title: Long-term prognosis after normal dobutamine stress echocardiography.
abstract: Patients with normal dobutamine stress echocardiography (DSE) were shown to have a favorable outcome at an intermediate-term follow-up. However, there are scarce data regarding long-term survival after normal DSE. This study sought to assess the long-term outcome after normal DSE. We studied 401 patients (age 62 +/- 10 years, 264 men) who had a normal echocardiogram at rest and with high-dose dobutamine stress. End points during a mean follow-up of 5 +/- 1.7 years (minimum 3.5) were all-cause mortality and hard cardiac events (cardiac death and nonfatal myocardial infarction). During follow-up, 45 patients (11%) died due to various causes (cardiac death in 10 patients). Thirteen patients had nonfatal myocardial infarction (a total of 23 hard cardiac events). The annual mortality rate was 2% in the first 3 years and 2.4% between the fourth and sixth years. The annual hard cardiac event rate was 0.8% in the first 3 years and 1.7% between the fourth and sixth years. Predictors of mortality in a multivariate analysis model were advanced age (hazard ratio 1.2, 95% confidence interval CI 1.1 to 1.4) and higher heart rate at rest (hazard ratio 0.92, 95% confidence interval 0.85 to 0.99). Patients with normal DSE had excellent outcomes during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth year; therefore, it may be useful to repeat the study after 3 years to reassess risk status.
authors.affiliation: Department of Cardiology, IRCCS, Ospedale Maggiore, Milan, Italy.
authors.forename: Fabiola B
authors.initials: FB
authors.lastname: Sozzi
authors.forename: Abdou
authors.initials: A
authors.lastname: Elhendy
authors.forename: Jos R T C
authors.initials: JR
authors.lastname: Roelandt
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Arend F L
authors.initials: AF
authors.lastname: Schinkel
authors.forename: Eleni C
authors.initials: EC
authors.lastname: Vourvouri
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rizzello
authors.forename: Don
authors.initials: D
authors.lastname: Poldermans
mesh_terms: D002316:Cardiotonic Agents; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004280:Dobutamine; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine