0.1 mV or more from baseline at 80 ms after J point in at least two contiguous leads, were submitted to DET according to high-dosage protocol and coadministered with atrophine. Results: The follow-up period was 25.11±8.3 months. The stress test produced positive results in 30 patients (36.5%); 16 (53%) and three (5%) cardiac events occurred in positive and negative stress test groups, respectively. At multivariate analysis, only positive DET response (P=0.000002), left ventricular mass index (P=0.028) and a family history of CAD (P=0.037) were independent predictors. The two-year event-free survival rates were 95% and 47% (log-rank 21.093, P=0.00001) for negative and positive stress test results, respectively. Conclusions: DET is a useful tool in the prognostic assessment of coronary events in this particular subgroup of patients with hypertension.
AB - Background: Hypertension is a major cardiovascular risk factor in the development of coronary artery disease (CAD); therefore, evaluating the presence of CAD is a primary clinical goal. However, the noninvasive tests that are commonly used have poor diagnostic specificity, particularly in patients with left ventricular hypertrophy. Objectives: To assess the prognostic value of dipyridamole stress echocardiography (DET) for ischemic events in a subset of patients with hypertension with left ventricular hypertrophy, chest pain and resting electrocardiographic repolarization abnormalities. Patients and methods: Eighty-two patients (48 men and 34 women; average age 65±7.2 years with left ventricular hypertrophy documented echocardiographically (left ventricular mass index greater than 50 g/h
2.7), and resting ST segment shift of 0.1 mV or more from baseline at 80 ms after J point in at least two contiguous leads, were submitted to DET according to high-dosage protocol and coadministered with atrophine. Results: The follow-up period was 25.11±8.3 months. The stress test produced positive results in 30 patients (36.5%); 16 (53%) and three (5%) cardiac events occurred in positive and negative stress test groups, respectively. At multivariate analysis, only positive DET response (P=0.000002), left ventricular mass index (P=0.028) and a family history of CAD (P=0.037) were independent predictors. The two-year event-free survival rates were 95% and 47% (log-rank 21.093, P=0.00001) for negative and positive stress test results, respectively. Conclusions: DET is a useful tool in the prognostic assessment of coronary events in this particular subgroup of patients with hypertension.
KW - Coronary disease
KW - Echocardiography
KW - Hypertension
KW - Hypertrophy
KW - Left ventricle
KW - Stress
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M3 - Article
C2 - 11381279
AN - SCOPUS:0034955999
VL - 17
SP - 571
EP - 577
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
SN - 0828-282X
IS - 5
ER -