Advertisement

Stress Echocardiography

  • Thomas H. MarwickEmail author
Chapter

Abstract

In inability of pathologic myocardium to augment function during stress is the cornerstone of stress echocardiography for both ischemic and non-ischemic disease. The time-course, extent and spatial distribution of abnormal wall motion abnormalities are markers of the severity of the underlying pathology. Potential confounders of this association of disease and abnormal function are the nature (and adequacy) of stress, the quality and timing of image acquisition, and the sensitivity and reliability of the diagnostic criteria. This chapter reviews the selection and performance of stress modalities, details of image acquisition and approaches to interpretation and reporting. The evidence-base for the accuracy and prognostic value of stress echocardiography is summarized, and its role, relative to other imaging approaches is discussed.

Keywords

Stress echocardiography Exercise Pharmacologic stress Accuracy Ischemia Viability 

References

  1. 1.
    Sicari R, Nihoyannopoulos P, Evangelista A, et al. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr. 2008;9:415–37.CrossRefGoogle Scholar
  2. 2.
    Rigo F, Cortigiani L, Pasanisi E, et al. The additional prognostic value of coronary flow reserve on left anterior descending artery in patients with negative stress echo by wall motion criteria. A Transthoracic Vasodilator Stress Echocardiography Study. Am Heart J. 2006;151:124–30.CrossRefGoogle Scholar
  3. 3.
    Nishimura RA, Reeder GS, Miller FA, et al. Prognostic value of predischarge 2-dimensional echocardiogram after acute myocardial infarction. Am J Cardiol. 1984;53:429–32.CrossRefGoogle Scholar
  4. 4.
    Hoffmann R, Lethen H, Marwick T, et al. Standardized guidelines for the interpretation of dobutamine echocardiography reduce interinstitutional variance in interpretation. Am J Cardiol. 1998;82:1520–4.CrossRefGoogle Scholar
  5. 5.
    Picano E, Lattanzi F, Orlandini A, Marini C, L’Abbate A. Stress echocardiography and the human factor: the importance of being expert. J Am Coll Cardiol. 1991;17:666–9.CrossRefGoogle Scholar
  6. 6.
    Hoffmann R, Lethen H, Marwick T, et al. Analysis of interinstitutional observer agreement in interpretation of dobutamine stress echocardiograms. J Am Coll Cardiol. 1996;27:330–6.CrossRefGoogle Scholar
  7. 7.
    Voigt JU, Exner B, Schmiedehausen K, et al. Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation. 2003;107:2120–6.CrossRefGoogle Scholar
  8. 8.
    Ishii K, Suyama T, Imai M, et al. Abnormal regional left ventricular systolic and diastolic function in patients with coronary artery disease undergoing percutaneous coronary intervention: clinical significance of post-ischemic diastolic stunning. J Am Coll Cardiol. 2009;54:1589–97.CrossRefGoogle Scholar
  9. 9.
    Detrano R, Lyons KP, Marcondes G, Abbassi N, Froelicher VF, Janosi A. Methodologic problems in exercise testing research. Are we solving them? [Review]. Arch Intern Med. 1988;148:1289–95.CrossRefGoogle Scholar
  10. 10.
    Armstrong WF, O’Donnell J, Dillon JC, McHenry PL, Morris SN. Complementary value of two-dimensional exercise echocardiography to routine treadmill exercise testing. Ann Intern Med. 1986;105:829–35.CrossRefGoogle Scholar
  11. 11.
    Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;63:380–406.CrossRefGoogle Scholar
  12. 12.
    Fleischmann KE, Hunink MG, Kuntz KM, Douglas PS. Exercise echocardiography or exercise SPECT imaging? A meta-analysis of diagnostic test performance. JAMA. 1998;280:913–20.CrossRefGoogle Scholar
  13. 13.
    Marwick TH. Stress echocardiography: its role in the diagnosis and evaluation of coronary artery disease. 2nd ed. Boston: Kluwer Academic Publishers; 2003.CrossRefGoogle Scholar
  14. 14.
    Kaul S. Response of dysfunctional myocardium to dobutamine. “The eyes see what the mind knows”. J Am Coll Cardiol. 1996;27:1608–11.CrossRefGoogle Scholar
  15. 15.
    Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol. 2002;39:1151–8.CrossRefGoogle Scholar
  16. 16.
    Bonow RO, Maurer G, Lee KL, et al. Myocardial viability and survival in ischemic left ventricular dysfunction. N Engl J Med. 2011;364:1617–25.CrossRefGoogle Scholar
  17. 17.
    Gibbons RJ, Chatterjee K, Daley J, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina). J Am Coll Cardiol. 1999;33:2092–197.CrossRefGoogle Scholar
  18. 18.
    Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118:887–96.CrossRefGoogle Scholar
  19. 19.
    Bax JJ. J Am Col Cardiol. 1995.Google Scholar
  20. 20.
    Poldermans D, Arnese M, Fioretti PM, et al. Improved cardiac risk stratification in major vascular surgery with dobutamine-atropine stress echocardiography. J Am Coll Cardiol. 1995;26:648–53.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Baker Heart and Diabetes InstituteMelbourneAustralia

Personalised recommendations