title: Long-term prognostic importance of transient left ventricular dilation during pharmacologic stress echocardiography.
abstract: OBJECTIVE
  We sought to evaluate the prognostic significance of left ventricular (LV) transient ischemic dilation (TID) for patients with a positive stress echocardiogram (SE).
  
  
  BACKGROUND
  TID during SE has been related to the presence of extensive coronary artery disease, but its long-term prognostic implications have not been reported.
  
  
  METHODS
  In all, 99 consecutive patients with a positive SE comprised the study group. LV volumes were evaluated according to the modified Simpson's rule. TID during SE was defined as the presence of an increase in LV end-diastolic volume during the stress test. A clinical history was fulfilled for each patient and all of them were followed up.
  
  
  RESULTS
  Of 99 patients, 32 (32.3%) showed TID. Mean age was 65.8 +/- 9.8 years for non-TID group and 70.2 +/- 8.4 for TID group (P = .048). Baseline characteristics and subsequent treatment were similar in both groups. Mean follow-up was 21.4 +/- 15.8 months. In non-TID group the mean survival free of acute myocardial infarction was 47.28 months and 39.7 months in TID group (log rank = 0.012). In the univariate and multivariate analysis only TID and the wall motion score index were found as independent predictors related to long-term prognosis (risk ratio = 6.9; 95% confidence interval = 0.8-59.6; P = .042; and risk ratio = 0.4; 95% confidence interval = 0.18-0.89; P = .047, respectively).
  
  
  CONCLUSIONS
  LV TID during SE is an easy and independent prognostic marker. It helps to select patients with increased risk.
authors.affiliation: Echocardiographic Laboratory, Hospital Clínico San Carlos, 28040 Madrid, Spain.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Pérez de Isla
authors.forename: José
authors.initials: J
authors.lastname: Zamorano
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: David
authors.initials: D
authors.lastname: Villagómez
authors.forename: José
authors.initials: J
authors.lastname: Florit
authors.forename: Adalia
authors.initials: A
authors.lastname: Aubele
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D000368:Aged; D004108:Dilatation, Pathologic; D004176:Dipyridamole; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011379:Prognosis; D016019:Survival Analysis; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology
chemical_list: D014665:Vasodilator Agents; D004176:Dipyridamole