open access

Vol 15, No 3 (2008)
Original articles
Published online: 2008-04-14
Submitted: 2013-01-14
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Prognostic significance of submaximal negative dobutamine stress echocardiography: A 3-year follow-up study

Salil J. Patel, Ajay Srivastava, Natesh Lingam, Gordon Jacobsen, Karthik Ananthasubramaniam
Cardiol J 2008;15(3):237-244.

open access

Vol 15, No 3 (2008)
Original articles
Published online: 2008-04-14
Submitted: 2013-01-14

Abstract

Background: To estimate the prognostic value of submaximal negative dobutamine stress echocardiography (NDSE) on major cardiac events.
Methods and results: Patients with NDSE were analyzed in 2 cohorts based on predicted maximal heart rate (PMHR) (< 85% or ≥ 85% PMHR) and were assessed for major adverse cardiac events over 3 years. Of 756 patients with NDSE, 415 achieved ≥ 85% PMHR. Both groups had comparable ejection fractions (EF) > 50% (80.6% vs. 81.9%, p = 0.66). The NsubDSE group had higher rates of atrioventricular nodal blocker use (58.7% vs. 39.9%, p < 0.0001), and diabetes (38.7% vs. 27.6%, p = 0.001). Kaplan-Meier survival analysis showed no differences in freedom from cardiac death (98% vs. 98%, p = 0.88), nonfatal myocardial infarction (94% vs. 94%, p = 0.85), or combined major cardiac events (81% vs. 78%, p = 0.24). Diabetes and preserved ejection fraction were predictive of cardiac events in a multi-variate analysis (p = 0.005).
Conclusions: In our study, NsubDSE carried a favorable prognosis. Diabetics were more likely to have an NsubDSE and suffer from a cardiac event despite a preserved ejection fraction. Hence further evaluation for coronary artery disease in this high risk cohort should be pursued. (Cardiol J 2008; 15: 237-244)

Abstract

Background: To estimate the prognostic value of submaximal negative dobutamine stress echocardiography (NDSE) on major cardiac events.
Methods and results: Patients with NDSE were analyzed in 2 cohorts based on predicted maximal heart rate (PMHR) (< 85% or ≥ 85% PMHR) and were assessed for major adverse cardiac events over 3 years. Of 756 patients with NDSE, 415 achieved ≥ 85% PMHR. Both groups had comparable ejection fractions (EF) > 50% (80.6% vs. 81.9%, p = 0.66). The NsubDSE group had higher rates of atrioventricular nodal blocker use (58.7% vs. 39.9%, p < 0.0001), and diabetes (38.7% vs. 27.6%, p = 0.001). Kaplan-Meier survival analysis showed no differences in freedom from cardiac death (98% vs. 98%, p = 0.88), nonfatal myocardial infarction (94% vs. 94%, p = 0.85), or combined major cardiac events (81% vs. 78%, p = 0.24). Diabetes and preserved ejection fraction were predictive of cardiac events in a multi-variate analysis (p = 0.005).
Conclusions: In our study, NsubDSE carried a favorable prognosis. Diabetics were more likely to have an NsubDSE and suffer from a cardiac event despite a preserved ejection fraction. Hence further evaluation for coronary artery disease in this high risk cohort should be pursued. (Cardiol J 2008; 15: 237-244)
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Keywords

dobutamine stress echocardiography; target heart rate; prognosis; double product; beta-blockers

About this article
Title

Prognostic significance of submaximal negative dobutamine stress echocardiography: A 3-year follow-up study

Journal

Cardiology Journal

Issue

Vol 15, No 3 (2008)

Pages

237-244

Published online

2008-04-14

Bibliographic record

Cardiol J 2008;15(3):237-244.

Keywords

dobutamine stress echocardiography
target heart rate
prognosis
double product
beta-blockers

Authors

Salil J. Patel
Ajay Srivastava
Natesh Lingam
Gordon Jacobsen
Karthik Ananthasubramaniam

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