Author + information
- Thomas Porter,
- Juefei Wu,
- Feng Xie,
- Stacey Therrien,
- Valentina Lorenzoni,
- Sabrina Molinaro,
- Claudio Reverberi and
- Nicola Gaibazzi
The incremental prognostic value of myocardial perfusion imaging (MP) during contrast stress-echocardiography (cSE) has been demonstrated, but whether this applies to patients with known coronary artery disease (CAD) who are at high risk for hard cardiac events (all-cause death and nonfatal myocardial infarction) remains to be determined.
We analyzed the outcome of 754 patients with known CAD referred for Dipyridamole (n=483) or Dobutamine (n=271) cSE in two echo labs (Parma, Italy and Omaha, USA) between 2005 and 2011, with a mean follow-up time of 39±24 months. MP and wall motion (WM) were assessed at rest and stress using real time perfusion imaging with either intravenous Sonovue or Definity contrast agents.
Patients without either a fixed or reversible MP defect had a 3 year mortality of 1.7% and a hard cardiac event rate of 3.1%, while patients without rest or reversible WM abnormalities had a mortality rate of 3.7% and hard event rate of 6.0% (p<0.001 compared to MP). C-index was higher (p=0.015) when MP analysis was added to clinically predictive variables and WM data; net reclassification index confirmed (p<0.01) better risk stratification by MP.
Patients with known CAD but no fixed or reversible MP defects during cSE fared significantly better than patients without either rest or reversible WM abnormalities, whose cardiac hard event rate and all-cause mortality was doubled.
Oral Contributions West, Room 3006
Saturday, March 09, 2013, 9:15 a.m.-9:30 a.m.
Session Title: Novel Applications of Echocardiography: Implications for Clinical Use
Abstract Category: 18. Imaging: Echo
Presentation Number: 909-8
- 2013 American College of Cardiology Foundation