Overview of stress echocardiography: uses, advantages, and limitations

Gottdiener, John S.

doi:10.1016/j.cpcardiol.2003.10.001

Cited by 8 publications

(7 citation statements)

References 92 publications

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“…The time from the beginning of QRS complex to peak systolic velocity was measured from 8 segments at rest and at peak stress. Measurements were corrected for heart rate using the Bazett Formula (Tscor=Ts/√R-R) 2). The absolute value of the difference between opposite segments' Tscor values (inferior and anterior, lateral and septal) was accepted as intraventricular dyssynchrony 8).…”

Section: Methodsmentioning

confidence: 99%

“…However, it provides knowledge about the physiological importance of the obstruction in the coronary lumen. This technique, in particular, can be used for patients who cannot tolerate an exercise test, while at the same time it is important for evaluating myocardial viability, hibernation, valvular heart diseases, and, in selected patients, can be utilized prior to non-cardiac surgery 2). When used for detecting ischemia, the most important limitation of this technique's effectiveness depends on the physician and image quality of the patient 1).…”

Section: Introductionmentioning

confidence: 99%

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Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

et al. 2013

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Background and ObjectivesDobutamine stress echocardiography (DSE) is an important non-invasive imaging method for evaluating ischemia. However, wall motion interpretation can be impaired by the experience level of the interpreter and the subjectivity of the visual assessment. In our study we aimed to combine DSE and tissue syncronisation imaging to increase sensitivity for detecting ischemia.Subjects and Methods50 patients with indications for DSE were included in the study. In 25 patients we found DSE positive for ischemia and in the other 25 patients we found it to be negative. The negative group was accepted as the control group. There was no significant difference in terms of risk factors and echocardiographic parameters between the two groups, except for wall motion scores. In both groups, left ventricular dyssychrony was accepted as the difference between time to peak systolic velocity (Ts) in the reciprocal four couple of non-apical segments at rest and during peak stress. Timings were corrected for heart rate. We compared the differences of the dyssynchronisation value at rest and during peak stress to determine the distinctions within the groups and between the groups of DSE positive and negative patients.ResultsWe found that stress and ischemia did not create any significant difference over the left intraventricular dyssynchrony with DSE, although at the segmenter level it prolonged the time to peak systolic velocity (p<0.05). These alterations did not show any significant difference between positive and negative DSE groups.ConclusionAs a result, this segmenter dyssynchrony and the time to peak systolic velocity, which is corrected for heart rate, did not enhance any new value over DSE for detecting ischemia.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

et al. 2013

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“…20 Flow heterogeneity, especially between the subendocardial and subepicardial perfusion, is the forerunner of ischemia, followed by metabolic changes, alteration in regional mechanical function, and only at a later stage by electrocardiographic changes, global left ventricular (LV) dysfunction, and chest pain. 19,21 Studies found exercise stress echocardiography was more sensitive and specific than exercise electrocardiography in the early diagnosis of coronary artery disease. 22 In diagnosis of coronary artery stenosis >50%, the average sensitivity was 88%, and specificity was 83%, respectively.…”

Section: Four-dimensional Echocardiography Area Strain Combined Witmentioning

confidence: 99%

Four‐dimensional echocardiography area strain combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis

et al. 2017

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In patients with mild single vessel coronary artery stenosis, the area strain was decreased at involved segments, while compensatory increased at noninvolved segments after exercise stress. Four-dimensional echocardiography area strain combined with exercise stress echocardiography could sensitively find left ventricular regional systolic function abnormality in patients with mild single vessel coronary artery stenosis, and locate stenosis coronary artery accordingly.

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“…9 Severe ventricular arrhythmias may occur during the test, but such events are rare, confirming that dobutamine is safe to be used in stress echocardiography. [10][11][12] However, there is hesitation in clinical practice in using this test for patients with CD due to the arrhythmogenic potential of the drug in a population of patients more susceptible to arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Incidence and variables associated with arrhythmias during dobutamine–atropine stress echocardiography among patients with Chagas disease

et al. 2019

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Background Dobutamine stress echocardiography (DSE) is an important tool in the diagnosis of coronary artery disease. However, there is hesitation in clinical practice for using it in patients with Chagas disease (CD) due to the arrhythmogenic potential of this heart condition. This study aimed to evaluate the incidence and variables associated with arrhythmias during DSE in a population of patients with CD. Methods A population of 205 consecutive patients with CD and suspected coronary heart disease was assessed through a retrospective database analysis. CD was confirmed in all patients by serological testing. Results The mean age of the patients selected was 64 years, and 65.4% of the patients were female. Significant arrhythmias occurred as follows: nonsustained ventricular tachycardia in 7.3% of patients; supraventricular tachycardia and sustained ventricular tachycardia in 1%; and atrial fibrillation in 0.5%. Nonsignificant arrhythmias occurred as follows: premature ventricular contractions in 48% of patients and bigeminy in 4.4%. Values for the wall‐motion score index at rest greater than 1.12 and 1.18 were independently correlated with the occurrence of nonsignificant arrhythmias (odds ratio [OR] = 2.90, P < 0.001) and significant arrhythmias (OR = 4.23, P = 0.044), respectively. Conclusion DSE should be considered a safe examination in patients with CD despite the known increased risk of arrhythmias in this group of patients. The occurrence of arrhythmias was low in this study. Abnormal wall‐motion score index values at rest were associated with the occurrence of significant and nonsignificant arrhythmias during the test.

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Overview of stress echocardiography: uses, advantages, and limitations

Cited by 8 publications

References 92 publications

Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

Four‐dimensional echocardiography area strain combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis

Incidence and variables associated with arrhythmias during dobutamine–atropine stress echocardiography among patients with Chagas disease

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