[Echocardiographic Stress Test with Adenosine Triphosphate: Optimization of the Algorithm].

Area of Science:

• Cardiology
• Medical Imaging
• Pharmacology

Background:

• Stress echocardiography (s-Echo) is crucial for diagnosing heart conditions.
• Adenosine triphosphate (ATP) is a vasodilator used in stress testing.
• Optimizing ATP infusion protocols is essential for accurate diagnostic imaging.

Purpose of the Study:

• To optimize the algorithm for stress echocardiography (s-Echo) using intravenous adenosine triphosphate (ATP) infusion.
• To incorporate the pharmacokinetics and pharmacodynamics of ATP into the optimized algorithm.
• To validate the new algorithm in patients with coronary and other heart diseases.

Main Methods:

• A comprehensive literature review of 48 publications on ATP diagnostic applications was conducted.
• An optimized algorithm for ATP s-Echo was developed based on the literature analysis.
• The optimized algorithm was tested on 26 subjects undergoing 4D strain-stress-echocardiography.

Main Results:

• The optimized algorithm involves three stages of Echo data acquisition during and after ATP infusion.
• Effective vasodilation was achieved in all patients, with an average systolic blood pressure decrease of 16.4±13.7 mm Hg.
• Interpretable 4D LV Echo data sets were obtained for local contractility and strain analysis.

Conclusions:

• The optimization of the ATP s-Echo algorithm was successfully performed.
• The safety and efficacy of the optimized algorithm for echo data acquisition were demonstrated.
• The new ATP infusion algorithm is recommended for other cardiac imaging modalities like SPECT, CT, MRI, and PET.