Academic Journal
Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome
| العنوان: | Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome |
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| المؤلفون: | Marcos-Garces, Victor, Merenciano-Gonzalez, Hector, Gabaldon-Perez, Ana, Nuñez-Marin, Gonzalo, Lorenzo-Hernandez, Miguel, Gavara, Jose, Perez, Nerea, Rios-Navarro, Cesar, De Dios, Elena, Bonanad, Clara, Racugno, Paolo, Lopez-Lereu, Maria Pilar, Monmeneu, Jose Vicente, Chorro, Francisco Javier, Bodi, Vicente |
| المصدر: | Journal of Cardiopulmonary Rehabilitation and Prevention ; volume 42, issue 1, page E7-E12 ; ISSN 1932-7501 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2021 |
| الوصف: | Purpose: Vasodilator stress cardiac magnetic resonance (VS-CMR) has become crucial in the workup of patients with known or suspected chronic coronary syndrome (CCS). Whether traditional exercise ECG testing (ExECG) contributes prognostic information beyond VS-CMR is unclear. Methods: We retrospectively included 288 patients with known or suspected CCS who had undergone ExECG and subsequent VS-CMR in our institution. Clinical, ExECG, and VS-CMR variables were recorded. We defined the serious adverse events (SAE) as a combined endpoint of acute coronary syndrome, admission for heart failure, or all-cause death. Results: During a mean follow-up of 4.2 ± 2.15 yr, we registered 27 SAE (15 admissions for acute coronary syndrome, eight admissions for heart failure, and four all-cause deaths). Once adjusted for clinical, ExECG, and VS-CMR parameters associated with SAE, the only independent predictors were HR max in ExECG (HR = 0.98: 95% CI, 0.96-0.99; P = .01) and more extensive stress-induced perfusion defects (PDs, number of segments) in VS-CMR (HR = 1.19: 95% CI, 1.07-1.34; P < .01). Adding HR max significantly improved the predictive power of the multivariable model for SAE, including PDs (continuous reclassification improvement index: 0.47: 95% CI, 0.10-0.81; P < .05). The annualized SAE rate was 1% (if PD < 2 segments and HR max > 130 bpm), 2% (if PD < 2 segments and HR max ≤ 130 bpm), 3.2% (if PD ≥ 2 segments and HR max > 130 bpm), and 6.3% (if PD ≥ 2 segments and HR max ≤ 130 bpm), P < .01, for the trend. In patients on β-blocker therapy, however, only PDs in VS-CMR, but not HR max , predicted SAE. Conclusions: We conclude that ExECG contributes significantly to prognostic information beyond VS-CMR in patients with known or suspected CCS. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/hcr.0000000000000621 |
| DOI: | 10.1097/HCR.0000000000000621 |
| الاتاحة: | http://dx.doi.org/10.1097/hcr.0000000000000621 https://journals.lww.com/10.1097/HCR.0000000000000621 |
| رقم الانضمام: | edsbas.7B1F3B90 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/hcr.0000000000000621 |
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