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Article ; Online: Assessing functional mitral regurgitation with exercise echocardiography

Bovenzi Francesco / Cortigiani Lauro / Bigi Riccardo / Fiorentini Cesare

Cardiovascular Ultrasound, Vol 7, Iss 1, p

rationale and clinical applications

2009 Volume 57

Abstract: Abstract Secondary or functional mitral regurgitation (FMR) represents an increasing feature of mitral valve disease characterized by abnormal function of anatomically normal leaflets in the context of the impaired function of remodelled left ventricles. ...

Abstract	Abstract Secondary or functional mitral regurgitation (FMR) represents an increasing feature of mitral valve disease characterized by abnormal function of anatomically normal leaflets in the context of the impaired function of remodelled left ventricles. The anatomic and pathophysiological basis of FMR are briefly analyzed; in addition, the role of exercise echocardiography for the assessment of FMR is discussed in view of its relevance to clinical practice.
Keywords	Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2009-12-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing functional mitral regurgitation with exercise echocardiography: rationale and clinical applications.

Bigi, Riccardo / Cortigiani, Lauro / Bovenzi, Francesco / Fiorentini, Cesare

Cardiovascular ultrasound

2009 Volume 7, Page(s) 57

Abstract: Secondary or functional mitral regurgitation (FMR) represents an increasing feature of mitral valve disease characterized by abnormal function of anatomically normal leaflets in the context of the impaired function of remodelled left ventricles. The ... ...

Abstract	Secondary or functional mitral regurgitation (FMR) represents an increasing feature of mitral valve disease characterized by abnormal function of anatomically normal leaflets in the context of the impaired function of remodelled left ventricles. The anatomic and pathophysiological basis of FMR are briefly analyzed; in addition, the role of exercise echocardiography for the assessment of FMR is discussed in view of its relevance to clinical practice.
MeSH term(s)	Echocardiography ; Exercise Test ; Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/physiopathology ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/physiopathology ; Prognosis
Language	English
Publishing date	2009-12-14
Publishing country	England
Document type	Journal Article ; Review
ISSN	1476-7120
ISSN (online)	1476-7120
DOI	10.1186/1476-7120-7-57
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Article ; Online: Rationale and design of the EPLURIBUS Study (Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner).

Andreini, Daniele / Conte, Edoardo / Mushtaq, Saima / Pontone, Gianluca / Guglielmo, Marco / Baggiano, Andrea / Annoni, Andrea / Mancini, Maria E / Formenti, Alberto / Nicoli, Flavia / Tanzilli, Alessandra / Muscogiuri, Giuseppe / Magini, Alessandra / Agostoni, Piergiuseppe / Bartorelli, Antonio L / Fiorentini, Cesare / Pepi, Mauro

Journal of cardiovascular medicine (Hagerstown, Md.)

2020 Volume 21, Issue 10, Page(s) 812–819

Abstract: Background: Cardiac magnetic resonance (CMR) is the standard of reference for myocardial fibrosis detection by late gadolinium enhancement. Cardiac computed tomography (CCT) is emerging as a promising alternative. The Evidence for a comPrehensive ... ...

Abstract	Background: Cardiac magnetic resonance (CMR) is the standard of reference for myocardial fibrosis detection by late gadolinium enhancement. Cardiac computed tomography (CCT) is emerging as a promising alternative. The Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner study will assess the feasibility and diagnostic accuracy of a comprehensive functional and anatomical cardiac evaluation with CCT as compared with CMR and invasive coronary angiography as standard of reference. Methods: Consecutive patients with a newly diagnosed left ventricle (LV) dysfunction (left ventricular ejection fraction <50%) and a clinical indication to CMR will be screened. Exclusion criteria will be contraindications to contrast agents and impaired renal function. CCT will be performed per protocol within 10 days from CMR. A total of 100 patients will be enrolled within 24 months. We will evaluate with CCT volume and ejection fraction of the LV and right ventricle, presence, extent and pattern of delayed enhancement and cardiac venous system. Moreover, presence and degree of coronary stenoses will be evaluated among patients undergoing invasive coronary angiography in the 6 months following CCT. Results: The primary study endpoints will be: first, to assess the diagnostic performance of CCT vs. CMR to detect the delayed enhancement in a territory-based and patient-based analysis; second, to assess the agreement between CCT and CMR in the discrimination between ischemic vs. nonischemic delayed enhancement patters in a territory-based analysis; third, to assess the correlation between CCT and CMR for LV and right ventricle end-diastolic and end-systolic volumes and ejection fraction measurements. Conclusion: The Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner study will assess the diagnostic performance of CCT using the latest scanner generation for a comprehensive evaluation of patients with new-onset LV dysfunction.
MeSH term(s)	Coronary Angiography ; Equipment Design ; Feasibility Studies ; Humans ; Magnetic Resonance Imaging, Cine ; Multidetector Computed Tomography/instrumentation ; Predictive Value of Tests ; Prognosis ; Research Design ; Risk Assessment ; Risk Factors ; Stroke Volume ; Time Factors ; Tomography Scanners, X-Ray Computed ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left
Language	English
Publishing date	2020-07-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000001051
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Article ; Online: Right heart chamber geometry and tricuspid annulus morphology in patients undergoing mitral valve repair with and without tricuspid valve annuloplasty.

Tamborini, Gloria / Fusini, Laura / Muratori, Manuela / Gripari, Paola / Ghulam Ali, Sarah / Fiorentini, Cesare / Pepi, Mauro

The international journal of cardiovascular imaging

2016 Volume 32, Issue 6, Page(s) 885–894

Abstract: According to current recommendations, patients could benefit from tricuspid valve (TV) annuloplasty at the time mitral valve (MV) surgery if tricuspid regurgitation is severe or if tricuspid annulus (TA) dilatation is present. Therefore, an accurate pre- ... ...

Abstract	According to current recommendations, patients could benefit from tricuspid valve (TV) annuloplasty at the time mitral valve (MV) surgery if tricuspid regurgitation is severe or if tricuspid annulus (TA) dilatation is present. Therefore, an accurate pre-operative echocardiographic study is mandatory for left but also for right cardiac structures. Aims of this study are to assess right atrial (RA), right ventricular (RV) and TA geometry and function in patients undergoing MV repair without or with TV annuloplasty. We studied 103 patients undergoing MV surgery without (G1: 54 cases) or with (G2: 49 cases) concomitant TV annuloplasty and 40 healthy subjects (NL) as controls. RA, RV and TA were evaluated by three-dimensional (3D) transthoracic echocardiography. Comparing the pathological to the NL group, TA parameters and 3D right chamber volumes were significantly larger. RA and RV ejection fraction and TA% reduction were lower in pathological versus NL, and in G2 versus G1. In pathological patients, TA area positively correlated to systolic pulmonary pressure and negatively with RV and RA ejection fraction. Patients undergoing MV surgery and TV annuloplasty had an increased TA dimensions and a more advanced remodeling of right heart chambers probably reflecting an advanced stage of the disease.
MeSH term(s)	Aged ; Arterial Pressure ; Atrial Function, Right ; Atrial Remodeling ; Cardiac Valve Annuloplasty/adverse effects ; Case-Control Studies ; Echocardiography, Three-Dimensional ; Female ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging ; Mitral Valve/physiopathology ; Mitral Valve/surgery ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/physiopathology ; Mitral Valve Insufficiency/surgery ; Mitral Valve Prolapse/diagnostic imaging ; Mitral Valve Prolapse/physiopathology ; Mitral Valve Prolapse/surgery ; Observer Variation ; Predictive Value of Tests ; Pulmonary Artery/physiopathology ; Reproducibility of Results ; Severity of Illness Index ; Treatment Outcome ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/physiopathology ; Tricuspid Valve/surgery ; Tricuspid Valve Insufficiency/diagnosis ; Tricuspid Valve Insufficiency/physiopathology ; Tricuspid Valve Insufficiency/surgery ; Ventricular Function, Right ; Ventricular Remodeling
Language	English
Publishing date	2016-06
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-016-0846-8
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Article ; Online: The Stress-Recovery Index for the risk stratification of women with typical chest pain.

Bigi, Riccardo / Cortigiani, Lauro / Gregori, Dario / Fiorentini, Cesare

International journal of cardiology

2008 Volume 127, Issue 1, Page(s) 64–69

Abstract: Aim: To prospectively assess the prognostic value of the Stress-Recovery Index (SRI) in women with typical chest pain.: Methods: 165 women without known coronary artery disease, who complained of typical chest pain, were exercise tested and ... ...

Abstract	Aim: To prospectively assess the prognostic value of the Stress-Recovery Index (SRI) in women with typical chest pain. Methods: 165 women without known coronary artery disease, who complained of typical chest pain, were exercise tested and prospectively followed-up for the occurrence of cardiac death and nonfatal myocardial infarction. SRI, defined as the difference in absolute values between the area of heart rate-adjusted ST-segment depression during exercise and recovery, was derived in all. Clinical data, resting ejection fraction, and exercise testing data were entered into a sequential Cox's model; SRI was entered last. Model validation was performed by bootstrap adjusted by the degree of optimism in estimates. Survival curves were set up using Kaplan-Meier method and compared by the log-rank test. Results: During a median follow-up time of 42 months, 19 events (14 cardiac deaths and 5 nonfatal myocardial infarction) were observed. Age (hazard ratio 3.58, 95% CI 0.87-15) and SRI (hazard ratio 0.62, 95% CI 0.42-0.92) were multivariate predictors of outcome. However, the addition of SRI increased the prognostic power of the model on top of clinical and exercise testing variables, as demonstrated by the significant (p=0.003) increase of the area under the ROC curve of the risk function. Survival analysis showed ascending SRI quartiles to identify a significant (p=0.005) increase in event-free survival. Conclusions: SRI is of value in predicting outcome of women with typical chest pain and provides additional prognostic information on the top of clinical and standard exercise testing data.
MeSH term(s)	Aged ; Chest Pain/classification ; Chest Pain/physiopathology ; Electrocardiography ; Exercise Test ; Female ; Humans ; Middle Aged ; Myocardial Infarction/mortality ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; ROC Curve ; Risk Assessment ; Survival Analysis
Language	English
Publishing date	2008-06-23
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2007.06.001
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Article ; Online: Noninvasive techniques to assess myocardial ischemia in hypertensive patients.

Rambaldi, Riccardo / Bigi, Riccardo / Fiorentini, Cesare

Future cardiology

2008 Volume 4, Issue 6, Page(s) 569–581

Abstract: Hypertensive patients are more affected by coronary artery disease (CAD) than normotensive patients. Currently, established techniques are able to diagnose myocardial ischemia/CAD in hypertensive patients with suspected CAD. An irrevocable role remains ... ...

Abstract	Hypertensive patients are more affected by coronary artery disease (CAD) than normotensive patients. Currently, established techniques are able to diagnose myocardial ischemia/CAD in hypertensive patients with suspected CAD. An irrevocable role remains for exercise electrocardiogram (ECG) owing to the many parameters evaluated under physiologic conditions. However, the suboptimal specificity of a positive exercise ECG demands further examination of hypertensive patients with either myocardial single-photon emission computed tomography (SPECT) or stress echocardiography, both more specific than exercise ECG in diagnosing CAD. The high specificity of imaging techniques also makes them highly predictive of cardiac events. Additional techniques to help diagnose CAD are available. Tissue Doppler imaging, strain and other echo-derived techniques may add quantitative elements to recognize CAD in hypertensive hearts. The accuracy of MRI is improving to study myocardial function and perfusion. Positron emission tomography and multislice computed tomography, also in-built with fusion scanners, are playing roles in combining coronary angiography and myocardial function/ischemia assessment. However, no significant application of these additional techniques is available for hypertensive patients. Epicardial CAD assessed by coronary angiography remains the gold standard to decide for revascularization procedures. The presence of microcirculatory dysfunction, a symptom typical of hypertensive hearts, is opening up new areas of noninvasive diagnostic techniques for the detection of coronary flow reserve (CFR) and related myocardial ischemia. The quantification of CFR may render this parameter pivotal to deciding the need for revascularization procedures of intermediate coronary stenosis and it may become an additional gold standard in evaluating coronary vessels. Moreover, even with normal epicardial coronary arteries, microcirculation dysfunction bears prognostic stratification capabilities for hypertensive patients and it may become a promising therapeutic target in the near future.
Language	English
Publishing date	2008-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2274267-0
ISSN	1744-8298 ; 1479-6678
ISSN (online)	1744-8298
ISSN	1479-6678
DOI	10.2217/14796678.4.6.569
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Article ; Online: Ventricular arrhythmias in athletes: Role of a comprehensive diagnostic workup.

Heart rhythm

2021 Volume 19, Issue 1, Page(s) 90–99

Abstract: Background: Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined.: ... ...

Abstract	Background: Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined. Objective: The purpose of this study was to assess the clinical implications of invasive electrophysiological assessments and endomyocardial biopsy (EMB) among athletes with VAs. Methods: We evaluated 227 consecutive athletes who presented to our institutions after being disqualified from participating in sports because of VAs. After noninvasive tests, electrophysiological study (EPS), electroanatomic mapping (EAM), and EAM- or cardiac magnetic resonance imaging-guided EMB was performed, following a prespecified protocol. Sports eligibility status was redefined at 6-month follow-up. Results: From our sample, 188 athletes (82.8%) underwent EAM and EPS, and 42 (15.2%) underwent EMB. A diagnosis of heart disease could be formulated in 30% of the study population (67/227; 95% confidence interval [CI] 0.24-0.36) after noninvasive tests; in 37% (83/227; 95% CI 31%-43%) after EPS and EAM; and in 45% (102/227; 95% CI 39%-51%) after EMB. In the subset of athletes undergoing EMB, invasive diagnostic workup allowed diagnostic reclassification of half of the athletes (n = 21 [50%]). Reclassification was particularly common among subjects without definitive findings after noninvasive evaluation (n = 23; 87% reclassified). History of syncope, abnormal echocardiogram, presence of late gadolinium enhancement, and abnormal EAM were linked to sports ineligibility at 6-month follow-up. Conclusion: A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The extensive invasive evaluation presented could be especially helpful when noninvasive tests show unclear findings.
MeSH term(s)	Adult ; Arrhythmogenic Right Ventricular Dysplasia/diagnosis ; Arrhythmogenic Right Ventricular Dysplasia/physiopathology ; Athletes ; Biopsy ; Electrophysiologic Techniques, Cardiac/methods ; Female ; Humans ; Male ; Retrospective Studies ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/physiopathology
Language	English
Publishing date	2021-09-15
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2021.09.013
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Article ; Online: Prognostic implications of stress-induced transient ischemic dilation of the left ventricle in patients with systolic dysfunction and fixed perfusion defects.

Bestetti, Alberto / Bigi, Riccardo / Terranova, Paolo / Lombardi, Federico / Fiorentini, Cesare

International journal of cardiology

2010 Volume 140, Issue 3, Page(s) 323–327

Abstract: Purpose: To verify whether stress-induced transient ischemic dilation (TID) of the left ventricle may help refine prognostic assessment of patients with resting systolic dysfunction and fixed perfusion defects.: Methods: Two hundred seventy patients ... ...

Abstract	Purpose: To verify whether stress-induced transient ischemic dilation (TID) of the left ventricle may help refine prognostic assessment of patients with resting systolic dysfunction and fixed perfusion defects. Methods: Two hundred seventy patients with resting ejection fraction <or=50% and fixed perfusion defects on exercise (n=180) or dipyridamole (n=90) ECG-gated single-photon emission computed tomography (SPECT) were followed-up for the combined endpoint of death, acute coronary syndrome, and clinically-driven revascularization. The TID ratio was defined as the ratio of LV volumes at stress and rest.<br />Results: During a median time of 24 months, 47 events (10 deaths, 20 acute coronary syndromes and 17 revascularization) were observed. After adjusting for clinical and stress testing variables, the unfeasible exercise test [hazard ratio (HR) 1.82, 95% confidence interval (CI) 1.02, 3.24] and the highest quartile of TID ratio [HR 1.93, 95% CI 1.05, 3.54] were the only independent predictors of outcome. The highest quartile of TID ratio was associated to significantly lower percent of event-free survival. Conclusions: Left ventricular TID ratio helps refine outcome prediction in patients with resting systolic dysfunction and fixed perfusion defects, thus reducing risk of a false negative result.
MeSH term(s)	Aged ; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography ; Coronary Disease/diagnostic imaging ; Dipyridamole ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Survival Analysis ; Vasodilator Agents ; Ventricular Dysfunction, Left/diagnostic imaging
Chemical Substances	Vasodilator Agents ; Dipyridamole (64ALC7F90C)
Language	English
Publishing date	2010-04-30
Publishing country	Netherlands
Document type	Clinical Trial ; Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2008.11.121
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Article ; Online: Endomyocardial biopsy guided by intracardiac echocardiography as a key step in intracardiac mass diagnosis.

Zanobini, Marco / Dello Russo, Antonio / Saccocci, Matteo / Conti, Sergio / De Camilli, Elisa / Vettor, Giulia / Catto, Valentina / Roberto, Maurizio / Fiorentini, Cesare / Viale, Giuseppe / Tondo, Claudio / Casella, Michela

BMC cardiovascular disorders

2018 Volume 18, Issue 1, Page(s) 15

Abstract: Background: Based on a plenty of different applications, intracardiac echocardiography (ICE) is now a well-established technology in complex electrophysiological procedures. Recently, ICE has become the most widely used ultrasound-based imaging tool to ... ...

Abstract	Background: Based on a plenty of different applications, intracardiac echocardiography (ICE) is now a well-established technology in complex electrophysiological procedures. Recently, ICE has become the most widely used ultrasound-based imaging tool to guide diagnostic endomyocardial biopsy (EMB). EMB of cardiac mass guided by ICE is an interesting application of ICE. Allowing a correct positioning of the bioptome, ICE reduce the procedure-related risks and the need of a diagnostic open-chest procedure reserving the more invasive approach to selected cases. Case presentation: Hereby we report a case series of right ventricular masses in which the EMB was safely and effectively performed under ICE guidance giving essential information for planning the therapeutic strategy. Conclusions: The diagnosis of both metastatic and primary cardiac tumors relies on the histopathological analyses. The endomyocardial biopsy is a valuable tool for preoperative diagnosis and surgical planning of intracardiac masses suspected for tumors. In our experience, the use of ICE for right ventricle EMB of an intracardiac mass is an attractive modality thanks to the precise localization of the cardiac structures and the ability to guide bioptic withdrawal in the target area.
MeSH term(s)	Aged ; Echocardiography ; Female ; Heart Neoplasms/diagnostic imaging ; Heart Neoplasms/pathology ; Heart Neoplasms/secondary ; Heart Neoplasms/therapy ; Humans ; Image-Guided Biopsy/methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardium/pathology ; Predictive Value of Tests ; Prognosis
Language	English
Publishing date	2018--30
Publishing country	England
Document type	Case Reports ; Journal Article ; Video-Audio Media
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-018-0749-9
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Article: Comparison of the prognostic value of the stress-recovery index versus standard electrocardiographic criteria in patients with a negative exercise electrocardiogram.

Bigi, Riccardo / Cortigiani, Lauro / Gregori, Dario / Fiorentini, Cesare

The American journal of cardiology

2007 Volume 100, Issue 4, Page(s) 605–609

Abstract: To verify whether the stress recovery index (SRI) improves risk stratification in patients with a negative exercise electrocardiogram (ECG) using standard criteria, the SRI was derived in 708 consecutive patients with a negative exercise ECG. All-cause ... ...

Abstract	To verify whether the stress recovery index (SRI) improves risk stratification in patients with a negative exercise electrocardiogram (ECG) using standard criteria, the SRI was derived in 708 consecutive patients with a negative exercise ECG. All-cause mortality and the combination of death or nonfatal myocardial infarction were target end points. The individual effect of clinical and exercise testing data on outcome was evaluated using Cox regression analysis with separate models for each group of variables. Model validation was performed using bootstrap adjusted by degree of optimism in estimates. Survival analysis was performed using a product-limit Kaplan-Meier method. During a 37-month follow-up, 22 deaths and 40 nonfatal acute coronary syndromes occurred. After adjusting for confounding variables, age (hazard ratio 1.62, 95% confidence interval [CI] 1.14 to 2.31 for interquartile difference), hypertension (hazard ratio 1.74, 95% CI 1.04 to 2.89), and SRI (hazard ratio 0.75, 95% CI 0.65 to 0.86 for interquartile difference) were predictive of death or nonfatal myocardial infarction. Moreover, SRI increased the prognostic power of the model on top of clinical and exercise testing variables and provided significant discrimination of survival. In conclusion, the SRI may help refine the prognostic stratification of patients with a negative exercise test result using standard electrocardiographic criteria.
MeSH term(s)	Aged ; Cause of Death ; Electrocardiography/methods ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/mortality ; Myocardial Ischemia/physiopathology ; Outpatients ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Stress, Physiological/physiopathology ; Survival Rate
Language	English
Publishing date	2007-08-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2007.03.068
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