Abstract Background Stress echocardiography is widely used for clinical decision making of cardiac patients. However, whether its prognostic value for mortality changed over the years is not well known. Aim To assess the trends in mortality of patients who underwent stress echocardiography at different time periods over 20 years. Methods A total of 28 239 dobutamine and exercise stress echocardiography tests in one center (January 2002 – June 2022) were analyzed. Repeated tests on the same patient, referral for cardiac obstruction, valvular pathology, and tests with poor ultrasound image quality have been excluded. 21 063 patients remained including 16 612 (78.9%) with negative tests, 4 038 (19.2%) with positive results, and 413 (1.9%) with inconclusive results. The study period was stratified into seven-year intervals to assess temporal trends in clinical data and test outcomes: the first (2002-2009), the second (2009-2016), and the third (2016-2023). The follow-up period was 7.4 years (2700 days), corresponding to the median survival of the entire database population. We also evaluated changes in one-year, three-year, and four-year survival rates in different periods following stress echocardiography. Results Proportion of females and mean age of patients undergoing stress echocardiography increased over the years, while prevalence of positive tests decreased. The analysis of 7-year survival in the first two periods showed that positive test results were associated with significantly worse survival (p0.001). However, in 2009-2016 period, prognosis of patients with positive tests improved comparing with 2002-2009 period (Figure 1, p=0.017), with no change in the group of patients with negative tests (p=0.83). The one-year survival analysis showed that mortality of patients with a positive test decreased in all periods. Conclusion Short- and long-term survival of patients with positive stress echocardiography results remains significantly lower compared with negative results over the last 20 years. However, survival improved over time in the positive test group, with no changes in the negative test group.Figure 1. Table 1.
Balkevičienė et al. (Sat,) studied this question.