Aortic Valve Sclerosis on Echocardiography is a Good Predictor of Coronary Artery Disease in Patients With an Inconclusive Treadmill Exercise Test.
10.4070/kcj.2009.39.7.275
- Author:
Dong Bin KIM
1
;
Hae Ok JUNG
;
Doo Soo JEON
;
Chan Seok PARK
;
Sung Won JANG
;
Hoon Joon PARK
;
Pum Joon KIM
;
Sang Hong BAEK
;
Ki Bae SEUNG
;
Tai Ho RHO
;
Jae Hyung KIM
;
Kyu Bo CHOI
Author Information
1. Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. hojheart@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Echocardiography;
Treadmill test;
Aortic valve;
Sclerosis;
Coronary artery disease
- MeSH:
Aortic Valve;
Chest Pain;
Coronary Angiography;
Coronary Artery Disease;
Coronary Vessels;
Disease-Free Survival;
Echocardiography;
Exercise Test;
Follow-Up Studies;
Humans;
Logistic Models;
Phenobarbital;
Prospective Studies;
Sclerosis;
Sensitivity and Specificity
- From:Korean Circulation Journal
2009;39(7):275-279
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The treadmill exercise test (TMT) is used as a first-line test for diagnosing coronary artery disease (CAD). However, the findings of a TMT can be inconclusive, such as incomplete or equivocal results. Aortic valve sclerosis (AVS) is known to be a good predictor of CAD. We determined the usefulness of assessing AVS on 2-dimensional (2D) echocardiography for making the diagnosis of CAD in patients with inconclusive results on a TMT. SUBJECTS AND METHODS: This prospective study involved 165 consecutive patients who underwent a TMT that resulted in inconclusive findings, 2D echocardiography to detect AVS, and coronary angiography to detect CAD. Following echocardiography, AVS was classified as none, mild, or severe. CAD was defined as > or =70% narrowing of the luminal diameter on coronary angiography. RESULTS: CAD was more common in patients with AVS than in patients without AVS (75% vs. 47%, respectively, p<0.01). Multiple logistic regression analysis showed that AVS was the only independent predictor of CAD {odds ratio=8.576; 95% confidence interval (CI), 3.739-19.672}. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the presence of AVS for predicting CAD in a patient with an inconclusive TMT were 62%, 67%, 64%, 75%, and 53%, respectively. During a 1-year clinical follow-up, patients with and without AVS were similar in terms of event-free survival rates. CONCLUSION: If the results of TMT for patients with chest pain on exertion are inconclusive, the presence of AVS on echocardiography is a good predictor of CAD.
