Author + information
- Dan G. Halpern,
- Edgar Argulian,
- Vikram Agarwal and
- Farooq A. Chaudhry
Self-reported dyspnea is associated with a higher risk of mortality in patients referred for stress testing. We examined the predictors of mortality in an unselected cohort of patients undergoing stress echocardiography referred for exertional dyspnea as the indication.
We evaluated 308 consecutive patients with unexplained exertional dyspnea from August 2008 to March 2012. Stress tests were performed using the standard exercise echocardiography (ExSE) or dobutamine stress echocardiography (DSE) protocol. Outcome analysis was performed by assessing all-cause mortality.
The mean age was 61 (±13 years) and 63% were females. One fourteen patients (37%) underwent ExSE and the rest underwent DSE. Evidence of ischemia was present in 30 (11%) patients. Over a mean follow-up period of 2±0.9 years, 1(1%) patient in the ExSE group and 22 (11%) in the DSE group died. The rate of mortality with DSE was 14.6%/year with a positive and 4.3%/year with a negative DSE (p=0.01), whereas the event rates with ExSE were less than 1%/year in both groups (see figure). Multivariate predictors of all-cause mortality were pharmacological stress modality (HR 8.7, 95% CI 1.1-66.4) and septal E’ velocity (HR 0.82, 95% CI 0.67-0.99).
Inability to exercise and resting diastolic dysfunction are independent predictors of all cause mortality in patients with exertional dyspnea referred for stress echocardiography.
Monday, March 31, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Stress and Contrast Echocardiography
Abstract Category: 15. Non Invasive Imaging: Echo
Presentation Number: 1248-36
- 2014 American College of Cardiology Foundation