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Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease
European Heart Journal, 10/16/09

Peteiro J et al. – Peak treadmill EE provides significant incremental information over post–EE for predicting outcome in patients with known or suspected CAD.

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Jesús Peteiro, 10/19/09

The most important finding of this investigation is that in 1 of 5 patients with ischemia at EE, new or worsening wall motion abnormalities were detected only at peak exercise. These patients would be deemed at low risk if treadmill EE had only relied on post-exercise imaging. Also, in patients with post-exercise ischemia (4 of 5 patients), peak exercise wall motion score index (WMSI) was dramatically worse at peak than at post-exercise, indicating that the ischemic burden in more easily seen at peak exercise. The increase in WMSI from post-exercise to peak exercise increased significantly the prognostic value of the clinical model plus resting echo plus exercise testing plus post-exercise WMSI for predicting overall mortality and major cardiac events.

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