title: The long prognostic value of wall motion abnormalities during the recovery phase of dobutamine stress echocardiography after receiving acute beta-blockade.
abstract: OBJECTIVE
  To assess the prognostic value of wall motion abnormalities during the recovery phase of dobutamine stress echocardiography in addition to wall motion abnormalities at peak stress.
  
  
  METHODS
  Wall motion abnormalities were assessed at peak and during recovery phase of dobutamine stress echocardiography in 187 consecutive patients, who were followed for occurrence of cardiac events.
  
  
  RESULTS
  During follow-up (mean 36+/-28 months), 19 patients (10%) died from cardiac causes, 34 (18%) patients suffered nonfatal myocardial infarction, and 77 (41%) patients underwent late revascularization. Univariable predictors of cardiac events by Cox regression analysis were age (hazard ratio: 1.01; confidence interval: 1.00-1.03), dyslipidemia (hazard ratio: 1.41; confidence interval: 1.02-1.95), rest wall motion abnormalities (hazard ratio: 1.37; confidence interval: 1.14-1.64), new wall motion abnormalities (hazard ratio: 1.18; confidence interval: 0.95-1.45) at peak and new wall motion abnormalities (hazard ratio: 1.33; confidence interval: 1.11-1.59) at recovery phase of dobutamine stress echocardiography. The best multivariable model to predict cardiac events included new wall motion abnormality (hazard ratio: 5.34; confidence interval: 1.71-16.59) at recovery phase of dobutamine stress echocardiography, after controlling for clinical and peak dobutamine stress echocardiography data.
  
  
  CONCLUSIONS
  Myocardial ischemia at recovery phase of dobutamine stress echocardiography is an independent predictor of cardiac events and has an incremental value when added to ischemia at peak.
authors: Department of Cardiology, Erasmus MC, Rotterdam, Leiden University, Leiden, The Netherlands.
authors: Stefanos E
authors: SE
authors: Karagiannis
authors: Abdou
authors: A
authors: Elhendy
authors: Harm H H
authors: HH
authors: Feringa
authors: Ron
authors: R
authors: van Domburg
authors: Jeroen J
authors: JJ
authors: Bax
authors: Radosav
authors: R
authors: Vidakovic
authors: Dennis V
authors: DV
authors: Cokkinos
authors: Don
authors: D
authors: Poldermans
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000368:Aged; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D011379:Prognosis; D011859:Radiography
chemical_list: D000319:Adrenergic beta-Antagonists