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exercise ECG angiography

Ivan Zeljković, Hrvoje Pintarić, Mislav Vrsalović, Ivan Kruljac
AIMS: To investigate the effectiveness of cardiogoniometry, a novel, non-invasive method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-ECG test, by using coronary angiography as a reference method. METHODS: It was a single-centre, case-series study including consecutive female patients with stable angina pectoris undergoing coronary angiography. Exercise-ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to coronary angiography...
September 23, 2016: QJM: Monthly Journal of the Association of Physicians
James McKinney, Ian Pitcher, Christopher B Fordyce, Masoud Yousefi, Tee Joo Yeo, Andrew Ignaszewski, Saul Isserow, Sammy Chan, Krishnan Ramanathan, Carolyn M Taylor
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...
2016: PloS One
Micha T Maeder, Christian Mueller, Otto D Schoch, Peter Ammann, Hans Rickli
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with "cardiovascular stress", i.e. cardiovascular risk factors, cardiovascular diseases, and an increased risk of heart failure, stroke, and death. Experimental and clinical studies have characterized potential underlying mechanisms including biventricular dysfunction, atherosclerosis, and arrhythmia. Assessment of these cardiovascular features of OSA requires a spectrum of clinical tools including ECG, echocardiography, exercise testing, and angiography...
September 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Mi-Na Kim, Su-A Kim, Yong-Hyun Kim, Soon Jun Hong, Seong-Mi Park, Mi Seung Shin, Myung-A Kim, Kyoung-Soon Hong, Gil Ja Shin, Wan-Joo Shim
BACKGROUND: Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women...
June 2016: Journal of Cardiovascular Ultrasound
Marco Zimarino, Elena Montebello, Francesco Radico, Sabina Gallina, Matteo Perfetti, Francesco Iachini Bellisarii, Silva Severi, Ugo Limbruno, Michele Emdin, Raffaele De Caterina
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...
October 2016: European Journal of Preventive Cardiology
R Andrew Archbold
Cardiologists in the UK use clinical practice guidelines from the National Institute for Health and Care Excellence (NICE) and from the European Society of Cardiology (ESC) to aid clinical decision-making. This review compares their recommendations regarding stable angina. NICE's diagnostic algorithm changed clinical practice in the UK, with most cardiologists moving from the exercise ECG towards newer, more accurate imaging modalities such as CT and MRI for diagnostic testing in patients with a low or medium probability of coronary artery disease (CAD), and directly to invasive coronary angiography in patients with a high probability of CAD...
2016: Open Heart
Thijs L Braber, Arend Mosterd, Niek H Prakken, Rienk Rienks, Hendrik M Nathoe, Willem P Mali, Pieter A Doevendans, Frank J Backx, Michiel L Bots, Diederick E Grobbee, Birgitta K Velthuis
BACKGROUND: Most exercise-related cardiac arrests in men aged ≥45 years are due to coronary artery disease (CAD). The current sports medical evaluation (SME) of middle-aged sportsmen includes medical history, physical examination and resting and exercise electrocardiography (ECG). We investigated the added value of low-dose cardiac computed tomography (CCT) - both non-contrast CT for coronary artery calcium scoring (CACS) and contrast-enhanced coronary CT angiography (CCTA) - in order to detect occult CAD in asymptomatic recreational sportsmen aged ≥45 years without known cardiovascular disease...
October 2016: European Journal of Preventive Cardiology
Francis R Joshi, Luigi Biasco, Frants Pedersen, Lene Holmvang, Steffen Helqvist, Hans-Henrik Tilsted, Ulrik Abildgaard, Henning Kelbaek, Jens F Lassen, Erik Jørgensen, Ole De Backer, Thomas Engstrøm
BACKGROUND: There are limited data to guide the optimum approach to patients presenting with angina after coronary artery bypass grafting (CABG). Although often referred for invasive angiography, the effectiveness of this is unknown; angina may also result from diffuse distal or micro-vascular coronary disease and it is not known how often targets for intervention are identified. METHODS: Retrospective review of 50,460 patients undergoing angiography in East Denmark between January 2010 and December 2014...
May 24, 2016: Catheterization and Cardiovascular Interventions
Daniel B Mark, Kevin J Anstrom, Shubin Sheng, Khaula N Baloch, Melanie R Daniels, Udo Hoffmann, Manesh R Patel, Lawton S Cooper, Kerry L Lee, Pamela S Douglas
BACKGROUND: The Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial found that initial use of ≥64 detector-row computed tomography angiography versus standard functional testing strategies (exercise ECG, stress nuclear methods, or stress echocardiography) did not improve clinical outcomes in 10 003 stable symptomatic patients with suspected coronary artery disease requiring noninvasive testing. Symptom burden and quality of life (QOL) were major secondary outcomes...
May 24, 2016: Circulation
Kuan-Yin Ko, Yen-Wen Wu, Chia-Ju Liu, Mei-Fang Cheng, Ruoh-Fang Yen, Kai-Yuan Tzen
OBJECTIVE: Identification of right ventricular (RV) abnormalities is important in patients with suspected coronary artery disease (CAD). RV activity can be better visualized on myocardial single-photon emission computerized tomography (SPECT) using a higher sensitivity cadmium-zinc-telluride (CZT) detector. The aim of this study was to investigate the clinical significance of RV/left ventricular (LV) uptake ratios during exercise thallium-201 SPECT using CZT detectors. PATIENTS AND METHODS: A total of 102 patients underwent treadmill ECG-gated SPECT, coronary angiography, and echocardiography...
June 2016: Nuclear Medicine Communications
Eduardo G Bertoldi, Steffan F Stella, Luis E Rohde, Carisi A Polanczyk
Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost-effectiveness information to aid physicians and decision-makers in selecting the most appropriate testing strategy. We used the state-transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex-ECG), stress echocardiography (ECHO), single-photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C-MRI) as the initial test...
May 2016: Clinical Cardiology
Astrid E Lammers, Christian Apitz, Peter Zartner, Alfred Hager, Karl-Otto Dubowy, Georg Hansmann
Pulmonary hypertension (PH) is a condition of multiple aetiologies with underestimated prevalence and incidence. Indeed, despite access to modern therapies, pulmonary hypertensive vascular disease (PHVD) remains a progressive, usually life-limiting condition, severely impacting on the patients' well-being. We herein provide practical, expert consensus recommendations on the initial diagnostic work-up, clinical management and follow-up of children and adolescents with PH/PHVD, including a diagnostic algorithm...
May 2016: Heart: Official Journal of the British Cardiac Society
Kye-Hwan Kim, Kyung Nyeo Jeon, Min Gyu Kang, Jong Hwa Ahn, Jin-Sin Koh, Yongwhi Park, Seok-Jae Hwang, Young-Hoon Jeong, Choong Hwan Kwak, Jin-Yong Hwang, Jeong Rang Park
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)...
September 2016: Korean Journal of Internal Medicine
Konstantinos Zacharias, Asrar Ahmed, Benoy N Shah, Sothinathan Gurunathan, Grace Young, Dionisio Acosta, Roxy Senior
AIMS: Exercise electrocardiography (ExECG) is widely used in suspected stable angina (SA) as the initial test for the evaluation of coronary artery disease (CAD). We hypothesized that exercise stress echo (ESE) would be efficacious with cost advantage over ExECG when utilized as the initial test. METHODS AND RESULTS: Consecutive patients with suspected SA, without known CAD were randomized into ExECG or ESE. Patients with positive tests were offered coronary angiography (CA) and with inconclusive tests were referred for further investigations...
March 24, 2016: European Heart Journal Cardiovascular Imaging
Monica Lamberti, Gennaro Ratti, Carlo Tedeschi, Cristina Capogrosso
A single coronary artery (SCA) ostium is a rare finding. In the general population, the incidence of SCA is approximately 0.024%. We introduce a case of a warehouseman presenting with chest pain after a morning work. The exercise ECG showed ST segment depression in the V 1-4 leads. The coronary angiography procedure and the CT demonstrated an SCA dividing into the right coronary artery and left main coronary artery. We identified a borderline lesion in the distal left anterior descending artery with fractional flow reserve of 0...
2016: BMJ Case Reports
S M Stieger-Vanegas, K F Scollan, L Meadows, D Sisson, J Schlipf, T Riebold, C V Löhr
BACKGROUND: The prevalence of congenital heart disease is higher in camelids than in other domestic species and complex defects, often involving the great vessels, are more frequently encountered in llamas and alpacas than in other species. Some of these complex defects can be difficult to accurately characterize via echocardiography, the most commonly used diagnostic imaging technique to evaluate the heart in veterinary patients. Contrast-enhanced, electrocardiogram (ECG)-gated computed tomography (CT) has proven utility for the evaluation of human patients with certain congenital heart defects, including those with conotruncal septation defects and other abnormalities involving the formation of the great vessels...
March 2016: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Jian-Wei Yuan, Yue-Tao Wang, Cun-Zhi Lu
OBJECTIVE: Anatomic coronary artery disease (CAD) can be determined by coronary angiography (CAG) in patients with normal stress single photon emission tomography (SPET) myocardial perfusion imaging (MPI). Coronary angiography results of patients with negative exercise MPI and the prognosis of these patients (CAG-diagnosed CAD vs. non-CAD) were investigated in the current study. SUBJECTS AND METHODS: Suspected CAD patients who had SPET-MPI and subsequent CAG studies were retrospectively reviewed from May 2002 to November 2006...
September 2015: Hellenic Journal of Nuclear Medicine
Anita Sabzghabaei, Setareh Asgarzadeh, Reza Miri, Majid Shojaee, Hossein Alimohammadi, Kamran Heidari
INTRODUCTION: Chest pain is a common problem in patients referring to emergency units. The present study was undertaken to evaluate the short-term outcome of patients presenting with a low risk chest pain and discharging without provoke ischemia study during emergency department admission. METHODS: In the present prospective cohort study, patients with low-risk chest pain, referring to the emergency department of Imam Hossein Hospital, Tehran, during the first half of 2012, were evaluated...
2014: Emergency (Tehran, Iran)
Kaspar Broch, Arne K Andreassen, Einar Hopp, Trond P Leren, Helge Scott, Fredrik Müller, Svend Aakhus, Lars Gullestad
OBJECTIVE: Dilated cardiomyopathy (DCM) is characterised by left ventricular dilation and dysfunction not caused by coronary disease, valvular disease or hypertension. Owing to the considerable aetiological and prognostic heterogeneity in DCM, an extensive diagnostic work-up is recommended. We aimed to assess the value of diagnostic testing beyond careful physical examination, blood tests, echocardiography and coronary angiography. METHODS: From October 2008 to November 2012, we prospectively recruited 102 patients referred to our tertiary care hospital with a diagnosis of 'idiopathic' DCM based on patient history, physical examination, routine blood tests, echocardiography and coronary angiography...
2015: Open Heart
A Födinger, C Wöss, S Semsroth, K H Stadlbauer, V Wenzel
This report describes a case of sudden cardiac arrest and subsequent attempted cardiopulmonary resuscitation of an 11-year-old child on the shores of a swimming lake. Reports of eyewitnesses excluded the obviously suspected diagnosis of a drowning accident. The result of the autopsy was sudden cardiac death due to a congenital coronary anomaly (abnormal left coronary artery, ALCA). Favored by vigorous physical activity, this anomaly can lead to malignant arrhythmias because the ectopic coronary artery with its intramural course through the aortic wall is compressed during every systole...
November 2015: Der Anaesthesist
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