2020
Implications of Abnormal Exercise Electrocardiography With Normal Stress Echocardiography
Daubert MA, Sivak J, Dunning A, Douglas PS, Coyne B, Wang TY, Mark DB, Velazquez EJ. Implications of Abnormal Exercise Electrocardiography With Normal Stress Echocardiography. JAMA Internal Medicine 2020, 180: 494-502. PMID: 31985749, PMCID: PMC6990669, DOI: 10.1001/jamainternmed.2019.6958.Peer-Reviewed Original ResearchMeSH KeywordsCoronary DiseaseEchocardiography, StressElectrocardiographyExercise TestFemaleHumansMaleMiddle AgedPrognosisConceptsNormal stress echocardiographyComposite end pointStress echoExercise electrocardiographyStress echocardiographyMyocardial infarctionDownstream testingEnd pointDuke University Medical CenterExercise stress echoNegative exercise ECGStress ECG findingsAdverse cardiac eventsIncremental prognostic valueObservational cohort studyAdverse clinical eventsCoronary artery diseaseIndividual adverse eventsPopulation of patientsUniversity Medical CenterImaging resultsCoronary revascularizationAdverse eventsCardiac eventsCohort study
2019
Echocardiographic Assessment of Right Ventricular Function and Response to Therapy in Pulmonary Arterial Hypertension
Shelburne NJ, Parikh KS, Chiswell K, Shaw LK, Sivak J, Arges K, Tomfohr J, Velazquez EJ, Kisslo J, Samad Z, Rajagopal S. Echocardiographic Assessment of Right Ventricular Function and Response to Therapy in Pulmonary Arterial Hypertension. The American Journal Of Cardiology 2019, 124: 1298-1304. PMID: 31481176, DOI: 10.1016/j.amjcard.2019.07.026.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAntihypertensive AgentsEchocardiographyExercise TestFemaleFollow-Up StudiesHeart VentriclesHumansMaleMiddle AgedNorth CarolinaPrognosisPulmonary Arterial HypertensionRetrospective StudiesSeverity of Illness IndexStroke VolumeSurvival RateVentricular Function, RightYoung AdultConceptsTricuspid annular plane systolic excursionPulmonary arterial hypertensionRV global longitudinal strainRV systolic pressureRight ventricular functionGlobal longitudinal strainArterial hypertensionSystolic pressureVentricular functionSevere pulmonary arterial hypertensionAnnular plane systolic excursionLongitudinal strainPAH-specific therapyManagement of patientsRight atrial areaMid-RVPAH therapyCause mortalityEchocardiographic parametersClinical responseEchocardiographic variablesSystolic excursionWalk distanceEchocardiographic assessmentAtrial areaTrends in cardiorespiratory fitness: The evolution of exercise treadmill testing at a single Academic Medical Center from 1970 to 2012
Kelly JP, Andonian BJ, Patel MJ, Huang Z, Shaw LK, McGarrah RW, Borges-Neto S, Velazquez EJ, Kraus WE. Trends in cardiorespiratory fitness: The evolution of exercise treadmill testing at a single Academic Medical Center from 1970 to 2012. American Heart Journal 2019, 210: 88-97. PMID: 30743212, PMCID: PMC6441626, DOI: 10.1016/j.ahj.2019.01.001.Peer-Reviewed Original ResearchConceptsExercise treadmill testingCardiorespiratory fitnessTreadmill testingMetabolic equivalentsSingle academic medical centerStandard Bruce protocolMaximal treadmill speedDuke University HospitalAcademic medical centerBaseline comorbiditiesEligible patientsNuclear perfusionBruce protocolClinical outcomesStress echocardiographyUniversity HospitalMedical CenterMedical care environmentClinical practiceRamp protocolMaximal exertionPatientsTreadmill speedPowerful predictorCare environment
2016
Associations between positive emotional well-being and stress-induced myocardial ischemia Well-being scores predict exercise-induced ischemia
Feigal JP, Boyle SH, Samad Z, Velazquez EJ, Wilson JL, Becker RC, Williams RB, Kuhn CM, Ortel TL, Rogers JG, O'Connor CM, Jiang W. Associations between positive emotional well-being and stress-induced myocardial ischemia Well-being scores predict exercise-induced ischemia. Journal Of Psychosomatic Research 2016, 93: 14-18. PMID: 28107887, PMCID: PMC6044283, DOI: 10.1016/j.jpsychores.2016.11.012.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionHealth-related behaviorsMyocardial ischemiaStable ischemic heart disease patientsIschemic heart disease patientsWall motion score indexExercise-induced ischemiaTreadmill exercise testingEpidemiologic Studies Depression ScaleStress-induced ischemiaInverse correlationHeart disease patientsSignificant inverse correlationInducible ischemiaAdult patientsExercise testingIschemic responseEjection fractionDisease patientsTreatment trialsSimilar inverse correlationDepression ScaleExercise stressDepressive symptomsUnderscore areas
2015
Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease
Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, Cole J, Dolor RJ, Fordyce CB, Huang M, Khan MA, Kosinski AS, Krucoff MW, Malhotra V, Picard MH, Udelson JE, Velazquez EJ, Yow E, Cooper LS, Lee KL. Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease. New England Journal Of Medicine 2015, 372: 1291-1300. PMID: 25773919, PMCID: PMC4473773, DOI: 10.1056/nejmoa1415516.Peer-Reviewed Original ResearchConceptsObstructive coronary artery diseaseCoronary artery diseaseCTA groupSymptomatic patientsArtery diseaseComposite primary end pointPrimary end-point eventEnd pointRadiation exposureInvasive cardiac catheterizationMajor procedural complicationsPrimary end pointSecondary end pointsEnd-point eventsCumulative radiation exposureMedian followChest painUnstable anginaCardiac catheterizationMore patientsProcedural complicationsClinical outcomesRandomized trialsAnatomical testingMean age
2014
Exercise Capacity and Mortality in Patients With Ischemic Left Ventricular Dysfunction Randomized to Coronary Artery Bypass Graft Surgery or Medical Therapy An Analysis From the STICH Trial (Surgical Treatment for Ischemic Heart Failure)
Stewart RA, Szalewska D, She L, Lee KL, Drazner MH, Lubiszewska B, Kosevic D, Ruengsakulrach P, Nicolau JC, Coutu B, Choudhary SK, Mark DB, Cleland JG, Piña IL, Velazquez EJ, Rynkiewicz A, White H. Exercise Capacity and Mortality in Patients With Ischemic Left Ventricular Dysfunction Randomized to Coronary Artery Bypass Graft Surgery or Medical Therapy An Analysis From the STICH Trial (Surgical Treatment for Ischemic Heart Failure). JACC Heart Failure 2014, 2: 335-343. PMID: 25023813, PMCID: PMC4127151, DOI: 10.1016/j.jchf.2014.02.009.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryIschemic left ventricular dysfunctionLeft ventricular dysfunctionArtery bypass graft surgeryBypass graft surgeryPoor exercise capacityExercise capacityMedical therapyVentricular dysfunctionSTICH trialGraft surgeryBetter exercise capacityWalk testMedical managementPrognostic significanceTreatment allocationPhysical activityPatientsEarly riskHigh mortalityMortalityTherapyDysfunctionSurgeryTrialsPROspective Multicenter Imaging Study for Evaluation of chest pain: Rationale and design of the PROMISE trial
Douglas PS, Hoffmann U, Lee KL, Mark DB, Al-Khalidi HR, Anstrom K, Dolor RJ, Kosinski A, Krucoff MW, Mudrick DW, Patel MR, Picard MH, Udelson JE, Velazquez EJ, Cooper L, investigators P. PROspective Multicenter Imaging Study for Evaluation of chest pain: Rationale and design of the PROMISE trial. American Heart Journal 2014, 167: 796-803.e1. PMID: 24890527, PMCID: PMC4044617, DOI: 10.1016/j.ahj.2014.03.003.Peer-Reviewed Original ResearchConceptsCoronary artery diseasePROMISE trialAnatomical testingProspective Multicenter Imaging StudyDiagnostic strategiesInitial diagnostic strategyMajor procedural complicationsSubsequent care decisionsComposite of deathPrimary end pointLarge pragmatic trialClinical care teamQuality of lifeDiagnostic testing strategiesMultidetector coronaryChest painSymptomatic patientsUnstable anginaArtery diseaseProcedural complicationsRandomized trialsSymptomatic subjectsClinical effectivenessMyocardial infarctionPragmatic trialImpaired Resting Myocardial Annular Velocities Are Independently Associated With Mental Stress–Induced Ischemia in Coronary Heart Disease
Ersbøll M, Al Enezi F, Samad Z, Sedberry B, Boyle SH, O’Connor C, Jiang W, Velazquez EJ, Investigators R. Impaired Resting Myocardial Annular Velocities Are Independently Associated With Mental Stress–Induced Ischemia in Coronary Heart Disease. JACC Cardiovascular Imaging 2014, 7: 351-361. PMID: 24631512, PMCID: PMC3992174, DOI: 10.1016/j.jcmg.2013.10.014.Peer-Reviewed Original ResearchMeSH KeywordsAgedChi-Square DistributionEchocardiography, DopplerEchocardiography, StressExercise TestFemaleHumansLogistic ModelsMaleMiddle AgedMyocardial ContractionMyocardial IschemiaOdds RatioPredictive Value of TestsRandomized Controlled Trials as TopicRisk FactorsStress, PsychologicalStroke VolumeVentricular Function, LeftConceptsMental stress-induced ischemiaStress-induced myocardial ischemiaLeft ventricular ejection fractionTissue Doppler myocardial velocitiesVentricular ejection fractionMental stress testMyocardial velocitiesMyocardial ischemiaEjection fractionHeart diseaseConventional exercise stress testingWall motion index scoreIschemic ST-segment changesMyocardial tissue Doppler velocitiesRegional wall motion abnormalitiesPreclinical cardiac dysfunctionStress-induced ischemiaCoronary artery diseaseExercise stress testingTissue Doppler velocitiesCoronary heart diseaseLate diastolic velocityST-segment changesWall motion abnormalitiesStress–Induced IschemiaUtility of 3-dimensional echocardiography, global longitudinal strain, and exercise stress echocardiography to detect cardiac dysfunction in breast cancer patients treated with doxorubicin-containing adjuvant therapy
Khouri MG, Hornsby WE, Risum N, Velazquez EJ, Thomas S, Lane A, Scott JM, Koelwyn GJ, Herndon JE, Mackey JR, Douglas PS, Jones LW. Utility of 3-dimensional echocardiography, global longitudinal strain, and exercise stress echocardiography to detect cardiac dysfunction in breast cancer patients treated with doxorubicin-containing adjuvant therapy. Breast Cancer Research And Treatment 2014, 143: 531-539. PMID: 24390149, PMCID: PMC4521213, DOI: 10.1007/s10549-013-2818-1.Peer-Reviewed Original ResearchMeSH KeywordsAdultBreast NeoplasmsDoxorubicinEchocardiography, StressExercise TestFemaleHeart DiseasesHumansMiddle AgedConceptsGlobal longitudinal strainBreast cancer patientsSubclinical cardiac dysfunctionCardiac dysfunctionCancer patientsCardiac indexStress echocardiographyEarly breast cancer patientsLongitudinal strainVentricular ejection fraction assessmentLeft ventricular ejection fraction assessmentAdult oncology settingsPost-exercise increaseEarly breast cancerLeft ventricular functionSex-matched controlsSpeckle tracking echocardiographyEjection fraction assessmentSimilar LVEFAdjuvant therapyEchocardiographic parametersCardiopulmonary exerciseAsymptomatic womenVentricular functionCardiopulmonary function
2013
Depressive Symptoms and Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease
Boyle SH, Samad Z, Becker RC, Williams R, Kuhn C, Ortel TL, Kuchibhatla M, Prybol K, Rogers J, O’Connor C, Velazquez EJ, Jiang W. Depressive Symptoms and Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease. Psychosomatic Medicine 2013, 75: 822-831. PMID: 24163385, PMCID: PMC4378828, DOI: 10.1097/psy.0b013e3182a893ae.Peer-Reviewed Original ResearchConceptsMental stress-induced myocardial ischemiaCoronary heart diseaseLeft ventricular ejection fractionVentricular ejection fractionDepressive symptomsMyocardial ischemiaEjection fractionHeart diseaseMental Stress–Induced Myocardial IschemiaStress-induced myocardial ischemiaIschemic ST-segment changesBeck Depression Inventory-II scoresΒ-blocker withdrawalEpidemiologic Studies Depression ScaleFuture cardiovascular eventsMental stress testTreadmill exercise testST-segment changesWall motion abnormalitiesBeck Depression Inventory-IICardiovascular eventsII scoreTransthoracic echocardiographyAdult patientsUnadjusted analysesPrevalence and Clinical Characteristics of Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease
Jiang W, Samad Z, Boyle S, Becker RC, Williams R, Kuhn C, Ortel TL, Rogers J, Kuchibhatla M, O'Connor C, Velazquez EJ. Prevalence and Clinical Characteristics of Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease. Journal Of The American College Of Cardiology 2013, 61: 714-722. PMID: 23410543, PMCID: PMC3913125, DOI: 10.1016/j.jacc.2012.11.037.Peer-Reviewed Original ResearchConceptsMental stress-induced ischemiaStress-induced ischemiaCoronary heart diseaseMental stress-induced myocardial ischemiaStable coronary heart diseaseStress-induced myocardial ischemiaExercise-induced ischemiaHeart diseaseMyocardial ischemiaClinical characteristicsHigh riskMental Stress–Induced Myocardial IschemiaExercise-induced myocardial ischemiaVentricular ejection fraction reductionRegional wall motion abnormalitiesEjection fraction reductionST-segment depressionMental stress testWall motion abnormalitiesUnmarried menEligible patientsPoor prognosisMotion abnormalitiesRisk factorsExercise test
2011
Responses of mental stress–induced myocardial ischemia to escitalopram treatment: Background, design, and method for the Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment trial
Jiang W, Velazquez EJ, Samad Z, Kuchibhatla M, Martsberger C, Rogers J, Williams R, Kuhn C, Ortel TL, Becker RC, Pristera N, Krishnan R, O'Connor CM. Responses of mental stress–induced myocardial ischemia to escitalopram treatment: Background, design, and method for the Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment trial. American Heart Journal 2011, 163: 20-26. PMID: 22172432, PMCID: PMC3254211, DOI: 10.1016/j.ahj.2011.09.018.Peer-Reviewed Original ResearchConceptsMental stress-induced myocardial ischemiaCoronary heart diseaseStable coronary heart diseaseStress-induced myocardial ischemiaMyocardial ischemiaMental Stress–Induced Myocardial IschemiaSelective serotonin reuptake inhibitor (SSRI) treatmentStress testingSerotonin reuptake inhibitor treatmentEjection fraction reductionReuptake inhibitor treatmentMental stress testingPsychometric questionnairesEffects of SSRIsIschemic ST changesInduced Myocardial IschemiaAbnormal wall motionAdult patientsEscitalopram treatmentSSRI treatmentPoor outcomeTreatment trialsPlatelet activityHeart diseaseRisk factors
2004
Usefulness of myocardial viability or ischemia in predicting long-term survival for patients with severe left ventricular dysfunction undergoing revascularization
Liao L, Cabell CH, Jollis JG, Velazquez EJ, Smith WT, Anstrom KJ, Pappas PA, Ryan T, Kisslo JA, Landolfo CK. Usefulness of myocardial viability or ischemia in predicting long-term survival for patients with severe left ventricular dysfunction undergoing revascularization. The American Journal Of Cardiology 2004, 93: 1275-1279. PMID: 15135703, DOI: 10.1016/j.amjcard.2004.01.071.Peer-Reviewed Original ResearchConceptsSevere left ventricular dysfunctionLeft ventricular dysfunctionVentricular dysfunctionDobutamine stress echocardiographySignificant survival advantageLong-term survivalCoronary diseaseStress echocardiographyViable myocardiumMyocardial viabilityPrognostic powerSurvival advantagePatientsRevascularizationDysfunctionEchocardiographyIschemiaMyocardiumDiseaseMonths