The diagnostic value of stress echocardiography with limited myocardial ischemia in high-risk patients

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology Pub Date : 2025-03-01 DOI:10.1016/j.hjc.2023.12.007

Nikolaos P.E. Kadoglou , Constantinos Η. Papadopoulos , Elina Khattab , Nikolaos Velidakis , Stylianos Lambropoulos

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引用次数: 0

Abstract

Background

The diagnostic value of limited myocardial ischemia in DSE is not well known.

Objectives

We investigated whether myocardial ischemia during dobutamine stress echocardiography (DSE) in 1 apical segment of any of the ventricular walls of the left ventricle relates to the anatomical and functional stenosis of the suppling coronary artery.

Methods

Our observational, prospective study enrolled 212 patients, symptomatic or asymptomatic, with newly diagnosed limited myocardial ischemia on DSE. Almost 25% of them had already known CAD, while the rest were divided into low-risk and high-risk groups, integrating 1-2 and ≥3 classical cardiovascular risk factors, respectively. After DSE, all patients underwent invasive coronary angiography (ICA) and were followed up for one year. In coronary arteries distributing ischemic area, the calculated stenosis ≥50% and FFR<0.8 were considered anatomically and functionally significant, respectively. In the latter cases, the patients underwent coronary revascularization.

Results

Significant anatomical and functional stenosis of the supplying coronary artery was common among patients with already known CAD (62.5% and 44.5%, respectively) or those without CAD but a high-risk profile (60.2% and 25.6%, respectively). In logistic regression analysis, CAD revascularization was independently determined by an already known CAD, diabetes mellitus, and high-risk profile. During follow-up, 24 patients experienced ACS or new angina episodes, which were associated with diabetes and smoking in univariate analysis.

Conclusion

Limited myocardial ischemia may implicate significant anatomical and functional coronary stenosis among individuals with a history of CAD or those without known CAD but a high-risk profile. The prognostic value of our findings requires further investigation.

Abstract Image

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对高危患者进行有限心肌缺血应激超声心动图检查的诊断价值

目的我们研究了多巴酚丁胺负荷超声心动图（DSE）检查中左心室任一室壁心尖段的心肌缺血是否与冠状动脉的解剖和功能性狭窄有关。方法我们的观察性前瞻性研究纳入了 212 例 DSE 检查新诊断为局限性心肌缺血的无症状或无症状患者。其中近 25% 的患者已知患有 CAD，其余患者被分为低危和高危组，分别整合了 1-2 和≥3 个经典心血管危险因素。DSE 后，所有患者都接受了有创冠状动脉造影术（ICA），并随访一年。在分布缺血区域的冠状动脉中，计算出的狭窄率≥50%和FFR<0.8分别被视为解剖和功能上有意义。结果在已知有 CAD 的患者（分别为 62.5%、44.5%）或无 CAD 但有高危因素的患者（分别为 60.2%、25.6%）中，供血冠状动脉的解剖和功能性明显狭窄很常见。在逻辑回归分析中，已知有 CAD、糖尿病和高危人群是决定 CAD 血管再通的独立因素。在随访期间，24 名患者出现了 ACS 或新的心绞痛发作，单变量分析显示这与糖尿病和吸烟有关。我们的研究结果的预后价值还需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.