Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina and Its Prognostic Implications in 3,094 Consecutive Patients
- Author:
Yeo Jeong SONG
1
;
Sang Jin HA
;
Dong Seok LEE
;
Woo Dae BANG
;
Dong Geum SHIN
;
Yeongmin WOO
;
Sangsig CHEONG
;
Sang Yong YOO
Author Information
- Publication Type:Original Article
- Keywords: Coronary vasospasm; Ergonovine; Echocardiography; Safety; Prognosis
- MeSH: Cholesterol; Coronary Angiography; Coronary Vasospasm; Diagnosis; Echocardiography; Echocardiography, Stress; Ergonovine; Follow-Up Studies; Humans; Male; Medical Records; Mortality; Myocardial Infarction; Prognosis; Risk Factors
- From:Korean Circulation Journal 2018;48(10):906-916
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population. METHODS: We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed. RESULTS: The overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p < 0.001) at a median follow-up of 10.5 years. Cox regression survival analyses revealed that male sex, age, presence of diabetes, total cholesterol level of >220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs. CONCLUSIONS: ErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.
