Prognostic significance of the location of wall motion abnormalities during exercise echocardiography

Prognostic impact of location and extent of vessel-related ischemia at myocardial perfusion scintigraphy in patients with or at risk for coronary artery disease

“…While these findings may challenge the pivotal role of monodimensional SSS, similar results have been previously reported for stress echocardiography. 23 Notably, it must be emphasized that the lower prognostic predictive value of VRI not involving LAD is not necessarily the fault of MPS, but it may be most likely due to the established variability in coronary anatomy, which impedes a correct and consistent characterization of such regional involvement over several cases. 20 In addition, it is conceivable that the very use of the MIS method, with its capability to synthesize the prognostic outlook of a patient undergoing MPS, may have diluted the independent predictive impact of LAD involvement in subjects with single-VRI.…”

Incremental prognostic value of stress echo positivity in the left anterior descending coronary artery territory

“…In a recent study, simultaneous evaluation of wall motion and coronary flow reserve during DSE showed an higher diagnostic accuracy for significant LAD disease [27]. In a large retrospective study including patients with known or suspected CAD, Elhendy et al [28] evaluated the correspondence between LV segmental dyssynergies induced by exercise echocardiography and coronary perfusion territories. The presence of segmental wall motion defects in the LAD coronary territory was strongly associated with cardiac events at follow-up independently from the degree of LV dysfunction and the extent of ischemia.…”

“…Differently from the previous study [28], we investigated the comparative prognostic values of positive DSE in the LAD territory and angiographically visualized significant LAD stenosis.…”

The year in echocardiography

“…Recent clinical stress echocardiography studies have primarily centered on the evaluation of prognosis in large populations with acute and chronic coronary artery disease and have confirmed that dipyridamole or DSE are effective in predicting cardiac death during long-term follow-up (54,55), that a negative test is associated with a favorable outcome (54), and that the location (anterior wall) of ischemia is predictive of increased risk of cardiac death and nonfatal myocardial infarction independent of the extent of abnormal wall motion (56). In addition, it has been demonstrated that a biphasic response (improvement at low stress followed by deterioration with increased stimulation) can be seen with exercise as well as dobutamine stress in patients early after acute myocardial infarction and is an accurate tool for detecting infarct-artery-related stenosis and predicting functional recovery (57).…”