Exercise echocardiography in octogenarian patients: a valid and feasible tool for diagnostic and prognostic assessment in ischemic heart disease

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Abstract Background The increase in life expectancy in general population is leading to a rise in the number of elderly patients visiting cardiology clinics. Often, the reason for these visits is the diagnostic suspicion or follow-up of patients with ischemic heart disease. Furthermore, elderly patients are often underdiagnosed and undertreated and they are a population poorly represented in clinical trials for coronary artery disease (CAD). Exercise echocardiography (EE) is a fundamental test in the evaluation of patients with diagnostic suspicion or prognostic assessment of CAD. However, there is limited evidence in the literature regarding its usefulness in elderly patients. Purpose The aim of our study is to analyze the usefulness of EE in octogenarian patients referred for diagnostic or prognostic assessment of CAD. Methods Retrospective analysis of consecutive patients aged 80-89 years referred for treadmill EE for diagnostic suspicion or prognostic assessment of CAD between January 2021 and December 2023. Results Ninety three octogenarian patients (aged 80-89 years) were included, representing 5.3% of the total patients who underwent EE during the analyzed period. The average age was 83.1 years, 40% were women and 41.9% had a previous history of CAD. Bruce protocol was performed in 87.1% of the cases. A mean METs level significantly higher than predicted by age and sex was achieved (6.6 vs. 4.9 METs, p<0.001). The test was negative for ischemia in 48.4%, positive in 24.7%, and inconclusive in 26.9%. 5.4% of the studies were considered non-assessable. There were no complications resulting from the test. Conclusions EE is an appropriate and feasible diagnostic and evaluative test that is valid and safe for octogenarian patients who do not have a limitation in walking on a treadmill. The vast majority of the studies (95%) were considered assessable.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.