Influence of @entity4346 on detection of XXXX using exercise echocardiography.

@entity1 @entity308 @entity583 @entity101 @entity301 @entity1184 @entity4346 @entity453 @entity472
OBJECTIVES: This study examined the influence of @entity4346 on the accuracy of exercise electrocardiography and echocardiography for detection of @entity453 . BACKGROUND: Electrocardiographic repolarization abnormalities caused by @entity4346 compromise the diagnostic accuracy of exercise electrocardiography but not of exercise echocardiography. The relative merits of these investigations are less well defined in @entity1 with @entity1184 but without electrocardiographic (ECG) changes. METHODS: We prospectively evaluated 147 consecutive @entity1 without prior @entity583 undergoing both exercise echocardiography and coronary arteriography. Coronary stenoses > 50% diameter were present in 62 @entity1 (42%). Positive test results were defined by a new or worsening wall motion abnormality or > 0.1 mV of ST @entity308 . @entity4346 (mass > 131 g/m2 in @entity1 , > 100 g/m2 in @entity1 ) was identified in 68 @entity1 . A subgroup with clinically suspected @entity1184 was defined according to the presence of ECG evidence of @entity1184 , @entity101 or @entity472 . RESULTS: The overall sensitivity of exercise echocardiography exceeded that of exercise electrocardiography (71% vs. 54%, p = 0.06). @entity1184 had no significant effect on the sensitivity of either test. The specificity of exercise echocardiography exceeded that of exercise electrocardiography (91 vs. 74%, p = 0.01). In @entity1 with @entity1184 , the specificity of exercise echocardiography exceeded that of exercise electrocardiography (95% vs. 69%, p < 0.01), whereas among @entity1 without @entity1184 , the specificities (respectively, 87% and 78%) were more comparable. The accuracy of exercise echocardiography exceeded that of the exercise ECG in the overall group (82% vs. 65%, p = 0.002) and in @entity1 with @entity1184 (85% vs. 60%, p = 0.004), but this difference was less prominent in @entity1 without @entity1184 (80% vs. 69%, p = NS). In @entity1 with clinically suspected @entity1184 , exercise echocardiography demonstrated a higher sensitivity, specificity and accuracy than exercise electrocardiography. The cost incurred in the identification of @entity301 was least with a strategy involving use of the exercise echocardiogram instead of routine exercise testing in @entity1 with known or clinically suspected @entity4346 . CONCLUSIONS: Exercise echocardiography is more accurate than exercise electrocardiography for the detection of @entity453 in @entity1 with known or clinically suspected @entity4346 .
