ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The concept of incremental value in prognosis and outcome of patients with coronary artery disease is important to the field of noninvasive imaging. Because these tests are expensive, they should be held to the standard of demonstrating a statistical improvement over the information provided by clinical assessment and treadmill testing. Responding to the demand for cost-effective applications of myocardial perfusion scintigraphy, a large amount of research has recently been devoted to defining specific patient subsets in which incremental value exists for scintigraphy. Subsets thus far demonstrated to benefit incrementally include those men and women referred for possible coronary artery disease, with known coronary artery disease, and after percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, unstable angina, or recent infarction. Incremental cost savings also apply to these subsets except for patients with normal ECGs at rest and less than 15% likelihood for significant coronary artery disease.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The assessment of myocardial viability is of increasing clinical relevance in the era of thrombolytic therapy and coronary revascularization. Dobutamine stress echocardiography has been proposed as a method of detecting residual viability. The echocardiographic hallmark for viability of a dyssynergic segment is improvement of wall thickening after inotropic challenge. Several clinical studies published over the past year have shown the value of dobutamine stress echocardiography in predicting improvement in regional and global ventricular function after revascularization.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Stress echocardiography is increasingly used for the assessment of coronary artery disease and is valuable in the treatment of patients with known disease as well. Although several studies are available on the accuracy of stress echocardiography in the detection of coronary artery disease and evaluation of its severity, studies on the use of this technique for evaluation of prognosis are just now emerging. Over the past decade, few studies have investigated its prognostic value in different patient populations. The versatility and advantage of stress echocardiography lie in the fact that it provides information on both resting ventricular function and stress-induced ischemia, two important determinants of cardiac events. Exercise echocardiography with the bicycle or posttreadmill approach is used in subjects who can exercise and provides important additional prognostic data from physiologic exercise variables. In patients unable to exercise, pharmacologic stress echocardiography with dobutamine or vasodilators is used. Stress echocardiography has been shown to identify different populations of patients at risk of cardiac events, including those with stable or suspected coronary artery disease, those with acute myocardial infarction, and those scheduled for major noncardiac surgery. In the early postinfarct setting, exercise and vasodilator stress have been used more often, whereas dobutamine echocardiography has been used predominantly at low doses for the assessment of residual myocardial viability. This review focuses on recently published investigations evaluating the prognostic effect of stress echocardiography in patients with stable coronary artery disease or acute myocardial infarction.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Magnetic resonance imaging of the cardiovascular system is now a well-recognized primary investigative technique for many conditions of structural abnormality in clinical cardiology, but the assessment of functional abnormality is also valuable and is increasingly being recognized by clinicians because of the accuracy and reproducibility of the techniques. Recently, focus has centered on reduction of motion artifact and scan time by rapid imaging techniques and on applications in coronary artery disease. Magnetic resonance coronary angiography can be used reliably to assess coronary artery bypass graft patency and anomalous coronary artery anatomy, and techniques of assessing native coronary artery stenosis and flow are close to being clinically useful. Advances continue in the assessment of myocardial perfusion, right and left ventricular function, and myocardial metabolism. With this combination of anatomic and functional information, magnetic resonance imaging will play an ever-increasing role in the assessment of cardiac disease.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID