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- Title
Temporal changes in the use and results of exercise echocardiography.
- Authors
Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J.; Calviño-Santos, Ramón; Mosquera, Víctor X.; Sánchez-Fernández, Gabriel; Barbeito-Caamaño, Cayetana; Pérez-Cebey, Lucía; Martínez, Dolores; Yáñez, Juan C.; lvarez-García, Nemesio Á; Vázquez-Rodríguez, José Manuel
- Abstract
Aims Limited data are available regarding changes over time in referral patterns and outcomes of non-invasive cardiac stress testing. Our aim was to evaluate the temporal changes in the use and results of exercise echocardiography in our area of reference. Methods and results A total of 12 339 patients referred to our unit for exercise echocardiography between 1997 and 2012 were included. We divided the 16-year period into four quadrennia and evaluated the changes in clinical data, results of the tests, referrals for invasive management and outcomes. We observed a gradual decrease in the frequency of detection of myocardial ischaemia from 35.3% in 1997-2000 to 25.4% in 2009-12 (P < 0.001). There was also a progressive increase in the prevalence of cardiovascular risk factors and in the frequency of non-ischaemic chest pain and dyspnoea, while the proportion of patients with prior myocardial infarction and non-interpretable electrocardiograms declined. The rate of referral to coronary angiography within 6 months decreased from 24.8% in 1997-2000 to 19.6% in 2009-12 (P, 0.001), but the rate of coronary revascularization remained almost unchanged (13.1 to 11.7%, P for the trend = 0.16).We also observed a progressive decrease in the 1-year mortality rate from 3.4 to 1% (P < 0.001). Conclusion Over a 16-year period, there was a gradual decrease in the frequency of myocardial ischaemia among patients referred to our unit for exercise echocardiography, which was parallel to changes in their clinical profile. However, this was not accompanied by a significant reduction in the rate of coronary revascularization.
- Subjects
ATRIAL fibrillation diagnosis; DIAGNOSIS; THERAPEUTICS; HEART diseases; ISCHEMIA diagnosis; MYOCARDIAL infarction diagnosis; SMOKING; EXERCISE tests; CALCIUM antagonists; ADRENERGIC beta blockers; ANGINA pectoris; ACE inhibitors; ATRIAL fibrillation; CARDIOLOGY; CARDIOPULMONARY system; CARDIOVASCULAR diseases risk factors; CORONARY artery bypass; CORONARY disease; DEMOGRAPHY; DIABETES; DYSPNEA; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAPHY; EXERCISE; PATIENT aftercare; HYPERLIPIDEMIA; HYPERTENSION; MEDICAL needs assessment; MEDICAL referrals; MYOCARDIAL revascularization; NITRATES; OPERATIVE surgery; COMORBIDITY; DATA analysis; ANGIOTENSIN receptors; DESCRIPTIVE statistics
- Publication
European Heart Journal - Cardiovascular Imaging, 2015, Vol 16, Issue 11, p1207
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jev068