Long-term prognostic importance of exercise echocardiography after an episode of unstable angina.
The aim of this study was to determine whether exercise echocardiography gives long-term prognostic information in patients with unstable angina. Treadmill exercise echocardiography was performed before discharge in 33 consecutive patients (23 men, 10 women) with unstable angina. A wall motion score index (WMSI) was calculated from visual interpretation of 9 left-ventricular segments, registered with two-dimensional echocardiography. Within an 8-year follow-up period, there were 10 medical events (2 cardiac deaths and 8 myocardial infarctions). New or worsening wall motion abnormalities and a low WMSI immediately after the exercise test were associated with subsequent myocardial infarction or cardiac death during follow-up (p < 0.05). Only 1 of the patients with a WMSI above the median suffered a myocardial infarction, which was not fatal. In contrast, 9 (56%) of the 16 patients with a WMSI below the median suffered myocardial infarction or cardiac death during follow-up. These findings in patients with unstable angina suggest that exercise echocardiography is a sensitive method for detecting those with increased risk of myocardial infarction or cardiac death. These high-risk patients might benefit from a more aggressive therapeutic approach.
Eriksson
S V
SV
Department of Medicine, Danderyd Hospital, Sweden.
Erhardt
L
L
Lindvall
K
K
Melcher
A
A
Rehnqvist
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D015588:Observer Variation; D011379:Prognosis; D011897:Random Allocation; D012680:Sensitivity and Specificity