stress test – ABC CARDIOL

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Original Article

Prognostic Value of Adenosine Stress Perfusion Cardiac Magnetic Resonance Imaging in Older Adults with Known or Suspected Coronary Artery Disease

Yodying Kaolawanich et al. Thananya Boonyasirinant

Abstract

Background:

There is limited data on the prognostic value of stress cardiac magnetic resonance (CMR) in older adults.

Objective:

To determine the prognostic value of adenosine stress CMR in older individuals with known or suspected coronary artery disease (CAD).

Methods:

Between 2010 and 2015, consecutive patients aged 65 years or older referred for adenosine stress CMR were followed for the occurrence of severe cardiac events (cardiac death and nonfatal myocardial infarction) and major adverse cardiovascular events (MACE) that also included hospitalization for heart failure and ischemic stroke. Univariate and multivariate analyses were performed to determine the prognostic value of myocardial ischemia, with p-value <0.05 considered statistically significant.

Results:

After a mean follow-up period of 50.4 months in 324 patients (48% male, 73±7 years), 21 severe cardiac events and 52 MACE occurred. Patients with myocardial ischemia (n=99) had significantly higher rates of severe cardiac events (HR 5.25 [95% CI 2.11-13.04], p<0.001) and MACE (HR 3.01 [95% CI 1.75-5.20], p<0.001) than those without ischemia. Multivariable analysis determined ischemia as an independent predictor of severe cardiac events (HR 3.14 [95% CI 1.22-8.07], p=0.02) and MACE (HR 1.91 [95%CI 1.02-3.59], p=0.04). Ischemia provided an incremental prognostic value over clinical factors and left ventricular ejection fraction for predicting severe cardiac events and MACE (p<0.01 for both). No severe adverse events occurred during or immediately after CMR examinations.

Conclusion:

Adenosine stress CMR is safe and has prognostic value in older adults with known or suspected CAD.

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Artigo Original

Maximal workload prediction models in the clinical cardio-pulmonary effort test

Fernando dos Santos Nogueira et al. Fernando Augusto Monteiro Sabóia Pompeu

OBJECTIVE: This study sought to derive generalized equations for predicting maximal workload for young men and women. METHODS: Direct ergospirometry (Aerosport® TEEM 100, USA) was used to determine VO2máx and the maximal work load (Wmax) on the cycle ergometer test (Monark®, Brazil) of thirty men (25 ± 5 years, 75.0 ± 10.7 kg; 48.4 ± 8.8 mL . kg -1 . min -1 and 243 ± 51 Watts) and thirty women (26 ± 5 years, 56.7 ± 5.9 kg, 39.8 ± 7.6 mL . kg -1 . min -1 and 172 ± 37 Watts). Age and body mass were used as independent variables. For all statistic tests, a p < 0.05 significance level was adopted. RESULTS: In the multiple linear adjustment, the maximal workload was explained by age and body mass as 54% (r = 0.73) for men, and as 76% (r = 0.87) for women, with standard errors of 0.66 W . kg -1 and 25 Watts. The proposed equations were cross-validated using another sample with similar age and VO2máx characteristics comprised of fifteen men and fifteen women. The intraclass correlation between the predicted Wmax values and those measures by ergospirometry were 0.70 and 0.69, with standard errors of 28.4 and 15.8 Watts, respectively, for men and women. CONCLUSIONS: This study exhibits valid generalized equations for determining the maximal cycle ergonometer workload for men and women.

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Original Article

Response of blood pressure to maximum exercise in hypertensive patients under different therapeutic programs

Maria Angela Magalhães de Queiroz Carreira et al. Jamila Costa Ribeiro José Antônio Caldas Leandro Reis Tavares Eduardo Nani

OBJECTIVE: To evaluate the behavior of blood pressure during exercise in patients with hypertension controlled by frontline antihypertension drugs. METHODS: From 979ergometric tests we retrospectively selected 49 hipertensive patients (19 males). The age was 53±12 years old and normal range rest arterial pressure ( or = 10 mmHg/MET; or increase of diastolic pressure greater than 15 mmHg. RESULTS: Physiologic response of arterial blood pressure occurred in 50% of patients on beta blockers, the best one (p<0.05), in 36% and 31% on calcium antagonists and on diuretics, respectively, and in 20% on angiotensin converting enzyme inhibitor, the later the leastr one (p<0.05). CONCLUSION: Beta-blockers were more effective than calcium antagonists, diuretics and angiotensin-converting enzyme inhibitors in controlling blood pressure during exercise, and angiotensin converting enzyme inhibitors the least effective drugs.

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Prognostic Value of Adenosine Stress Perfusion Cardiac Magnetic Resonance Imaging in Older Adults with Known or Suspected Coronary Artery Disease

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Maximal workload prediction models in the clinical cardio-pulmonary effort test

Response of blood pressure to maximum exercise in hypertensive patients under different therapeutic programs

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)