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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Improving stress echocardiography-based decision pathways for coronary intervention patients: where can current and

Nikolaos Pe Kadoglou1, Constantinos H Papadopoulos2, Evaggelos Tatsis2

  • 1Medical School, University of Cyprus, Nicosia, Cyprus.

Expert Review of Cardiovascular Therapy
|August 5, 2026
PubMed

Insights

Stress echocardiography (SE) can help detect myocardial ischemia in coronary artery disease (CAD). However, interpretation challenges and technical limitations can affect its accuracy and clinical decision-making.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Stress echocardiography (SE) is a key noninvasive tool for diagnosing myocardial ischemia and patient prognosis in coronary artery disease (CAD).
  • Technical performance and interpretation of SE can present challenges, potentially impacting clinical management decisions.

Purpose of the Study:

  • This review addresses critical diagnostic issues in SE that influence interpretation and treatment pathways for coronary intervention.
  • It examines discordance with coronary angiography, challenges in specific patient groups, and emerging technologies.

Main Methods:

  • A comprehensive literature search was conducted using PubMed and Embase databases.
  • The review synthesizes findings on SE interpretation challenges and potential solutions.

Main Results:

  • Key issues include discordance between SE and angiography, limited ischemia detection, and normal wall motion with ischemic symptoms.
  • Specific patient populations (e.g., LV hypertrophy, LBBB, arrhythmias) present unique interpretive challenges.
  • Technological advancements like 3D SE and speckle tracking show promise but require further data.

Conclusions:

  • SE is operator-dependent, necessitating strategies to enhance objectivity, such as optimizing workload and using contrast agents.
  • Improving SE accuracy requires addressing technical limitations and operator experience, with ongoing research into advanced techniques.
Abstract

Keywords:
Stress echocardiographyatrial fibrillationcoronary artery diseasediagnostic pitfallsfalse-negative resultsfalse-positive resultsspeckle tracking echocardiographythree-dimensional echocardiography

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