Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL
In the last 10 years, stress echocardiography has reached its established rank in the diagnosis and prognosis of coronary artery disease. These guidelines conclude that nuclear cardiology and stress echocardiography provide comparable information on diagnosis accuracy for noninvasive detection of coronary disease, identification of myocardial viability and prognostic stratification.
Reference: Eur Heart J 2009; 30:278-89
Douglas PS, Khandheria B, Stainback RF, Weissman NJ, Peterson ED, Hendel RC, Stainback RF, Blaivas M, Des Prez RD, Gillam LD, Golash T, Hiratzka LF, Kussmaul WG, Labovitz AJ, Lindenfeld J, Masoudi FA, Mayo PH, Porembka D, Spertus JA, Wann LS, Wiegers SE, Brindis RG, Douglas PS, Patel MR, Wolk MJ, Allen JM
Comment: American guidelines
Reference: Circulation 2008; 117:1478-97
Rigo F, Sicari R, Gherardi S, Djordjevic-Dikic A, Cortigiani L, Picano E
In the last 5 years, a major innovation changed the face and the diagnostic content of stress echocardiography: dual imaging of wall motion and coronary flow reserve with pulsed-Doppler imaging of the middistal left anterior descending coronary artery. Imaging coronary flow reserve expands the prognostic potential of stress echocardiography, since in the absence of wall motion negativity, the patient subset with reduced coronary flow reserve also have a more malignant prognosis.
Reference: Eur Heart J 2008; 29:79-88
Rigo F, Murer B, Ossena G, Favaretto E
In the same setting, with the same stress, it is now possible to image function and flow simultaneously and therefore catch both flow and function, with vasodilatator stone. Although coronary flow reserve in a technology-in-progress and has yet to reach its full maturity, it is now considered a new standard in the clinical application of stress echocardiography.
Reference: Cardiovasc Ultrasound 2008; 6:7
Armstrong WF, Ryan T
In USA, exercise echocardiography is based on the posttreadmill approach with imaging at rest and as soon as possible during the recovery period.
Reference: J Am Soc Echocardiogr 2008; 21:22-8
Pingitore A, Lombardi M, Scattini B, De Marchi D, Aquaro GD, Positano V, Picano E
Ischemic effect is the requiqite for functional imaging, usually with2D echocardiography but also performed with cardiovascular magnetic resonance.
Reference: Am J Cardiol 2008;101:8-14
Picano E, Molinaro S, Pasanisi E
The sensitivity, specificity and accuracy of fast (or atropine-potentiated) high-dose dipyridamole is identical to dobutamine stress echocardiography, as shown by this meta-analysis including five studies with 435 patients.
Reference: Cardiovasc Ultrasound 2008; 6:30
Sicari R, Rigo F, Gherardi S, Galderisi M, Cortigiani L, Picano E
The combination of conventional wall motion analysis with 2D echocardiography and coronary flow reserve with pulsed Doppler flowmetry of the mid-distal left anterior descending artery has been shown to provide an added and complementary power of prognostication in patients with known or suspected coronary artery disease.
Reference: Am Heart J 2008; 156:573-9
Pellikka PA, Nagueh SF, Elhendy AA, FESC, Kuehl CA, Sawada SG.
In comparison to the 1998 publication of the Recommendations for Performance and Interpretation of Stress Echocardiography, the present release include improvements in imaging equipment, refinements in stress testing protocols and standards for image interpretation,and important progress toward quantitative analysis.
Reference: J Am Soc Echocardiogr 2007; 20: 1021-1041.
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