Prognostic significance of nonsustained ventricular tachycardia during dobutamine stress echocardiography.
Nonsustained ventricular tachycardia (NSVT) is a well-recognized side effect during dobutamine stress echocardiography (DSE). This study sought to evaluate the prognostic implications of NSVT during DSE on 1,266 consecutive dobutamine stress echocardiograms performed over 1 year. NSVT, defined as > or =3 consecutive ventricular premature beats, occurred in 65 of 1,266 patients (5.1%). There was no absolute increased risk in all-cause mortality between the NSVT and no NSVT groups (22% vs 17%, p = 0.15) during the 3-year follow-up. Survival curves generated by the Kaplan-Meier method also demonstrated no increased risk in mortality between the NSVT and no NSVT groups (p = 0.43). When only studies with negative results for inducible ischemia were taken into account, survival curves showed no significant difference in all-cause mortality (p = 0.26). Studies with negative results for inducible ischemia were also stratified according to the ejection fraction (EF). Patients without inducible ischemia and mildly reduced to normal EFs (>0.45) did not have significant differences in survival between the NSVT and no NSVT groups over the 3-year follow-up (p = 0.86). However, patients without inducible ischemia and moderately reduced EFs (0.35 to 0.45) who had NSVT during DSE had significantly reduced survival over the follow-up (p = 0.01).
Cox
David E
DE
Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina.
Farmer
Laurance D
LD
Hoyle
John R
JR
Wells
Gretchen L
GL
D000368:Aged; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology