Ischaemic burden determined by myocardial contrast echocardiography predicts mortality in patients with new-onset shortness of breath, suspected heart failure and no previous coronary artery disease

摘要

It is important to identify myocardial ischaemia (commonly due to coronary artery disease {CAD}) early as the cause of suspected heart failure besides assessment of left ventricle (LV) function. It is established that patients with CAD and LV dysfunction have worse prognosis compared to those without ischaemic heart disease and LV dysfunction [1]. LV dysfunction due to CAD has therapeutic implications in that the prognosis can be altered by revascularisation and relevant pharmacological therapies [2]. In the absence of a prior history of CAD (ie, previous myocardial infarction or revascularisation) or in the absence of typical ECG changes and cardiac enzyme rise, the diagnosis of CAD as the cause of a new-onset shortness of breath is often difficult to establish. Non-invasive functional testing, ie, stress radionuclide perfusion imaging or stress echocardiography testing, has been advocated as the initial diagnostic strategy but the prognostic significance of ischaemic burden beyond the presence and extent of CAD is unknown.