Exercise Echocardiography in Patients with Normal Exercise ECGs

Imaging stress tests, such as exercise echocardiograms (exEcho), often are used in patients whose exercise electrocardiograms (exECG) are not interpretable. But how much value does echocardiographic imaging add when exECG results are normal? Researchers analyzed the prognostic value of echocardiographic imaging for mortality and major adverse cardiac events (MACE) in more than 4000 patients with known or suspected coronary artery disease and with normal resting ECG and normal exECG at a single center in Spain.

Almost 17% of the cohort exhibited echocardiographic evidence of ischemia. During a mean follow-up of 4.5 years, 313 patients died, and 183 experienced MACE before any revascularization. Rates of mortality and MACE at 5 years were sign…