Journal of the American Society of Echocardiography
Clinical InvestigationStress EchocardiographyThe Prognostic Value of the Diastolic Stress Test in Patients Undergoing Treadmill Stress Echocardiography
Section snippets
Methods
Consecutive patients referred to GenesisCare clinical testing facilities for SE between June 2011 and June 2014 were studied prospectively. Indications for testing were typically dyspnea or chest pain. Standard Bruce protocol treadmill testing with digital gated echocardiography before and after exercise was performed. Patients requiring dobutamine SE and those with resting left bundle branch block, a paced rhythm or atrial fibrillation, reduced ejection fractions (<50%), or mitral valve
Results
There were 2,201 consecutive SEs available with complete data for analysis from 770 female (35%), and 1,431 male patients. Mean ± SD age was 58 ± 12 years. The baseline characteristics are detailed in Table 1. Total follow-up was for 27,964 patients-months (up to 5 years per patient, for a mean of 13 ± 19 months).
Discussion
SE is a well validated investigation for the assessment of cardiac status and pathologies, especially for the detection of obstructive coronary artery disease.5, 21, 22 One of the manifestations of myocardial ischemia is abnormal relaxation and diastolic dysfunction.1, 23, 24 Diastolic abnormalities occur earlier in the ischemic cascade than systolic changes.1, 3 Assessment of diastolic parameters during exercise has been shown to be feasible and valuable.1, 5, 7, 8 In normal subjects, exertion
Conclusion
The 2016 American Society of Echocardiography and the European Association of Cardiovascular Imaging Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography Guidelines define and discuss the role of the DST. The results presented in this study generally validate the DST in a very large stress testing population. These new data suggest an expansion in the role of the DST, with minor changes to the definitions suggested in the 2016 guidelines. Measuring the
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Expanding the Utility of Exercise Echocardiography with Doppler Assessment of Left Ventricular Filling Pressure
2024, Journal of the American Society of EchocardiographyPrognostic Significance of Elevated Left Ventricular Filling Pressures with Exercise: Insights from a Cohort of 14,338 Patients
2024, Journal of the American Society of EchocardiographyAssociation of Echocardiographic Parameter E/e’ With Cardiovascular Events in a Diverse Population of Inpatients and Outpatients With and Without Cardiac Diseases and Risk Factors
2023, Journal of the American Society of EchocardiographyCitation Excerpt :The septal E/e’ ratio showed a graded mortality hazard when >9, with a markedly worse mortality profile when >14.27 In addition to the aforementioned studies, E/e’ has been shown to be associated with outcomes in patients with sepsis and chronic kidney disease, and E/e’ measured in diastolic stress test is associated with myocardial ischemia.35-37 The present study investigated the association of E/e’ with various CV events by using ICD codes.
What are the prognostic implications and factors relating to exercise induced electrocardiographic ST segment changes in the setting of a non-ischemic stress echocardiogram?
2022, International Journal of CardiologyCitation Excerpt :The mean age was 58 ± 12 years. There were 1087 females (36%), which was expected for this cohort [13,17,18]. During follow-up, overall event rates were low.
Updated knowledge and practical implementations of stress echocardiography in ischemic and non-ischemic cardiac diseases: An expert consensus of the Working Group of Echocardiography of the Hellenic Society of Cardiology
2022, Hellenic Journal of CardiologyCitation Excerpt :In this case, the exercise achieved parameters: average E/e’ ≥15 which may be accompanied or not by TR Vmax >3.4 m/s, have been proposed as supportive indices of HFpEF, but only after assessing resting functional and morphological echocardiographic indices and natriuretic peptides measurements. Positive DSTE is highly predictive of future HFpEF-related events (admissions, cardiovascular death, worsening NYHA Class, or worsening ejection fraction)151. Therefore, it is necessary to incorporate DSTE in a diagnostic algorithm for HFpEF or unexplained dyspnea, accompanied by a complex of echocardiographic and hemodynamic indices.
Conflicts of Interest: None.