Ecoestresse Físico: Predição de Mortalidade e Eventos Cardíacos em Pacientes com Ergometria Isquêmica

AUTOR(ES)

Araujo, Ana Carla Pereira de, Santos, Bruno F. de Oliveira, Calasans, Flavia Ricci, Pinto, Ibraim M. Francisco, Oliveira, Daniel Pio de, Melo, Luiza Dantas, Andrade, Stephanie Macedo, Tavares, Irlaneide da Silva, Sousa, Antonio Carlos Sobral, Oliveira, Joselina Luzia Menezes

FONTE

Arq. Bras. Cardiol.

DATA DE PUBLICAÇÃO

28/10/2014

RESUMO

Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

ASSUNTO(S)

ecocardiografia sob estresse/mortalidade teste de esforço esforço físico doença da artéria coronariana isquemia miocárdica

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