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Anatomical and Functional Targets of Stress Testing

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Stress Echocardiography

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Abstract

The principle of stress under controlled conditions derives from the Industrial Revolution: metallic materials undergo endurance tests to identify the breaking load. This approach identifies structural defects, which — although occult in the resting or static state — might show up under real-life loading conditions, leading to a dysfunction of the industrial product. In the same way, a patient with normal findings at rest undergoes a stress test to identify a potential vulnerability of the myocardium to ischemia — if there is clinical suspicion of ischemic heart disease.

Degree and number of coronary artery stenoses do not predict onset, course, complications, infarct size and death in ischemic heart disease.

Giorgio Baroldi [1]

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References

  1. Baroldi G, Giuliano G (1986) Ischemie heart disease: clinical and pathological mismatch. Can J Cardiol Suppl A:248A–254A

    Google Scholar 

  2. Marcus ML (1983) The coronary circulation in health and disease. McGraw Hill, New York, pp 65–92

    Google Scholar 

  3. Gould KL, Lipscomb K (1974) Effects of coronary stenoses on coronary flow reserve and resistance. Am J Cardiol 34:48–55

    Article  PubMed  CAS  Google Scholar 

  4. Maseri A (1987) Role of coronary artery spasm in symptomatic and silent myocardial ischemia. J Am Coll Cardiol 9:249–262

    Article  PubMed  CAS  Google Scholar 

  5. Gorlin R, Fuster V, Ambrose JA (1986) Anatomic-physiologic links between acute coronary syndromes. Circulation 74:6–9

    Article  PubMed  CAS  Google Scholar 

  6. Epstein SE, Cannon RO 3rd (1986) Site of increased resistance to coronary flow in patients with angina pectoris and normal epicardial coronary arteries. J Am Coll Cardiol 8:459–461

    Article  PubMed  CAS  Google Scholar 

  7. L’Abbate A, Marzilli M, Ballestra AM, et al (1980) Opposite transmural gradients of coronary resistance and extravascular pressure in the working dog’s heart. Cardiovasc Res 14:21–29

    Article  PubMed  Google Scholar 

  8. Ross J Jr (1989) Mechanisms of regional ischemia and antianginal drug action during exercise. Prog Cardiovasc Dis 31:455–466

    Article  PubMed  Google Scholar 

  9. Gallagher KP, Matsuzaki M, Koziol JA, et al (1984) Regional myocardial perfusion and wall thickening during ischemia in conscious dogs. Am J Physiol 247:H727–738

    PubMed  CAS  Google Scholar 

  10. Marcus ML, White CW, Kirchner PT (1986) Isn’t it time to reevaluate the sensitivity of noninvasive approaches for the diagnosis of coronary artery disease? J Am Coll Cardiol 8:1033–1034

    Article  PubMed  CAS  Google Scholar 

  11. White CW, Wright CB, Doty DB, et al (1984) Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis? N Engl J Med 310:819–824

    Article  PubMed  CAS  Google Scholar 

  12. Uren NG, Melin JA, De Bruyne B, et al (1994) Relation between myocardial blood flow and the severity of coronary-artery stenosis. N Engl J Med 330:1782–1788

    Article  PubMed  CAS  Google Scholar 

  13. Legrand V, Mancini GB, Bates ER, et al (1986) Comparative study of coronary flow reserve, coronary anatomy and results of radionuclide exercise tests in patients with coronary artery disease. J Am Coll Cardiol 8:1022–1032

    Article  PubMed  CAS  Google Scholar 

  14. Wilson RF, Marcus ML, Christensen BV, et al (1991) Accuracy of exercise electrocardiography in detecting physiologically significant coronary arterial lesions. Circulation 83:412–421

    Article  PubMed  CAS  Google Scholar 

  15. De Bruyne B, Bartunek J, Sys SU, et al (1995) Relation between myocardial fractional flow reserve calculated from coronary pressure measurements and exercise-induced myocardial ischemia. Circulation 92:39–46

    Article  PubMed  Google Scholar 

  16. Schulman DS, Lasorda D, Farah T, et al (1997) Correlations between coronary flow reserve measured with a Doppler guide wire and treadmill exercise testing. Am Heart J 134:99–104

    Article  PubMed  CAS  Google Scholar 

  17. Piek JJ, Boersma E, Mario C di, et al (2000) Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography. DEBATE study group. Doppler Endpoints Balloon Angioplasty Trial Europe. Eur Heart J 21:466–474

    Article  PubMed  CAS  Google Scholar 

  18. Joye JD, Schulman DS, Lasorda D, et al (1994) Intracoronary Doppler guide wire versus stress single-photon emission computed tomographic thallium-201 imaging in assessment of intermediate coronary stenoses. J Am Coll Cardiol 24:940–947

    Article  PubMed  CAS  Google Scholar 

  19. Daimon M, Watanabe H, Yamagishi H, et al (2001) Physiologic assessment of coronary artery stenosis by coronary flow reserve measurements with transthoracic Doppler echocardiography: comparison with exercise thallium-201 single photon emission computed tomography. J Am Coll Cardiol 37:1310–1315

    Article  PubMed  CAS  Google Scholar 

  20. Heller LI, Cates C, Popma J, et al (1997) Intracoronary Doppler assessment of moderate coronary artery disease: comparison with 201Tl imaging and coronary angiography. FACTS Study Group. Circulation 96:484–490

    Article  PubMed  CAS  Google Scholar 

  21. El-Shafei A, Chiravuri R, Stikovac MM, et al (2001) Comparison of relative coronary Doppler flow velocity reserve to stress myocardial perfusion imaging in patients with coronary artery disease. Catheter Cardiovasc Interv 53:193–201

    Article  PubMed  CAS  Google Scholar 

  22. Picano E, Parodi O, Lattanzi F, et al (1994) Assessment of anatomic and physiological severity of single-vessel coronary artery lesions by dipyridamole echocardiography. Comparison with positron emission tomography and quantitative arteriography. Circulation 89:753–761

    Article  PubMed  CAS  Google Scholar 

  23. Pijls NH, De Bruyne B, Peels K, et al (1996) Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 334:1703–1708

    Article  PubMed  CAS  Google Scholar 

  24. Bartunek J, Marwick TH, Rodrigues AC, et al (1996) Dobutamine-induced wall motion abnormalities: correlations with myocardial fractional flow reserve and quantitative coronary angiography. J Am Coll Cardiol 27:1429–1436

    Article  PubMed  CAS  Google Scholar 

  25. Bortone AS, Hess OM, Eberli FR, et al (1989) Abnormal coronary vasomotion during exercise in patients with normal coronary arteries and reduced coronary flow reserve. Circulation 79:516–527

    Article  PubMed  CAS  Google Scholar 

  26. Scheler S, Motz W, Strauer BE (1992) Transient myocardial ischemia in hypertensives: missing link with left ventricular hypertrophy. Eur Heart J 13 Suppl D:62–65

    Google Scholar 

  27. Motz W, Strauer BE (1996) Improvement of coronary flow reserve after long-term therapy with enalapril. Hypertension 27:1031–1038

    Article  PubMed  CAS  Google Scholar 

  28. Di Mario C, Gorge G, Peters R, et al (1998) Clinical application and image interpretation in intracoronary ultrasound. Study Group on Intracoronary Imaging of the Working Group of Coronary Circulation and of the Subgroup on Intravascular Ultrasound of the Working Group of Echocardiography of the European Society of Cardiology. Eur Heart J 19:207–229

    Article  PubMed  Google Scholar 

  29. Erbel R (1996) The dawn of a new era — non-invasive coronary imaging. Herz 21:75–77

    PubMed  CAS  Google Scholar 

  30. Verna E, Ceriani L, Giovanella L, et al (2000) “False-positive” myocardial perfusion scintigraphy findings in patients with angiographically normal coronary arteries: insights from intravascular sonography studies. J Nucl Med 41:1935–1940

    PubMed  CAS  Google Scholar 

  31. Spes CH, Klauss V, Rieber J, et al (1999) Functional and morphological findings in heart transplant recipients with a normal coronary angiogram: an analysis by dobutamine stress echocardiography, intracoronary Doppler and intravascular ultrasound. J Heart Lung Transplant 18:391–398

    Article  PubMed  CAS  Google Scholar 

  32. Topol EJ, Nissen SE (1992) Our preoccupation with coronary luminology. The dissociation between clinical and angiographic findings in ischemic heart disease. Circulation 92:2333–2342

    Article  Google Scholar 

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Authors and Affiliations

  1. Institute of Clinical Physiology, National Research Council, Via Moruzzi, 1, 56124, Pisa, Italy

    Eugenio Picano MD, PhD, FESC (Senior Medical Researcher of Italian National Research Council, Director, Echocardiography and Stress Testing Lab Institute of Clinical Physiology, Pisa, Scientific Director Cardiology, Clinica Cardiologica Montevergine, Mercogliano, Avellino, Editor-in-Chief Biomed Central Netjournal Cardiovascular Ultrasound)

Authors
  1. Eugenio Picano MD, PhD, FESC
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© 2003 Springer-Verlag Berlin Heidelberg

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Picano, E. (2003). Anatomical and Functional Targets of Stress Testing. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05096-5_2

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  • DOI: https://doi.org/10.1007/978-3-662-05096-5_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-05098-9

  • Online ISBN: 978-3-662-05096-5

  • eBook Packages: Springer Book Archive

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