This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Pines, A. Articles by Kellermann, J. J. Search for Related Content PubMed PubMed Citation Articles by Pines, A. Articles by Kellermann, J. J. Social Bookmarking                         What's this?

Usefulness of Immediate Postexercise Two-Dimensional Echocardiography in Post-Myocardial Infarction Patients Without Ischemic ECG Changes in Stress Testing: Comparison with Radionuclide Angiography

Present address: Department of Medicine T, Ichilov Medical Center, Tel-Aviv, Israel

Enrique Z. Fisman

From the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Efraim Ben-Ari

From the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Michaela Modan

From the Department of Clinical Epidemiology, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Gerald Kessler

From the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Yaacov Drory

From the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Jan J. Kellermann

From the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Of 38 post-myocardial infarction (MI) applicants for a cardiac rehabilitation program, 17 (45%) did not have ischemic ECG changes in exercise testing. Ten (59%) of these 17 patients had echocardiographic wall motion abnormalities at rest. Immediate postexercise two-dimensional echocardiography demonstrated exercise-induced changes in 8 (47%) patients (2 with normal and 6 with abnor mal results from rest studies). The comparative radionuclide (RNA) examina tions showed that there were 6 patients with abnormal findings from rest RNA; exercise-induced changes were detected in 7 (44%) of 16 patients (3 with normal and 4 with abnormal results from rest RNA tests). Statistical analyses, using RNA as reference point, revealed that the total correctly diagnosed cases for the echocardiographic rest studies was 13/17 (77%) and for the exercise studies, 13/16 (81%). The negative predictive values were 7/7 (100%) and 7/8 (88%), respectively. The corresponding positive predictive values were 6/10 (60%) and 6/8 (75%). The same pattern was observed when each segment (septal, apical, and posterolateral) was evaluated separately. The authors conclude that in post- MI patients with a negative stress test, the efficacy of postexercise echocardiog raphy equals that of RNA in the identification of additional patients with ische mia.

Angiology, Vol. 40, No. 7, 605-612 (1989)
DOI: 10.1177/000331978904000701


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?