Flow-mediated dilatation has an additive value to stress ECG for the diagnosis of angiographically significant coronary atherosclerosis

Journal of the American Society of Hypertension : JASH
Iana SimovaNikolay Dimitrov

Abstract

The objective of this study is to determine if flow-mediated endothelial-dependent vasodilatation (FMD) performed after stress electrocardiogram (ECG) test has an additive value for the diagnosis of significant coronary artery disease (CAD). We studied 322 patients who underwent stress ECG test, coronary arteriography (CAG), and FMD evaluation. The pretest probability (preTP) for the presence of significant CAD (>or=50% stenosis) was 73%. The probability for the disease after positive or negative ECG test (postTP) was 75% and 62%, respectively. A positive FMD response after a positive stress test resulted in 86% postTP with prevalence of advanced CAD in this subgroup -70.4%. A negative FMD response after a positive treadmill test decreased the postTP to 50% (prevalence of significant CAD 25.5%) and could change clinical behavior--additional tests before proceeding to CAG. After negative stress test the postTP increased to 78% when FMD was positive (prevalence of the disease 50%), necessitating the performance of CAG. It decreased to 36% after a negative FMD (prevalence of the disease 11.5%), directing to conservative behavior. In a group with a high pretest probability for the presence of advanced coronary atherosclerosis, FMD ...Continue Reading

Citations

Sep 1, 2012·Global Heart·John P McCrackenSanjay Rajagopalan
Jan 22, 2015·Future Cardiology·Andrew MitchellNicholas L Cruden
Mar 24, 2010·Proceedings of the National Academy of Sciences of the United States of America·V BrunettiP P Pompa
Aug 25, 2012·Stem Cells International·Serena Pillozzi, Andrea Becchetti

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