The Clinical use of Stress Echocardiography in Ischemic Heart Disease Cardiovascular Ultrasound (2017)15:7. Translation authors: Arystan A.Zh., Fettser D.V.

Abstract

Stress echocardiography is an established technique for the assessment of extent and severity of coronary artery disease. The combinationof echocardiography with a physical, pharmacological or electrical stress allows detecting myocardial ischemia with an excellentaccuracy. A transient worsening of regional function during stress is the hallmark of inducible ischemia. Stress echocardiographyprovides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging or magnetic resonance, butat a substantially lower cost, without environmental impact, and with no biohazards for the patient and the physician. The evidenceon its clinical impact has been collected over 35 years, based on solid experimental, pathophysiological, technological and clinicalfoundations. There is the need to implement the combination of wall motion and coronary flow reserve, assessed in the left anteriordescending artery, into a single test. The improvement of technology and in imaging quality will make this approach more andmore feasible. The future issues in stress echo will be the possibility of obtaining quantitative information translating the currentqualitative assessment of regional wall motion into a number. The next challenge for stress echocardiography is to overcome itsmain weaknesses: dependence on operator expertise, the lack of outcome data (a widespread problem in clinical imaging) to documentthe improvement of patient outcomes. This paper summarizes the main indications for the clinical applications of stressechocardiography to ischemic heart disease.