http://www.cnr.it/ontology/cnr/individuo/prodotto/ID24037

The prognostic value of Doppler echocardiographic-derived coronary flow reserve is not affected by concomitant antiischemic therapy at the time of testing (Articolo in rivista)

Type

Articolo in rivista (Classe)
Prodotto della ricerca (Classe)

Label

The prognostic value of Doppler echocardiographic-derived coronary flow reserve is not affected by concomitant antiischemic therapy at the time of testing (Articolo in rivista) (literal)

Anno

2008-01-01T00:00:00+01:00 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi

10.1016/j.ahj.2003.04.016 (literal)

Alternative label

Sicari R.; Rigo F.; Gherardi S.; Galderisi M.; Cortigiani L.; Picano E. (2008)
The prognostic value of Doppler echocardiographic-derived coronary flow reserve is not affected by concomitant antiischemic therapy at the time of testing
in The American heart journal; Mosby-Elsevier, New York (Stati Uniti d'America)
(literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori

Sicari R.; Rigo F.; Gherardi S.; Galderisi M.; Cortigiani L.; Picano E. (literal)

Pagina inizio

573 (literal)

Pagina fine

579 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#url

http://www.sciencedirect.com/science/article/pii/S0002870308003074 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume

156 (literal)

Rivista

?The ?American heart journal (Rivista)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#note

In: American Heart Journal, vol. 156 (3) pp. 573 - 579. Elsevier, 2008. (literal)

Note

ISI Web of Science (WOS) (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni

CNR-IFC, Pisa, Cardiology Division, Cesena Hospital, Cesena, Italy, Department of Clinical and Experimental Medicine, Federico II University Hospital,, Cardiology Division, Campo di Marte Hospital, Lucca, Italy (literal)

Titolo

The prognostic value of Doppler echocardiographic-derived coronary flow reserve is not affected by concomitant antiischemic therapy at the time of testing (literal)

Abstract

Background When wall motion abnormality is the diagnostic end point, concomitant antiischemic therapy heavily modulates the prognostic value of dipyridamole echocardiography test (DET). A negative test result is less benign, and a positive test result is more malignant if performed under therapy. Recently, coronary flow reserve (CFR) was added to wall motion in dual imaging DET. The aim of the study was to determine whether antianginal medications affect the prognostic value of Doppler echocardiographic-derived CFR in patients with known or suspected coronary artery disease undergoing DET. Methods. In a prospective, multicenter, observational study, we evaluated 1,779 patients (1,072 males; 64 ± 11 years) who underwent high-dose dipyridamole (0.84 mg/kg for 6 minutes) stress echo with CFR evaluation of left anterior descending (LAD) artery by Doppler. Results Seven hundred thirty-three (41%) patients were on antiischemic therapy at time of testing (nitrates and/or calcium antagonists and/or ß-blockers). Mean CFR was 2.3. ± 0.6. At individual patient analysis, 1,141 patients had normal (CFR N2.0) and 638 had abnormal (CFR =2.0) CFR on LAD. During a median follow-up of 36 months, 263 events occurred as follows: 36 deaths and 59 ST-elevation myocardial infarctions (STEMIs) and 168 non-STEMIs (NSTEMIs). Survival was highest in patients with normal CFR and lowest in patients with abnormal CFR (87% vs 34%, P = .0001). Survival was comparable in patients with normal CFR on and off therapy and in patients with abnormal CFR on and off therapy. At multivariable analysis, hypertension (hazard ratio [HR] 1.5, 95% CI 1.0-1.9, P = .010), DET positivity for regional wall motion abnormalities (HR 5.7, 95% CI 4.3-7.4, P = .000), an abnormal CFR on LAD (HR 3.3, 95% CI 2.5-4.4, P = .000) were independent prognostic predictors of hard cardiac events. Conclusion Ongoing antiischemic therapy at the time of testing does not modulate the prognostic value of Doppler echocardiographic-derived coronary flow reserve (literal)

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