Abstract
In patients undergoing coronary angiography for investigation of chest pain, the incidence of normal or near-normal coronary arteriographic findings varies between 10% and 20% [1]. In general, patients without significant epicardial coronary artery disease have an excellent prognosis, but not all nonsignificant stenosis are created prognosti-cally equal, since coronary events are rare in patients with smooth, normal arteriograms, sixfold more frequent in patients with mild (o%-20% stenosis), and 15-fold more frequent in patients with moderate (20%-40%, and still nonsignificant) lesions [2].
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References
Schwartz L, Bourassa MG (2001) Evaluation of patients with chest pain and normal coronary angiograms. Arch Intern Med 161:1825–1833
Proudfit WL, Albert VG, Bruschke MD, et al (1980) Clinical course of patients with normal or slightly or moderately abnormal coronary angiograms: 10-year follow-up of 521 patients Circulation 62:712–717
Bigi R, Cortigiani L, Bax JJ et al (2002) Stress echocardiography for risk stratification of patients with chest pain and normal or slightly narrowed coronary arteries. J Am Soc Echocardiogr 15:1285–9
Zeiher AM, Krause T, Schachinger V, et al (1995) Impaired endothelium-dependent vasodilation of coronary resistance vessels is associated with exercise-induced myocardial ischemia. Circulation 91:2345–2352
Picano E, Palinkas A, Amyot R (2001) Diagnosis of myocardial ischemia in hypertensive patients. J Hypert 19:1177–1183
Parisi AF, Folland ED, Hartigan P (1992) A comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease. N Engl J Med 326:10–16
Cortigiani L, Picano E, Landi P, et al on behalf of the Echo Persantine (EPIC) and Echo Dobutamine (EDIC) International Cooperative Study Groups (1998) Value of pharmacological stress echocardiography in risk stratification of patients with single-vessel disease: a report from the Echo-Persantine and Echo-Dobutamine International Cooperative studies. J Am Coll Cardiol 32:69–74
Topol EJ, Ellis SG, Cosgrowe D, et al (1993) Analysis of coronary angioplasty practice in the United States with an insurance-claims data base. Circulation 87:1489–1497
Smith SC Jr, Dove JT, Jacobs AK, et al; American Heart Association Task Force on Practice Guidelines. Committee to Revise the 1993 Guidelines for Percutaneous Transluminal Coronary Angioplasty (2001) ACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines) — executive summary. J Am Coll Cardiol 37:2215–2239
Andrade MJ, Picano E, Pingitore A, et al on behalf of the EPIC Study Group -Subproject “Left Main Detection” (1994) Dipyridamole stress echocardiography in patients with severe left main coronary artery narrowing. Am J Cardiol 73:450–455
Attenhofer CH, Pellikka PA, Oh JK, et al (1996) Comparison of ischemic response during exercise and dobutamine echocardiography in patients with left main coronary artery disease. J Am Coll Cardiol 27:1171–1177
Boersma E, Poldermans D, Bax JJ, et al; DECREASE Study Group (Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography) (2001) Predictors of cardiac events after major vascular surgery: role of clinical characteristics, dobutamine echocardiography, and beta-blocker therapy. JAMA 285:1865–1873
Shaw LJ, Eagle KA, Gersh BJ, et al (1996) Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular imaging. J Am Coll Cardiol 27:787–798
Tischler MD, Lee TH, Hirsch AT, et al (1991) Prediction of major cardiac events after peripheral vascular surgery using dipyridamole echocardiography. Am J Cardiol 68:593–597
Sicari R, Picano E, Lusa AM, et al on behalf of the EPIC Study Group — Subproject “Risk Stratification Before Major Vascular Surgery” (1995) The value of dipyridamole echocardiography in risk stratification before vascular surgery. A multicenter study. Eur Heart J 16:842–847
Rossi E, Citterio F, Vescio MF, et al (1998) Risk stratification of patients undergoing peripheral vascular revascularization by combined resting and dipyridamole echocardiography. Am J Cardiol 82:306–310
Pasquet A, D’Hondt AM, Verhelst R, et al (1998) Comparison of dipyridamole stress echocardiography and perfusion scintigraphy for cardiac risk stratification in vascular surgery patients. Am J Cardiol 82:1468–1474
Sicari R, Ripoli A, Picano E, et al (1999) on behalf of the EPIC study group. Perioperative prognostic value of dipyridamole echocardiography in vascular surgery: a large-scale multicenter study on 509 patients. Circulation 100 [Suppl II]:269–274
Zamorano J, Duque A, Baquero M, et al (2002) Stress echocardiography in the pre-operative evaluation of patients undergoing major vascular surgery. Are results comparable with dipyridamole versus dobutamine stress echo? Rev Esp Cardiol 55:121–126
Lane RT, Sawada SG, Segar DS, et al (1991) Dobutamine stress echocardiography for assessment of cardiac risk before noncardiac surgery. Am J Cardiol 68:976–977
Lalka SG, Sawada SG, Dalsing MC, et al (1992) Dobutamine stress echocardiography as a predictor of cardiac events associated with aortic surgery. J Vasc Surg 15:831–842
Davila-Roman VG, Waggoner AD, Sicard GA, et al (1993) Dobutamine stress echocardiography predicts surgical outcome in patients with an aortic aneurysm and peripheral vascular disease. J Am Coll Cardiol 21:957–963
Eichelberger JP, Schwarz KQ, Black ER, et al (1993) Predictive value of dobutamine echocardiography just before noncardiac vascular surgery. Am J Cardiol 72:602–607
Poldermans D, Fioretti PM, Forster T, et al (1993) Dobutamine stress echocardiography for assessment of perioperative cardiac risk in patients undergoing major vascular surgery. Circulation 87:1506–1512
Kertai MD, Boersma E, Sicari R et al (2002) Which stress test is superior for perioperative cardiac risk stratification in patients undergoing major vascular surgery? Eur J Vasc Endovasc Surg 24:222–9
Poldermans D, Arnese M, Fioretti PM, et al (1997) Sustained prognostic value of dobutamine stress echocardiography for late cardiac events after major noncardiac vascular surgery. Circulation 195:53–58
Sicari R, Ripoli A, Picano E et al on behalf of the EPIC (Echo Persantine International Cooperative) Study Group (2002) Long-term prognostic value of dipyridamole echocardiography in vascular surgery: a large-scale multicenter study. Coron Artery Dis 13:49–55
Institute for Clinical Systems Improvement (2001) Cardiac Stress Test Supplement. http://www.ICI.org
Schechter D, Bocher M, Berlatzky Y, et al (1994) Transient neurological events during dipyridamole stress test: an arterial steal phenomenon? J Nucl Med 35:1802–1804
Molnar T, Zambo K, Schmidt E, et al (2000) Dipyridamole test in the early detection of cerebrovascular disorders? Orv Hetil 141:2717–2722
Gruntzig AR, Senning A, Siegenthaler WE (1979) Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med 301:61–68
Sawada SG, Judson WE, Ryan T, et al (1989) Upright bicycle exercise echocardiography after coronary artery bypass grafting. Am J Cardiol 64:1123–1129
Biagini IA, Maffei S, Baroni M, et al (1990) Early assessment of coronary reserve after bypass surgery by dipyridamole transesophageal echocardiographic stress test. Am Heart J 120:1097–1101
Bongo AS, Bolognese L, Sarasso G, et al (1991) Early assessment of coronary artery bypass graft patency by high-dose dipyridamole echocardiography. Am J Cardiol 67:133–136
Crouse LJ, Vacek JL, Beauchamp GD, et al (1992) Exercise echocardiography after coronary artery bypass grafting. Am J Cardiol 70:572–576
Bjoernstad K, Aakhus S, Lundbom J, et al (1993) Digital dipyridamole stress echocardiography in silent ischemia after coronary artery bypass grafting and/or after healing of acute myocardial infarction. Am J Cardiol 72:640–646
Labovitz AJ, Lewen M, Kern MJ, et al (1989) The effects of successful PTCA on left ventricular function: assessment by exercise echocardiography. Am Heart J 117:1003–1008
Massa D, Pirelli S, Gara E, et al (1989) Exercise testing and dipyridamole echocardiography test before and 48 h after successful coronary angioplasty: prognostic implications. Eur Heart J 10 [Suppl G]:13–17
Picano E, Pirelli S, Marzilli M, et al (1989) Usefulness of high-dose dipyridamole echocardiography test in coronary angioplasty. Circulation 80:807–815
Broderick T, Sawada S, Armstrong WF, et al (1990) Improvement in rest and exercise-induced wall motion abnormalities after coronary angioplasty: an exercise echo cardiographic study. J Am Coll Cardiol 15:591–599
Aboul-Enein H, Bengston JR, Adams DB, et al (1991) Effect of the degree of effort on exercise echocardiography for the detection of restenosis after coronary artery angioplasty. Am Heart J 122:430–437
Pirelli S, Danzi GB, Alberti A, et al (1991) Comparison of usefulness of high-dose dipyridamole echocardiography and exercise electrocardiography for detection of asymptomatic restenosis after coronary angioplasty. Am J Cardiol 67:1335–1338
Pirelli S, Massa D, Faletra F, et al (1991) Exercise electrocardiography versus dipyridamole echocardiography testing in coronary angioplasty. Early functional evaluation and prediction of angina recurrence. Circulation 83 [Suppl III]:38–42
McNeil AT, Fioretti PM, Al-Said SM, et al (1992) Dobutamine stress echocardiography before and after coronary angioplasty. Am J Cardiol 69:740–745
Akosah KO, Porter TR, Simon R, et al (1993) Ischemia-induced regional wall motion abnormality is improved after coronary angioplasty: demonstration by dobutamine stress echocardiography. J Am Coll Cardiol 21:584–589
Mertes H, Erbel R, Nixdorff U, et al (1993) Exercise echocardiography for the evaluation of patients after nonsurgical coronary artery revascularization. J Am Coll Cardiol 21:1087–1093
Dagianti A, Rosanio S, Penco M et al (1997) Clinical and prognostic usefulness of supine bicycle exercise echocardiography in the functional evaluation of patients undergoing elective percutaneous transluminal coronary angioplasty. Circulation 95:1176–84
Pirelli S, Danzi GB, Massa D, et al (1993) Exercise thallium scintigraphy versus high-dose dipyridamole echocardiography testing for detection of asymptomatic restenosis in patients with positive exercise tests after coronary angioplasty. Am J Cardiol 71:1052–1056
Hecht HS, DeBord L, Shaw R, et al (1993) Usefulness of supine bicycle stress echocardiography for detection of restenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 71:293–296
Varga A, Picano E (1996) Evaluation of immediate and long-term results of intervention by echocardiography: can restenosis be predicted? Kluwer, Dordrecht, The Netherlands, pp387–399
Miller DD, Verani MS (1994) Current status of myocardial perfusion imaging after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 24:260–266
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Picano, E., Sicari, R. (2003). Special Subsets of Angiographically Defined Patients: Normal Coronary Arteries, Single-Vessel Disease, Left Main Coronary Artery Disease, Major Noncardiac Vascular Surgery, Patients Undergoing Coronary Revascularization. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05096-5_28
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DOI: https://doi.org/10.1007/978-3-662-05096-5_28
Publisher Name: Springer, Berlin, Heidelberg
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