Stress Echocardiography and Nuclear Imaging

Abstract

Although a number of tools have been used to image the heart, echocardiography and nuclear cardiology are the principal competitors. Although the comparison of these techniques previously involved a fundamental philosophical issue between the diagnosis of coronary disease based on perfusion (hence the possibility of influencing these data on the basis of small-vessel disease, hypertrophy and other causes of abnormal coronary flow reserve) and evidence of ischemia (hence less sensitivity to mild disease that may engender submaximal attainment of flow without ischemia), recent advances have made it possible for both techniques to offer function and perfusion data. However, not all of the differences between the techniques are likely to be altered by these advances. Nuclear techniques are widely practiced and have a huge evidence base, but have disadvantages with respect to availability, cost (especially recurrent cost such as isotopes and disposables) and patient convenience [1]. Echocardiography is potentially widely available but remains subjective and a trained, experienced reader remains critical.