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Circulation. Cardiovascular Imaging Jun 2019
Topics: Echocardiography; Echocardiography, Stress; Humans; Prognosis; Referral and Consultation; Ventricular Function, Left
PubMed: 31167562
DOI: 10.1161/CIRCIMAGING.119.009318 -
Circulation. Cardiovascular Imaging Jun 2019
Topics: Echocardiography, Stress; Exercise Test; Humans; Mitral Valve Insufficiency; Mitral Valve Stenosis
PubMed: 31203671
DOI: 10.1161/CIRCIMAGING.119.009319 -
Indian Heart Journal 2011Owing to the level of sensitivity, specificity, positive predictive value, negative predictive value and accuracy, stress echocardiography (SE) perhaps has the highest... (Review)
Review
Owing to the level of sensitivity, specificity, positive predictive value, negative predictive value and accuracy, stress echocardiography (SE) perhaps has the highest overall utility and is the most preferred and prescribed modality for the assessment of coronary artery disease (CAD). Additionally exercise stress echocardiography (ESE) and pharmacologic stress echocardiography (PSE) turn out to be the most cost-effective & risk-effective modality, without significant environmental/radiation/bio hazard, with the added advantage of repeatability, portability, an acceptable learning curve and high level of safety. Strain (E), Strain Rate Imaging (SRI), tissue Doppler imaging (TDI), myocardial contrast echocardiography (MCE), real time 3-dimensional echocardiography (RT-3DE), Speckle tracking Echocardiography (STE), combined MCE & RT-3DE, combined STE & TDI add newer dimensions and may unleash the full potential of SE.
Topics: Coronary Disease; Echocardiography, Stress; Exercise Test; Humans; Predictive Value of Tests; Prognosis; Risk Assessment; Sensitivity and Specificity
PubMed: 22734368
DOI: No ID Found -
Echocardiography (Mount Kisco, N.Y.) Aug 2018Two-dimensional (2D) stress echocardiography is well established in the assessment of patients with ischemic heart disease. However, in a number of patients, this... (Review)
Review
Two-dimensional (2D) stress echocardiography is well established in the assessment of patients with ischemic heart disease. However, in a number of patients, this technique results in nondiagnostic tests due to limited time available at peak stress to capture wall motion abnormalities. In order to obtain all segments of the left ventricle, the sonographer is expected to acquire multiple echocardiography views from multiple windows. The changes in heart rate during acquisition and the technical challenges in exactly matching the stress with the baseline 2D echocardiographic views may adversely impact the sensitivity of the test. Real-time three-dimensional (3D) stress echocardiography offers advantages in acquisition of all images from one echo window in a single capture, with the technique relatively easy to master. The current review will describe the 3D stress echocardiography technique, its advantages, and limitations. Additionally, the future direction of 3D stress echocardiography in detecting ischemia in patients with coronary artery disease will be discussed.
Topics: Echocardiography, Stress; Echocardiography, Three-Dimensional; Heart Ventricles; Humans; Myocardial Ischemia; Reproducibility of Results; Ventricular Function, Left
PubMed: 30133883
DOI: 10.1111/echo.14050 -
Current Pharmaceutical Design 2005Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of... (Review)
Review
Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of myocardial ischemia is the induction of a transient worsening in regional function during stress. Stress echocardiography provides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging, but at a substantially lower cost, without environmental impact, and with no biohazards for the patient and the physician. Among different stresses of comparable diagnostic and prognostic accuracy, semisupine exercise is the most used, dobutamine the best test for viability, and dipyridamole the safest and simplest pharmacological stress and the most suitable for combined wall motion--coronary flow reserve assessment. The additional clinical benefit of myocardial contrast echocardiography, tissue Doppler imaging and real time 3-D echocardiography has been inconsistent and disappointing, whereas the potential of adding coronary flow reserve evaluation of left anterior descending coronary artery by transthoracic Doppler echocardiography adds another potentially important dimension to stress echocardiography. In spite of its dependence upon operator's training, stress echocardiography is today the best possible imaging choice to achieve the still elusive target of sustainable cardiac imaging in the field of noninvasive diagnosis of coronary artery disease.
Topics: Coronary Artery Disease; Echocardiography, Stress; Humans; Sensitivity and Specificity
PubMed: 16026284
DOI: 10.2174/1381612054367454 -
Heart (British Cardiac Society) May 2018Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient's... (Review)
Review
Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient's clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning. DSE is useful in symptomatic patients with low-gradient aortic stenosis. It clarifies its severity and helps in assessing surgical risk in patients with severe disease and systolic dysfunction. It can be also used to test valve haemodynamics in asymptomatic patients with significant mitral stenosis unable to perform an exercise test or to test the left ventricle response, namely to test viability, in patients with ischaemic secondary mitral regurgitation. VSE has taught us that history taking, clinical examination and resting echocardiography give an 'incomplete picture' of the disease in patients presenting with a severe valve disease. Therefore, its use should be encouraged in such patients.
Topics: Echocardiography, Stress; Heart Valve Diseases; Humans; Patient Care Planning; Prognosis; Reproducibility of Results; Risk Adjustment; Severity of Illness Index
PubMed: 29217633
DOI: 10.1136/heartjnl-2017-311682 -
Congenital Heart Disease Sep 2017Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for... (Review)
Review
Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for traditional CAD in young patients due to obesity and other chronic pediatric diseases, there is also a growing population of adolescents and young adults with "at risk" coronary arteries due to: reimplanted coronaries in congenital heart disease, anomalous origin of the native coronary arteries, coronary abnormalities in Kawasaki's disease, and posttransplant coronary vasculopathy. Stress echocardiography is well suited for routine screening and monitoring in these patients. Also, due to the ability of stress echocardiography to provide real-time cardiac imaging, it is useful in areas beyond coronary ischemia. Utilizing Doppler derived velocities and pressure gradients, one is able to further evaluate and risk-stratify patients with valvular heart disease. In addition, stress echocardiography is useful in evaluating other areas including ventricular and coronary reserve. The benefits of stress echocardiography are it is: readily available, portable, and relatively cheap. It can be performed without sedation or radiation exposure which becomes very important in younger patients that require periodic monitoring. Stress echocardiography can also evaluate functional abnormalities instead of relative perfusion defects. Overall, stress echocardiography is currently an underutilized imaging modality that has a wide, and expanding, range of application in the practice of pediatric and congenital cardiology.
Topics: Cardiology; Child; Echocardiography, Stress; Heart Defects, Congenital; Humans
PubMed: 28580760
DOI: 10.1111/chd.12495 -
Expert Review of Cardiovascular Therapy Jan 2004Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of... (Review)
Review
Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of myocardial ischemia is the induction of a transient worsening in regional function during stress. Stress echocardiography provides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging but at a substantially lower cost, without environmental impact and with no biohazards for the patient and the physician. In spite of its dependence upon operator's training, it is the best possible choice to achieve the still elusive target of sustainable cardiac imaging in the field of noninvasive diagnosis of coronary artery disease.
Topics: Contraindications; Coronary Disease; Dipyridamole; Dobutamine; Echocardiography, Stress; Exercise Test; Humans; Myocardial Ischemia; Risk; Sensitivity and Specificity
PubMed: 15038415
DOI: 10.1586/14779072.2.1.77 -
Journal of Echocardiography Mar 2024Stress echocardiography has been one of the most promising methods for the diagnosis of ischemic heart disease, hypertrophic cardiomyopathy, and pulmonary hypertension.... (Review)
Review
Stress echocardiography has been one of the most promising methods for the diagnosis of ischemic heart disease, hypertrophic cardiomyopathy, and pulmonary hypertension. The Japanese Society of Echocardiography produced practical guidance for the implementation of stress echocardiography in 2018. At that time, stress echocardiography was not yet widely disseminated in Japan; therefore, the 2018 practical guidance for the implementation of stress echocardiography included a report on stress echocardiography and a specific protocol to promote its use at many institutions in Japan in the future. And now, an era of renewed interest and enthusiasm surrounding the diagnosis and treatment of valvular heart disease and heart failure with preserved ejection fraction (HFpEF) has come, which are driven by emerging trans-catheter procedures and new recommended guideline-directed medical therapy. Based on the continued evidence of stress echocardiography, the new practical guideline that describes the safe and effective methodology of stress echocardiography is now created by the Guideline Development Committee of the Japanese Society of Echocardiography and is designed to expand the use of stress echocardiography for valvular heart disease and HFpEF, as well as ischemic heart disease, hypertrophic cardiomyopathy, and pulmonary hypertension. The readers are encouraged to perform stress echocardiography which will enhance the diagnosis and management of these patients.
Topics: Humans; Echocardiography, Stress; Heart Failure; Hypertension, Pulmonary; Stroke Volume; Heart Valve Diseases; Myocardial Ischemia; Cardiomyopathy, Hypertrophic
PubMed: 38358595
DOI: 10.1007/s12574-024-00643-1 -
Pediatric Cardiology 2002Traditional health evaluations are performed while the patient is at rest. Stress echocardiography extends these examinations by providing data in a physiologic setting... (Review)
Review
Traditional health evaluations are performed while the patient is at rest. Stress echocardiography extends these examinations by providing data in a physiologic setting more closely mimicking the typically active state of children. The test represents a fusion of the fields of two-dimensional echocardiography and cardiovascular stress testing and can be used to assess myocardial perfusion in patients with suspected coronary artery pathology or to evaluate cardiac gradients or functional reserve in patients with noncoronary artery pathology. Testing should be performed with a trained sonographer and attending physician and in collaboration with adult cardiology colleagues. Stress can be administered to the patient through either exercise or pharmacologic agents. Echocardiography is used to assess regional wall motion abnormalities when evaluating myocardial perfusion or gradients and/or function when assessing the patient without coronary artery issues. Conditions with potential coronary artery pathology for which stress echocardiography is appropriate include Kawasaki disease, transplant graft vasculopathy, arterial switch operation for transposition of the great arteries, anomalous coronary artery origins or courses, pulmonary atresia with intact ventricular septum, hyperlipidemia, insulin-dependent diabetes mellitus, and supravalvar aortic stenosis. Stress echocardiography can also be helpful in determining the behavior during activity of gradients in conditions such as hypertrophic cardiomyopathy or aortic and pulmonic stenosis, of cardiac pressures in pulmonary hypertension and of ventricular function in conditions such as dilated cardiomyopathy or mitral and aortic regurgitation.
Topics: Child; Echocardiography, Stress; Heart; Heart Defects, Congenital; Humans; Myocardial Ischemia; Myocardium
PubMed: 11976781
DOI: 10.1007/s00246-001-0198-5