Stress-echocardiography or coronary computed tomography in suspected chronic coronary syndrome after the 2019...

Area of Science:

• Cardiology
• Cardiac Imaging
• Diagnostic Technologies

Background:

• Stress-echocardiography is a key cardiac functional imaging technique due to its real-time capabilities, high temporal resolution, safety, and low cost.
• Coronary computed tomography angiography (CCTA) directly assesses coronary anatomy, presenting a significant alternative to functional imaging.
• The 2019 European Society of Cardiology Guidelines on chronic coronary syndrome create a need to clarify the optimal use of functional versus anatomical testing.

Purpose of the Study:

• To compare functional stress-echocardiography with coronary computed tomography angiography.
• To evaluate their respective roles in diagnosing coronary artery disease (CAD).
• To assess their utility in guiding therapy and risk stratification for patients with suspected chronic coronary syndrome.

Main Methods:

• Review of existing data on stress-echocardiography and CCTA.
• Analysis of diagnostic accuracy, therapeutic guidance, and risk stratification capabilities.
• Inclusion of authors' expert opinion and clinical insights.

Main Results:

• Stress-echocardiography, when optimized with contrast media and coronary flow reserve measurement, offers high diagnostic sensitivity.
• CCTA provides direct anatomical assessment, which is highly valued by cardiologists.
• The optimal choice between functional and anatomical testing in various clinical scenarios remains unclear.

Conclusions:

• Both stress-echocardiography and CCTA have distinct advantages in evaluating coronary artery disease.
• Further clarification is needed on selecting the appropriate imaging modality based on clinical context.
• Comparative analysis supports informed decision-making in chronic coronary syndrome management.