Predictive Value of Stress Echocardiography
Research type
Research Study
Full title
Retrospective and Prospective Evaluation of Stress Echocardiography.
IRAS ID
251238
Contact name
Rajan Sharma
Contact email
Sponsor organisation
St George's University Hospitals NHS Foundation Trust
Duration of Study in the UK
10 years, 0 months, 1 days
Research summary
In patients with suspected coronary artery disease, stress echocardiography (SE) is a validated tool to detect possible blockages in the coronary arteries. During the test, ultrasound (non-invasive imaging, which possess no risk to the patient) is used to monitor cardiac function, while a drug (dobutamine) is infused based on the patients weight at predetermine rates (10, 20, 30 and 40 mcg/kg/min) to speed up the heart rate or the patient is exercised to a standardised regime. The main study is to determine the prognostic value of SE in the largest population to date (~20,000 participants). The results may provide important information for future guidelines regarding pre-test and stress test results, not previously explored in prior literature due to smaller sample sizes, as well as the strength of SE in predicting patient outcome (3-year follow-up) for minor (defined as non-fatal myocardial infarction, which includes chest pain associated with an elevation in cardiac enzymes with or without electrocardiographic changes) and major (defined as cardiac death due to a myocardial infarction [heart attack], cardiac arrhythmias [heart electrical conduction abnormality], or heart failure) cardiovascular events.
Sub-study 1: As with all clinical tests, SE does not have 100% specificity or sensitivity to detect disease and it is of interest to ascertain if changes in biomarkers (lactate and cardiac troponin) can improve the diagnostic accuracy of cardiac assessment by SE.
Sub-study 2: Shortness of breath is a common symptom among patients referred for SE and these patients are at greater risk of mortality compared to patients with typical chest pain. As such, it is important to ascertain if this sub- group of patients have underlying respiratory disease in addition to coronary disease. In this population we will perform spirometry (respiratory function test) prior to their SE and investigate the associated risks of heart disease and patient outcome (3 year follow-up) for minor and major cardiovascular events.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
18/LO/1715
Date of REC Opinion
23 Oct 2018
REC opinion
Favourable Opinion