Echocardiography Helps Identify Heart Disease
Test is more accurate than others when used in patients at risk, experts say
By Steven ReinbergHealthDay Reporter
FRIDAY, June 15 (HealthDay News) -- New uses of echocardiography to identify and stratify people with heart disease were highlighted Friday during the American Society of Echocardiography's annual meeting.
"Echocardiography has been around a long time, and it is part of the routine evaluation of heart disease," said Dr. Thomas Ryan, director of the Duke University Heart Center and the society's incoming president. "There has been a lot of technical developments and improvements over the last several years."
Echocardiography, which is basically ultrasound for the heart, is a very accurate and versatile test, Ryan noted. "It can be applied in a lot of different clinical situations," he said. "There is a new population that it is being applied to. It's useful in patients with symptoms, it's useful in patients with a high likelihood of having heart disease, and it is useful for defining the location and extent of heart disease."
In the first presentation, Dr. Farooq A. Chaudhry, director of echocardiography and associate chief of cardiology at St. Luke's-Roosevelt Hospital Center in New York City, and colleagues used stress echocardiography in 447 women to identify their risk for heart disease.
"To identify women at risk for heart disease, we used stress echocardiography, which is done at rest and then during stress," Chaudhry said. "Using this technique, you can differentiate high-risk women from others. If you have an abnormal echo-study, you are three times more likely to have a heart attack or die from heart-related causes."
Chaudhry thinks this technique is more accurate than other methods for identifying heart problems, especially in women. It is a good way to evaluate women who have risk factors for heart disease, he said.
"If women have a history of heart disease, high cholesterol, obesity or diabetes or high blood pressure, this technique should be used to risk stratify them," Chaudhry said.
In another study, Dr. Saritha Dodla and colleagues from the University of Nebraska Medical Center in Omaha found that by using echocardiography, they were able to identify diabetics who were at risk for heart disease even though they had no symptoms.
In the study, the researchers looked at 149 diabetic patients and followed them for an average of almost two years. They found that 25 of the patients had abnormalities in their cardiac arteries. Of these patients, 67 percent were alive after two years, compared with 72 percent of the normal patients.
By looking at heart abnormalities, doctors may be able to diagnose and treat more diabetes patients with blockages of the heart arteries, the researchers concluded.
In a third study, Dr. Jared J. Wyrick of Oregon Health & Science University, and colleagues found that by using echocardiography along with a contrast agent that makes abnormalities easier to see, they were able to identify patients who may be having a heart attack, compared to patients with low-risk chest pain.
In the study, researchers used myocardial contrast echocardiography to evaluate 957 patients complaining of chest pain. They found that by using myocardial contrast echocardiography, 55 percent of the patients could be discharged from the emergency department, thus avoiding admittance charges and follow-up tests. These patients could have saved about $700, plus the inconvenience of hospital stays, the researchers reported.
In the final presentation, Dr. John Postley of Columbia University and colleagues found that by using Screening Vascular Ultrasound, a type of echocardiography, they could identify patients with potential heart disease before symptoms appeared.
In the study, Postley's team used the technique to evaluate 398 patients, ages 33 to 79. The researchers found that 171 patients had plaque build-up in the arteries of the neck and thigh. Of these, 25 percent of men and 35 percent of women were at risk for heart disease.
"These findings suggest that even patients with low Framingham Risk Scores may have cardiovascular disease, as demonstrated by the presence of plaque build-up, and that Screening Vascular Ultrasound is an effective method to identify these patients," Postley said in a prepared statement. "This combination of technologies is wonderful news for the medical community, as it will help identify people with clogged arteries before they even begin showing symptoms, allowing physicians to be more proactive in treatment," he said.
The American Society of Echocardiography's annual meeting is taking place in Seattle.
For more information on echocardiography, visit the American Heart Association.
SOURCES: Thomas Ryan, M.D., director, Duke Heart Center, Duke University, Durham, N.C., incoming president, American Society of Echocardiography; Farooq A. Chaudhry, M.D., director, echocardiography, associate chief of cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York City; June 15, 2007, presentations, 18th annual scientific sessions of the American Society of Echocardiography, Seattle