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Int J Cardiovasc Imaging. 2002 Apr;18(2):93-9. doi: 10.1023/a:1014672704210.

Noninvasive prediction of coronary artery disease progression by comparison of serial exercise electrocardiography and dipyridamole stress echocardiography.

The international journal of cardiovascular imaging

Olaf Rodriguez, Eugenio Picano, Silvio Fedele, Martha Morelos, Mario Marzilli

Affiliations

  1. Instituto Mexicano de Seguridad Social, Mexico City, Mexico.

PMID: 12108913 DOI: 10.1023/a:1014672704210

Abstract

BACKGROUND: The possibility of noninvasive prediction of angiographically assessed coronary artery disease (CAD) progression by comparison of serial studies of exercise electrocardiography (EET) and dipyridamole stress echocardiography (DET) is not known.

AIM: To assess the relative value of EET and DET in predicting angiographically assessed progression of CAD.

METHODS: From the Institute of Clinical Physiology, National Research Council, Pisa Italy stress echo data bank (1983-1998), we selected 46 patients with two repeated EET, DET and coronary angiography (CA) in two different hospital admissions (46+/-30 months). A priori, angiographic progressors were defined as any stenosis progression to occlusion and/or any stenosis >30% with >20% stenosis progression measured by visual and quantitative CA. EET progressors were defined as a previous negative test becoming positive or as a positive test with decrease in ischemic threshold response in the second test. DET progressors were defined as previous negative test becoming positive or as a positive test with a more severe ischemic response in the second test.

RESULTS: Angiographic progressors were 31/46 patients (67%) and angiographic nonprogressors were 15/46 (33%). When angiography was taken as the gold standard, there were no differences in sensitivity for EET and DET (87 vs. 87%). Specificity was significantly higher for DET (93 vs. 40% p =< 0.001). By kappa statistics DET had a good concordance (kappa = 0.768) and EET a poor concordance (kappa = 0.299) with angiographic progression.

CONCLUSION: DET is more accurate than EET at predicting angiographically assessed CAD progression.

References

  1. J Am Soc Echocardiogr. 1989 Sep-Oct;2(5):358-67 - PubMed
  2. Am J Cardiol. 1991 Jun 15;67(16):1335-8 - PubMed
  3. Eur Heart J. 1993 Sep;14 (9):1216-22 - PubMed
  4. Circulation. 1976 Sep;54(3):522-3 - PubMed
  5. J Am Coll Cardiol. 1991 Mar 1;17(3):666-9 - PubMed
  6. Am J Cardiol. 1995 Jul 13;76(2):122A-125A - PubMed
  7. J Am Coll Cardiol. 1986 Oct;8(4):848-54 - PubMed
  8. Coron Artery Dis. 2001 May;12 (3):197-204 - PubMed
  9. JAMA. 1995 Sep 20;274(11):894-901 - PubMed
  10. Am J Cardiol. 1998 Dec 15;82(12 ):1520-4 - PubMed
  11. J Am Coll Cardiol. 1997 Feb;29(2):293-301 - PubMed
  12. J Am Coll Cardiol. 1992 Jan;19(1):34-42 - PubMed
  13. Circulation. 1991 Jul;84(1):412-23 - PubMed
  14. J Am Coll Cardiol. 1996 Feb;27(2):330-6 - PubMed
  15. Circulation. 1992 Sep;86(3):828-38 - PubMed
  16. Circulation. 1992 Dec;86(6):1864-71 - PubMed
  17. Circulation. 1995 Oct 15;92 (8):2333-42 - PubMed
  18. Circulation. 1999 Aug 3;100(5):509-15 - PubMed
  19. Am J Cardiol. 1994 Mar 1;73(7):478-82 - PubMed
  20. Circulation. 1994 Jul;90(1):50-60 - PubMed
  21. Am J Cardiol. 1986 Aug 1;58(3):235-7 - PubMed
  22. Circulation. 1999 Jun 1;99(21):2829-48 - PubMed
  23. J Am Coll Cardiol. 1989 Aug;14(2):357-63 - PubMed
  24. Circulation. 1994 Mar;89(3):1160-73 - PubMed
  25. J Am Coll Cardiol. 1988 Sep;12(3):682-5 - PubMed
  26. Circulation. 1993 Mar;87(3 Suppl):II38-47 - PubMed
  27. Circulation. 1994 Apr;89(4):1530-8 - PubMed
  28. Am J Cardiol. 1987 Sep 1;60(7):508-12 - PubMed
  29. Am J Hypertens. 1989 Feb;2(2 Pt 1):120-3 - PubMed
  30. Am J Cardiol. 1993 Oct 15;72 (12 ):865-70 - PubMed
  31. Circulation. 1996 May 15;93(10):1826-35 - PubMed
  32. J Am Coll Cardiol. 1991 Nov 15;18(6):1463-70 - PubMed
  33. Circulation. 1992 Jul;86(1):179-86 - PubMed
  34. Circulation. 1995 Jul 15;92 (2):197-204 - PubMed
  35. J Heart Lung Transplant. 1998 Mar;17 (3):259-67 - PubMed

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