Duke treadmill score

BACKGROUND: Several variables of electrocardiogram exercise testing (EET) predict cardiovascular events in the general population and in patients with coronary artery disease (CAD). However, most of the studies have not included patients with asymptomatic CAD. The aim of this study was to evaluate the prognostic value of EET in asymptomatic CAD patients. PATIENTS AND METHODS: We carried out a retrospective single-center analysis including all patients with asymptomatic CAD documented by angiography who underwent EET from January 2010 to December 2013...

BACKGROUND: Duke Treadmill score (DTS) is an index that provides prognostic information calculated at exercise stress test (EST). Fractional flow reserve (FFR) is an invasive method used to evaluate intermediate coronary stenosis. The direct relation of DTS and FFR has not been studied to date. AIM: The present study aims to investigate the relationship between the Duke Treadmill score (DTS) and fractional flow reserve (FFR). METHODS: The study population consisted of a total of 106 patients who have single-vessel disease, as confirmed by the coronary angiography (CAG), performed following EST, and whose FFRs have been measured...

Autonomic dysfunction may account for sudden unexpected death in patients with epilepsy (PWE). On the other hand, low cardiovascular fitness, which may affect autonomic function, is a risk factor for sudden death and all-cause mortality in the general population. Little is known about autonomic variables and cardiovascular response to exercise in PWE. We submitted thirty consecutive PWE with no known cardiovascular diseases to maximal treadmill test, comparing them with matched controls. All individuals were submitted to clinical assessment, 12-lead electrocardiogram (ECG) and echocardiogram to exclude cardiovascular disease...

BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...

BACKGROUND: Exercise electrocardiography is a long-standing method for the evaluation of coronary artery disease (CAD), and it remains the initial test for most patients who can exercise adequately with a baseline interpretable electrocardiogram. However, there is little information about the relationship between Duke treadmill test score (DTS) and severity of coronary artery lesion, as well as estimating the need for revascularisation. AIM: The aim of the study was to ascertain whether the DTS could be an efficient parameter in choosing coronary revascularisation in different DTS groups...

Importance: Risk assessment tools for exercise treadmill testing may have limited external validity. Cardiovascular mortality has decreased in recent decades, and women have been underrepresented in prior cohorts. Objectives: To determine whether exercise and clinical variables are associated with differential mortality outcomes in men and women and to assess whether sex-specific risk scores better estimate all-cause mortality. Design, Setting, and Participants: This retrospective cohort study included 59 877 patients seen at the Cleveland Clinic Foundation (CCF cohort) from January 1, 2000, through December 31, 2010, and 49 278 patients seen at the Henry Ford Hospital (FIT cohort) from January 1, 1991, through December 31, 2009...

BACKGROUND: Exercise-induced ST-segment elevation (STE) in lead aVR may be an important indicator of prognostically important coronary artery disease (CAD). However, the prevalence and associated clinical features of exercise-induced STE in lead aVR among consecutive patients referred for exercise stress electrocardiography (ExECG) is unknown. METHODS: All consecutive patients receiving a Bruce protocol ExECG for the diagnosis of CAD at a tertiary care academic center were included over a two-year period...

BACKGROUND: Preinvasive risk stratification is recommended in patients suspected of coronary artery disease (CAD). Stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), and exercise test are the dominant methods of choice. Vasodilator SE is fast and induces only minor increase in heart rate. The diagnostic value of the absolute stress-rest difference in endocardial global longitudinal strain (ΔeGLS) and wall motion (ΔWMI) from adenosine SE was compared to summed stress score (SSS) from MPS and Duke treadmill score (DTS) from exercise test, using quantitative invasive coronary angiography (ICA) as the reference...

BACKGROUND: The exercise electrocardiographic stress test (ExET) is the most widely used non-invasive diagnostic method to detect coronary artery disease. However, the sole ST depression criteria (ST-max) have poor specificity for coronary artery disease in patients with left ventricular hypertrophy. We hypothesised that ST-segment depression/heart rate hysteresis, depicting the relative behaviour of ST segment depression during the exercise and recovery phase of the test might increase the diagnostic accuracy of ExET for coronary artery disease detection in such patients...

BACKGROUND: Because the Diamond-Forrester (DF) model is predictive of obstructive coronary artery disease (CAD), it is often used to risk stratify acute chest pain patients. We sought to further evaluate the clinical utility of the DF model within a chest pain evaluation center. METHODS: Consecutive patients with chest pain and no known CAD or evidence of active ischemia were asked to participate in a prospective registry. Patients were classified based on cardiovascular risk factors, age, and DF classification...

BACKGROUND/AIMS: This study is a head-to-head comparison of predictive values for long-term cardiovascular outcomes between exercise electrocardiography (ex-ECG) and computed tomography coronary angiography (CTCA) in patients with chest pain. METHODS: Four hundred and forty-two patients (mean age, 56.1 years; men, 61.3%) who underwent both ex-ECG and CTCA for evaluation of chest pain were included. For ex-ECG parameters, the patients were classified according to negative or positive results, and Duke treadmill score (DTS)...

OBJECTIVE: Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. METHODS: In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64...

OBJECTIVE: The objective of this study is to compare the incremental prognostic and net risk reclassification value of exercise testing alone vs exercise myocardial perfusion imaging (MPI) for estimating the risk of death in patients with suspected and known coronary artery disease (CAD). METHODS: 6702 patients with suspected CAD and 2008 with known CAD had treadmill exercise MPI and were followed for 2.5 ± 0.9 years for the occurrence of all-cause death. The estimation of risk of death and net reclassification improvement (NRI) were examined in three models...

BACKGROUND AND AIM: We aimed to investigate the role of the Duke treadmill score (DTS) in predicting the presence and severity of coronary artery disease (CAD) by using the SYNTAX score (SS), and also to determine the cut-off value of DTS for both the presence and severity of CAD. METHODS: The study population consisted of 267 patients admitted to the outpatient clinic with chest pain, who under-went coronary angiography after a positive treadmill stress test. First the patients were divided into two groups: SS = 0 and SS > 0...

BACKGROUND: Coronary sinus filling time (CSFT) has been proposed as a simple method for assessment of coronary microvascular function in patients with angina and normal coronaries. But its correlation with inducible ischemia and prognostic significance in predicting future cardiovascular events has not been studied. The present study assessed the prognostic significance of CSFT during one year of follow up. METHODS: We compared coronary sinus filling time of patients with angina and normal coronaries with that of control population...

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BACKGROUND: Annual mortality rate can range from <1% for patients with normal myocardial perfusion by SPECT to >5% based on a high-risk Duke treadmill score (DTS). Information on the prognosis of patients with the combination of HRDTS and normal SPECT is limited and is the purpose of this study. METHODS: Data from a large nuclear cardiology registry (n = 17,972 patients) were reviewed. A total of 340 had HRDTS (score ≤ -11) while undergoing SPECT. Combined cardiovascular mortality and non-fatal myocardial infarction (MI) and cardiovascular mortality alone were available in 310 patients at a mean follow-up of 4...

INTRODUCTION: Reduced exercise capacity is of clinical importance. Sometimes no corresponding cardiovascular disease can be found to explain this condition. We hypothesized that coronary microvascular dysfunction may have an effect on exercise capacity in patients without apparent cardiovascular disease. METHODS: Fifty patients (33 female, mean age 46.8 ± 12.4 years) without coronary artery or other cardiac disease were enrolled. Coronary microvascular function was evaluated by measurement of coronary flow reserve (CFR) during transthoracic pulsed-wave Doppler echocardiography with pharmacological stress...

OBJECTIVE: This study aimed to investigate the effect of percutaneous coronary intervention (PCI) on heart rate recovery (HRR) in patients with angiographically defined coronary artery disease, and to search for a noninvasive method for evaluating the effect of revascularization. METHODS: From June 2012 to July 2013, 56 consecutive male patients with coronary artery disease were enrolled in the PCI group. Correspondingly, in the control group there were 56 consecutive male patients with chest pain but a normal coronary artery verified by angiography...

BACKGROUND: Treadmill exercise nitrogen-13 ((13)N)-ammonia positron emission tomography (PET) has logistical challenges and limited literature. We aimed to assess its feasibility, image quality, and diagnostic accuracy in obese and nonobese patients. METHODS AND RESULTS: Between 2009 and 2012, 10,804 patients were referred for myocardial perfusion imaging, including 300 for treadmill PET, of whom 265 were included in this study. Treadmill testing and PET were performed using standard procedures...