Abstract
Stress-echocardiography und myocardial scintigraphy provide similar
information on the prognosis of patients with and without heart disease. A
normal stress echocardiogram does not exclude coronary stenoses but indicates a
prognostically favourable outcome. Patients with a normal stress echocardiogram
usually do not need further invasive assessment of coronary artery disease.
There is an increasing risk of cardiac mortality and myocardial infarction
depending on extent of abnormal findings during stress echocardiography. Stress
echocardiography can be used to assess the short term prognosis of patients
undergoing major non-cardiac surgery. The results of the stress echocardiogram
identify those patients, in major surgery is of high risk. Newer
echocardiographic technologies like Doppler tissue imaging, speckle tracking
imaging and myocardial contrast echocardiography are promising, but still need
to be validated in larger studies.
Kernaussagen
-
Stressechokardiografie und Myokardszintigrafie haben
bezüglich der Prognose bei Patienten mit und ohne KHK eine ähnliche
Aussagekraft.
-
Ein normales Stressechokardiogramm schließt
Koronarstenosen nicht aus, spricht aber für eine gute Prognose. Die beste
Prognose haben diejenigen Patienten, die ein normales
Belastungs-Stressechokardiogramm haben.
-
Patienten mit einem normalen Belastungs-Stressechokardiogramm
benötigen keine weitere Diagnostik, es sei denn, die klinische Symptomatik
ändert sich. Auch Patienten mit einem normalen
Dobutamin-Stressechokardiogramm benötigen in der Regel keine weitere
Diagnostik, wenn kein Diabetes vorliegt.
-
Das kardiale Risiko steigt bei Frauen und Männern an, je
mehr pathologische Befunde sich in der Stressechokardiografie finden. Auch bei
Frauen erlaubt die Belastungs-Stressechokardiografie eine zuverlässige
Aussage zum kardiovaskulären Risiko.
-
Die Stressechokardiografie erlaubt eine Aussage zur Prognose
von Patienten, denen nicht kardiale chirurgische Eingriffe bevorstehen.
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Harald Becher, MD PhD FRCP
Consultant Cardiologist, Professor of Cardiac
Ultrasound
University of Oxford
John Radcliffe
Hospital
Cardiac Investigation Annexe
Headley Way
Oxford
OX3 9DU
United
Kingdom
Email: harald.becher@orh.nhs.uk
