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한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제28권 제2호
발행연도
2020.1
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123 - 133 (11page)

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BACKGROUND: Stress echocardiography has a 72%–85% sensitivity and an 80%–95% specificity. In this study, we characterized patients who received a false-positive stress echocardiogram result. METHODS: A total of 5,256 patients underwent a stress echocardiogram (induced by exercise, dobutamine, or dipyridamole) between 2009 to 2018, and 405 patients (7.7%) received a positive result. Among the positive patients, 300 underwent coronary angiography within 12 months, and these patients were included in this study (mean age = 64.9 ± 9.4 years, 230 men [76.7%]). Coronary artery disease was diagnosed by stenosis ≥50% in any epicardial coronary artery. Clinical and echocardiographic variables were compared between patients with true- and false-positive stress echocardiogram results. RESULTS: Seventy-two patients (24%) had a false-positive stress echocardiogram, with similar rates across stressor types (p = 0.574). Patients with false positives were less frequently men (63.9% vs. 80.7%, p = 0.003), had lower diabetes mellitus prevalence (15.3% vs. 45.6%, p = 0.001), were similar to true positive patients with regard to body-mass index, arterial hypertension prevalence, hyperlipidemia and smoking, and had lower pre-test probability of coronary artery disease (23% vs. 32%, p = 0.016). The wall motion score index (WMSI) was higher in the true-positive stress group, and wall motion abnormalities were more frequent in the apical segments (70.5% vs. 56.7%, p = 0.034). In a multivariable predictive model, men (odds ratio [OR] = 2.994), diabetes (OR = 5.440), and peak WMSI (OR = 10.690) were associated with a true-positive result. CONCLUSIONS: Twenty-four percent of our study population received a false-positive stress echocardiogram result, with similar rates across stressor types. Patients with true-positive stress echocardiogram results are more likely to be men, diabetic, and have a high peak WMSI.

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참고문헌 (15)

참고문헌 신청
Senior R / 2005 / Stress echocardiography for the diagnosis and risk stratification of patients with suspected or known coronary artery disease: a critical appraisal. Supported by the British Society of Echocardiography / Heart 91:427~436 google schola Task Force Members / 2013 / 2013 ESC guidelines on the management of stable coronary artery disease : the Task Force on the management of stable coronary artery disease of the European Society of Cardiology / Eur Heart J 34:2949~3003 google schola Heijenbrok-Kal MH / 2007 / Stress echocardiography, stress single-photon-emission computed tomography and electron beam computed tomography for the assessment of coronary artery disease: a meta-analysis of diagnostic performance / Am Heart J 154:415~423 google schola Pellikka PA / 2007 / American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography / J Am Soc Echocardiogr 20:1021~1041 google schola Qamruddin S / 2016 / False-positive stress echocardiograms : a continuing challenge / Ochsner J 16:277~279 google schola

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