Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation

Diana Rinkevich, Sanjiv Kaul, Xin Qun Wang, Leng Tong Khim, Todd Belcik, Saul Kalvaitis, Wolfgang Lepper, John M. Dent, Kevin Wei

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Aims: We hypothesized that the assessment of left ventricular regional function (RF) and myocardial perfusion (MP) will provide incremental value over routine evaluation in patients who present to the emergency department (ED) with chest pain (CP) and no ST-segment elevation. Methods and results: In addition to routine clinical evaluation, patients with suspected cardiac CP and no ST-segment elevation were evaluated in the ED for RF and MP using contrast echocardiography (CE). Cardiac-related death, acute myocardial infarction, unstable angina pectoris, congestive heart failure (CHF), and revascularization were considered as events within 48 h (early). Of the 1017 patients studied, 166 (16.3%) had early events. Adding RF increased the prognostic information of clinical and EKG variables significantly (Bonferroni corrected P <0.0001) for predicting these events. When MP was added, significant additional prognostic information was obtained (Bonferroni corrected P = 0.0002). All patients were followed for a median of 7.7 months (25th-75th percentiles: 2.7-12.5) Of these, 292 (28.7%) had events. Adding RF increased the prognostic information of clinical and EKG variables for determining the risk of events significantly (Bonferroni corrected P <0.0001), which was further increased by adding MP (Bonferroni corrected P <0.0001). Conclusion: Early assessment of RF on CE adds significant diagnostic and prognostic value to routine evaluation in patients presenting to the ED with suspected cardiac CP and no ST-segment elevation. MP provides additional significant value. CE could be a valuable tool in the early triage and management of CP patients presenting to the ED.

Original languageEnglish (US)
Pages (from-to)1606-1611
Number of pages6
JournalEuropean Heart Journal
Volume26
Issue number16
DOIs
StatePublished - Aug 2005
Externally publishedYes

Fingerprint

Chest Pain
Left Ventricular Function
Hospital Emergency Service
Perfusion
Echocardiography
Electrocardiography
Triage
Unstable Angina
Heart Failure
Myocardial Infarction

Keywords

  • Emergency department
  • Myocardial contrast echocardiography
  • Myocardial ischaemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation. / Rinkevich, Diana; Kaul, Sanjiv; Wang, Xin Qun; Khim, Leng Tong; Belcik, Todd; Kalvaitis, Saul; Lepper, Wolfgang; Dent, John M.; Wei, Kevin.

In: European Heart Journal, Vol. 26, No. 16, 08.2005, p. 1606-1611.

Research output: Contribution to journalArticle

Rinkevich, Diana ; Kaul, Sanjiv ; Wang, Xin Qun ; Khim, Leng Tong ; Belcik, Todd ; Kalvaitis, Saul ; Lepper, Wolfgang ; Dent, John M. ; Wei, Kevin. / Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation. In: European Heart Journal. 2005 ; Vol. 26, No. 16. pp. 1606-1611.
@article{d7522d937170425a8c7b1aedbbf3d6e5,
title = "Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation",
abstract = "Aims: We hypothesized that the assessment of left ventricular regional function (RF) and myocardial perfusion (MP) will provide incremental value over routine evaluation in patients who present to the emergency department (ED) with chest pain (CP) and no ST-segment elevation. Methods and results: In addition to routine clinical evaluation, patients with suspected cardiac CP and no ST-segment elevation were evaluated in the ED for RF and MP using contrast echocardiography (CE). Cardiac-related death, acute myocardial infarction, unstable angina pectoris, congestive heart failure (CHF), and revascularization were considered as events within 48 h (early). Of the 1017 patients studied, 166 (16.3{\%}) had early events. Adding RF increased the prognostic information of clinical and EKG variables significantly (Bonferroni corrected P <0.0001) for predicting these events. When MP was added, significant additional prognostic information was obtained (Bonferroni corrected P = 0.0002). All patients were followed for a median of 7.7 months (25th-75th percentiles: 2.7-12.5) Of these, 292 (28.7{\%}) had events. Adding RF increased the prognostic information of clinical and EKG variables for determining the risk of events significantly (Bonferroni corrected P <0.0001), which was further increased by adding MP (Bonferroni corrected P <0.0001). Conclusion: Early assessment of RF on CE adds significant diagnostic and prognostic value to routine evaluation in patients presenting to the ED with suspected cardiac CP and no ST-segment elevation. MP provides additional significant value. CE could be a valuable tool in the early triage and management of CP patients presenting to the ED.",
keywords = "Emergency department, Myocardial contrast echocardiography, Myocardial ischaemia",
author = "Diana Rinkevich and Sanjiv Kaul and Wang, {Xin Qun} and Khim, {Leng Tong} and Todd Belcik and Saul Kalvaitis and Wolfgang Lepper and Dent, {John M.} and Kevin Wei",
year = "2005",
month = "8",
doi = "10.1093/eurheartj/ehi335",
language = "English (US)",
volume = "26",
pages = "1606--1611",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "16",

}

TY - JOUR

T1 - Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation

AU - Rinkevich, Diana

AU - Kaul, Sanjiv

AU - Wang, Xin Qun

AU - Khim, Leng Tong

AU - Belcik, Todd

AU - Kalvaitis, Saul

AU - Lepper, Wolfgang

AU - Dent, John M.

AU - Wei, Kevin

PY - 2005/8

Y1 - 2005/8

N2 - Aims: We hypothesized that the assessment of left ventricular regional function (RF) and myocardial perfusion (MP) will provide incremental value over routine evaluation in patients who present to the emergency department (ED) with chest pain (CP) and no ST-segment elevation. Methods and results: In addition to routine clinical evaluation, patients with suspected cardiac CP and no ST-segment elevation were evaluated in the ED for RF and MP using contrast echocardiography (CE). Cardiac-related death, acute myocardial infarction, unstable angina pectoris, congestive heart failure (CHF), and revascularization were considered as events within 48 h (early). Of the 1017 patients studied, 166 (16.3%) had early events. Adding RF increased the prognostic information of clinical and EKG variables significantly (Bonferroni corrected P <0.0001) for predicting these events. When MP was added, significant additional prognostic information was obtained (Bonferroni corrected P = 0.0002). All patients were followed for a median of 7.7 months (25th-75th percentiles: 2.7-12.5) Of these, 292 (28.7%) had events. Adding RF increased the prognostic information of clinical and EKG variables for determining the risk of events significantly (Bonferroni corrected P <0.0001), which was further increased by adding MP (Bonferroni corrected P <0.0001). Conclusion: Early assessment of RF on CE adds significant diagnostic and prognostic value to routine evaluation in patients presenting to the ED with suspected cardiac CP and no ST-segment elevation. MP provides additional significant value. CE could be a valuable tool in the early triage and management of CP patients presenting to the ED.

AB - Aims: We hypothesized that the assessment of left ventricular regional function (RF) and myocardial perfusion (MP) will provide incremental value over routine evaluation in patients who present to the emergency department (ED) with chest pain (CP) and no ST-segment elevation. Methods and results: In addition to routine clinical evaluation, patients with suspected cardiac CP and no ST-segment elevation were evaluated in the ED for RF and MP using contrast echocardiography (CE). Cardiac-related death, acute myocardial infarction, unstable angina pectoris, congestive heart failure (CHF), and revascularization were considered as events within 48 h (early). Of the 1017 patients studied, 166 (16.3%) had early events. Adding RF increased the prognostic information of clinical and EKG variables significantly (Bonferroni corrected P <0.0001) for predicting these events. When MP was added, significant additional prognostic information was obtained (Bonferroni corrected P = 0.0002). All patients were followed for a median of 7.7 months (25th-75th percentiles: 2.7-12.5) Of these, 292 (28.7%) had events. Adding RF increased the prognostic information of clinical and EKG variables for determining the risk of events significantly (Bonferroni corrected P <0.0001), which was further increased by adding MP (Bonferroni corrected P <0.0001). Conclusion: Early assessment of RF on CE adds significant diagnostic and prognostic value to routine evaluation in patients presenting to the ED with suspected cardiac CP and no ST-segment elevation. MP provides additional significant value. CE could be a valuable tool in the early triage and management of CP patients presenting to the ED.

KW - Emergency department

KW - Myocardial contrast echocardiography

KW - Myocardial ischaemia

UR - http://www.scopus.com/inward/record.url?scp=25844527331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=25844527331&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehi335

DO - 10.1093/eurheartj/ehi335

M3 - Article

C2 - 15917277

AN - SCOPUS:25844527331

VL - 26

SP - 1606

EP - 1611

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 16

ER -