Myocardial Contrast Echocardiography Enhances Long-Term Prognostic Value of Supine Bicycle Stress Two-Dimensional Echocardiography

Miszalski-Jamka, Tomasz; Kuntz-Hehner, Stefanie; Schmidt, Harald; Peter, Daniel; Miszalski-Jamka, Karol; Hammerstingl, Christoph; Tiemann, Klaus; Ghanem, Alexander; Troatz, Clemens; Pasowicz, Mieczysław; Lüderitz, Berndt; Omran, Heyder

doi:10.1016/j.echo.2009.07.020

« Previous Next »Journal of the American Society of Echocardiography
Volume 22, Issue 11 , Pages 1220-1227, November 2009

Myocardial Contrast Echocardiography Enhances Long-Term Prognostic Value of Supine Bicycle Stress Two-Dimensional Echocardiography

Tomasz Miszalski-Jamka, MD
- Center for Diagnosis, Prevention and Telemedicine, John Paul II Hospital, Kraków, Poland
- Reprint requests: Tomasz Miszalski-Jamka, MD, Center for Diagnosis, Prevention and Telemedicine, John Paul II Hospital, ul Prądnicka 80, 31-202 Kraków, Poland
Stefanie Kuntz-Hehner, MD
- 2nd Department of Internal Medicine, University of Bonn, Bonn, Germany
Harald Schmidt, MD
- Department of Internal Medicine, St Marienhospital, Bonn, Germany
Daniel Peter, MD
- Department of Internal Medicine, St Marienhospital, Bonn, Germany
Karol Miszalski-Jamka, MD
- 1st Department of Cardiology, Silesian Centre for Heart Disease, Zabrze, Poland
Christoph Hammerstingl, MD
- Department of Internal Medicine, St Marienhospital, Bonn, Germany
Klaus Tiemann, MD, Prof
- Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany
Alexander Ghanem, MD
- 2nd Department of Internal Medicine, University of Bonn, Bonn, Germany
Clemens Troatz, MD
- 2nd Department of Internal Medicine, University of Bonn, Bonn, Germany
Mieczysław Pasowicz, MD, PhD
- Center for Diagnosis, Prevention and Telemedicine, John Paul II Hospital, Kraków, Poland
Berndt Lüderitz, MD
- 2nd Department of Internal Medicine, University of Bonn, Bonn, Germany
Heyder Omran, MD
- Department of Internal Medicine, St Marienhospital, Bonn, Germany

Background

The aim of this study was to determine the incremental prognostic value of myocardial contrast echocardiography (MCE) over two-dimensional echocardiography (2DE) in patients undergoing supine bicycle stress.

Methods

Eighty-four patients with known or suspected coronary artery disease who underwent supine bicycle stress with 2DE and MCE (mean age, 58.5 ± 9.7 years; 68 men) were followed up for 48.3 ± 8.9 months for cardiac death (n = 1), nonfatal myocardial infarction (n = 9), and revascularization (n = 20).

Results

In sequential Cox models, the predictive power of the clinical model was strengthened by 2DE (χ² = 7.73 vs 12.92, P = .02) and further improved by MCE (χ² = 19.04, P = .01). On multivariate analysis, the only independent follow-up event predictor was ischemia on MCE (hazard ratio, 6.79; 95% confidence interval, 2.02-22.82; P = .001). Among patients with normal results on 2DE, those with normal results on MCE had greater 4.5-year event-free survival than those with abnormal results on MCE (93% vs 69%, P = .01).