Andrade Stephanie Macedo, Telino Caio José Coutinho Leal, Sousa Antônio Carlos Sobral, Melo Enaldo Vieira de, Teixeira Carla Carolina Cardoso, Teixeira Clarissa Karine Cardoso, Santana Jaquiele Santos, Mota Igor Larchert, Matos Carlos José Oliveira de, Oliveira Joselina Luzia Menezes
Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Arq Bras Cardiol. 2016 Aug;107(2):116-23. doi: 10.5935/abc.20160096. Epub 2016 Jun 27.
Stress echocardiography is well validated for diagnosis and risk stratification of coronary artery disease. Exercise stress echocardiography (ESE) has been shown to be the most physiological among the modalities of stress, but its safety is not well established.
To study the complications related to ESE and clinical and echocardiographic variables most commonly associated with their occurrence.
Cross-sectional study consisting of 10250 patients submitted to ESE for convenience, from January 2000 to June 2014. Cardiac Arrhythmias (CA) were the most frequent complications observed during the examination. The volunteers were divided into two groups according to the occurrence of CA during ESE: G1 group, composed of patients who have CA, and G2 formed by individuals who did not show such complication.
Group G1, consisting of 2843 patients (27.7%), and Group G2 consisting of 7407 patients (72.3%). There was no death, acute myocardial infarction, ventricular fibrillation or asystole. Predominant CAs were: supraventricular extrasystoles (13.7%), and ventricular extrasystoles (11.5%). G1 group had a higher mean age, higher frequency of hypertension and smoking, larger aortic roots and left atrium (LA) and lower ejection fraction than G2. G1 group also had more ischemic changes (p < 0.001). The predictor variables were age (RR 1.04; [CI] 95% from 1.038 to 1.049) and LA (RR 1.64; [CI] 95% from 1.448 to 1.872).
ESE proved to be a safe modality of stress, with non-fatal complications only. Advanced age and enlargement of the left atrium are predictive of cardiac arrhythmias.
负荷超声心动图在冠状动脉疾病的诊断和危险分层方面已得到充分验证。运动负荷超声心动图（ESE）已被证明是各种负荷方式中最符合生理情况的，但它的安全性尚未完全确立。
研究与ESE相关的并发症以及与其发生最常相关的临床和超声心动图变量。
采用横断面研究，纳入了2000年1月至2014年6月期间因方便起见接受ESE检查的10250例患者。心律失常（CA）是检查期间观察到的最常见并发症。根据ESE期间CA的发生情况将志愿者分为两组：G1组，由发生CA的患者组成；G2组，由未出现此类并发症的个体组成。
G1组有2843例患者（27.7%），G2组有7407例患者（72.3%）。未发生死亡、急性心肌梗死、心室颤动或心搏停止。主要的CA类型为：室上性期前收缩（13.7%）和室性期前收缩（11.5%）。G1组的平均年龄更高，高血压和吸烟的频率更高，主动脉根部和左心房（LA）更大，射血分数低于G2组。G1组也有更多的缺血性改变（p<0.001）。预测变量为年龄（相对危险度1.04；95%置信区间为1.038至1.049）和LA（相对危险度1.64；95%置信区间为1.448至1.872）。
ESE被证明是一种安全的负荷方式，仅出现非致命性并发症。高龄和左心房增大是心律失常的预测因素。
