Stress Echocardiography in Stable Coronary Artery Disease
Sothinathan Gurunathan1,2,3, Roxy Senior4,5,6
1Department of Cardiology, Northwick Park Hospital, Harrow, UK.
Insights
Stress echocardiography (SE) is a valuable tool for diagnosing and assessing risk in coronary artery disease (CAD). Newer technologies enhance its efficacy, proving SE remains a safe, cost-effective cornerstone for CAD evaluation.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Stress echocardiography (SE) is a standard method for diagnosing and risk-stratifying patients with known or suspected coronary artery disease (CAD).
- This review examines the current role and advancements in SE for CAD assessment.
Purpose of the Study:
- To review the current status of stress echocardiography in the diagnosis and risk stratification of coronary artery disease (CAD).
- To summarize testing protocols, clinical efficacy, and the application of newer technologies in SE for CAD.
Main Methods:
- Review of current literature and multicentre studies on stress echocardiography.
- Evaluation of newer technologies including myocardial perfusion, strain imaging, 3D echocardiography, and carotid ultrasonography.
Main Results:
- Myocardial perfusion imaging integrated with SE shows significant clinical value.
- SE is more cost-effective than exercise ECG for patients with low-intermediate pre-test probability of CAD.
- Adjunctive carotid ultrasonography to SE offers synergistic prognostic value.
Conclusions:
- Stress echocardiography remains the cornerstone for CAD assessment due to its excellent clinical efficacy, safety, and cost-effectiveness.
- Advancements in imaging technologies further enhance the utility of SE in clinical practice.
Purpose Of Review:
Stress echocardiography (SE) is a well-established technique for the diagnosis and risk stratification of patients with known or suspected coronary artery disease (CAD). This review article summarizes the status of SE in CAD, including testing protocols, clinical efficacy and current use of newer technologies: myocardial perfusion, strain imaging, three-dimensional echocardiography and adjunctive carotid ultrasonography.
Recent Findings:
Recent major findings in SE include the clinical value of myocardial perfusion imaging in multicentre studies, as well as when added to left ventricular (LV) wall motion assessment in clinical service. Additionally, SE has been shown to be more cost-effective than exercise ECG in patients with low-intermediate pre-test probability of CAD. Adjunctive atherosclerosis imaging by carotid ultrasonography (CU) to ischaemia testing by SE provides synergistic prognostic value, equivalent to hybrid imaging by PET-CT. Despite the development of newer and more expensive imaging modalities, SE remains the cornerstone for the assessment of CAD and has excellent clinical efficacy, is safe and is cost-effective.
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Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
