Iranian Heart Journal

Iranian Heart Journal

Evaluation of the Diagnostic Value and Prognostic Role of Positive Exercise Stress Echocardiography in Coronary Artery Disease

Document Type : Original Article

Authors
Hamideh Khesali 1
Niloufar Samiei 2
Niloufar Akbari Parsa 3
Mahrokh Dalir 1
Nasim Jafari 1
Soheil Hassanipour 3
1 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
2 Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
3 Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran.
Abstract
Background: Despite steps in lifestyle changes and preventive measures, the incidence of heart disease is still rising. Coronary artery disease (CAD) is the world’s leading cause of death; thus, the early detection of this disease can significantly reduce its mortality rate. We evaluated the diagnostic value and prognostic role of positive exercise stress echocardiography in CAD.
Methods: The present retrospective study was performed on 350 patients with symptoms of IHD referred for exercise stress echocardiography between 2004 and 2017. The obtained data were analyzed using the SPSS software.
Results: Ischemic electrocardiographic (ECG) changes, the regional wall motion abnormality (RWMA) score index, the metabolic equivalent, and the peak left ventricular ejection fraction were associated with CAD (P=0.004, P=0.000, P=0.02, and P=0.000, respectively). The incidence of ventricular arrhythmias was associated with sudden cardiac death and myocardial infarction (P=0.00). Ischemic ECG changes were significantly associated with myocardial infarction and the need for percutaneous coronary interventions in the future (P=0.04 and P=0.03). The relationship between left ventricular dilation and sudden cardiac death was significant (P=0.01), and RWMAs were significantly associated with myocardial infarction (P=0.03). However, dyspnea and chest pain had no association with cardiac events.
Conclusions: Positive exercise stress echocardiography was associated with sudden cardiac death, myocardial infarction, and the need for future coronary revascularization, and its diagnostic and predictive role was observed in ischemic heart disease and predicting future cardiac events. (Iranian Heart Journal 2023; 24(2): 69-76)
Keywords
Ischemic heart disease
Prognostic value
Exercise stress echocardiography
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Iranian Heart Journal
Volume 24, Issue 2
Spring 2023
Pages 69-76