Yokoyama Naoyuki, Schwarz Karl Q, Steinmetz Sherry D, Li Xiang, Chen Xucai
University of Rochester and the Rochester Center for Biomedical Ultrasound, Rochester, New York, USA.
J Am Soc Echocardiogr. 2004 Jan;17(1):15-20. doi: 10.1016/j.echo.2003.09.008.
Clinical data and contrast stress echocardiography (CSE) results were analyzed in 283 patients to establish the prognostic value of CSE for patients with limited echocardiogram image quality at baseline. The mean follow-up period was 736 +/- 337 days. Only 7 patients (2.5%) had nondiagnostic image quality with contrast enhancement. During follow-up, 24 cardiac events (8.5%) occurred (5 cardiac-related deaths, 2 nonfatal myocardial infarction, 17 coronary revascularizations). Overall sensitivity, specificity, and positive and negative predictive values were 60.9%, 76.8%, 19.7%, and 95.5%, respectively. Kaplan-Meier event-free survival was higher for patients with a negative CSE result as compared with those with a positive CSE finding (P <.0001). In a multivariate Cox proportional hazards model, positive CSE was the strongest predictor of cardiac events (risk ratio 3.7; 95% confidence interval 1.6-8.7). CSE can successfully predict cardiac events for patients with limited noncontrast echocardiographic image quality. A negative CSE result conferred a good prognosis.
对283例患者的临床资料和对比增强负荷超声心动图（CSE）结果进行分析，以确定CSE对基线时超声心动图图像质量有限的患者的预后价值。平均随访期为736±337天。只有7例患者（2.5%）的对比增强图像质量无法诊断。随访期间，发生了24例心脏事件（8.5%）（5例心脏相关死亡、2例非致命性心肌梗死、17例冠状动脉血运重建）。总体敏感性、特异性以及阳性和阴性预测值分别为60.9%、76.8%、19.7%和95.5%。CSE结果为阴性的患者的Kaplan-Meier无事件生存率高于CSE结果为阳性的患者（P<.0001）。在多变量Cox比例风险模型中，CSE阳性是心脏事件的最强预测因素（风险比3.7；95%置信区间1.6 - 8.7）。CSE能够成功预测非对比超声心动图图像质量有限的患者的心脏事件。CSE结果为阴性预示着良好的预后。
