Exercise cross-sectional echocardiographic diagnosis of coronary artery disease

Morganroth, Joel; Chen, Chin C.; David, Daniel; Sawin, Henry S.; Naito, Masahito; Parrotto, Connie; Meixell, Linda L.

doi:10.1016/0002-9149(81)90284-8

Cited by 114 publications

(2 citation statements)

References 17 publications

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“…Alternatively, attention was put on the potential as surrogates of the ischemic process of the components of the ischemic cascade when induced by some form of stress. On these grounds, non-invasive procedures able to show the appearance of ECG-changes [ 10 ] or contractile dysfunction [ 11 ] found their place and are also routine in current practice nowadays.…”

Section: Myocardial Ischemia: Evolving Concepts and Study Methodsmentioning

confidence: 99%

State-of-the-Art of Myocardial Perfusion by CMR: A Practical View

Pons-Lladó¹,

Kellman²

2022

Rev. Cardiovasc. Med.

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Ischemic heart disease (IHD) outstands among diseases threatening public health. Essential for its management are the continuous advances in medical and interventional therapies, although a prompt and accurate diagnosis and prognostic stratification are equally important. Besides information on the anatomy of coronary arteries, well covered nowadays by invasive and non-invasive angiographic techniques, there are also other components of the disease with clinical impact, as the presence of myocardial necrosis, the extent of pump function impairment, and the presence and extent of inducible myocardial ischemia, that must be considered in every patient. Cardiovascular Magnetic Resonance (CMR) is a multiparametric diagnostic imaging technique that provides reliable information on these issues. Regarding the detection and grading of inducible ischemia in particular, the technique has been widely adopted in the form of myocardial perfusion sequences under vasodilator stress, which is the subject of this review. While the analysis of images is conventionally performed by visual inspection of dynamic first-pass studies, with the inherent dependency on the operator capability, the recent introduction of a reliable application of quantitative perfusion (QP) represents a significant advance in the field. QP is based on a dual-sequence strategy for conversion of signal intensities into contrast agent concentration units and includes a full automatization of processes such as myocardial blood flow (MBF) calculation (in mL/min/g), generation of a pixel-wise flow mapping, myocardial segmentation, based on machine learning, and allocation of MBF values to myocardial segments. The acquisition of this protocol during induced vasodilation and at rest gives values of stress/rest MBF (in mL/min/g) and myocardial perfusion reserve (MPR), both global and per segment. Dual-sequence QP has been successfully validated against different reference methods, and its prognostic value has been shown in large longitudinal studies. The fact of the whole process being automated, without operator interaction, permits to conceive new interesting scenarios of integration of CMR into systems of entirely automated diagnostic workflow in patients with IHD.

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Section: Myocardial Ischemia: Evolving Concepts and Study Methodsmentioning

confidence: 99%

State-of-the-Art of Myocardial Perfusion by CMR: A Practical View

Pons-Lladó¹,

Kellman²

2022

Rev. Cardiovasc. Med.

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“… 77 Others developed the technique using wider sector angles, in 1981. 78 , 79 Pharmacological stress echocardiography using dipyridamole was proposed by Eugenio Picano and Alessandro Distante in 1985 122 and stress echocardiography using dobutamine by Luc Piérard and colleagues in 1986. 123 …”

Section: Imagingmentioning

confidence: 99%

A concise history of echocardiography: timeline, pioneers, and landmark publications

Fraser

Monaghan

Steen

et al. 2022

European Heart Journal - Cardiovascular Imaging

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Echocardiography is less than 70 years old, and many major advances have occurred within living memory, but already some pioneering contributions may be overlooked. In order to consider what circumstances have been common to the most successful innovations, we have studied and here provide a timeline and summary of the most important developments in transthoracic and transoesophageal ultrasound imaging and Doppler techniques, as well as in intravascular ultrasound and imaging in paediatric cardiology. The entries are linked to a comprehensive list of first publications and to a collection of first-hand historical accounts published by early investigators. Review of the original manuscripts highlights that it is difficult to establish unequivocal precedence for many new imaging methods, since engineers were often working independently but simultaneously on similar problems. Many individuals who are prominently linked with particular developments were not the first in their field. Developments in echocardiography have been highly dependent on technological advances, and most likely to be successful when engineers and clinicians were able to collaborate with open exchange between centres and disciplines. As with many other new medical technologies, initial responses were sceptical and introduction into clinical practice required persistence and substantial energy from the first adopters. Current developments involve advances in software as much as in equipment, and progress will depend on continuing collaborations between engineers and clinical scientists, for example to identify unmet needs and to investigate the clinical impact of particular imaging approaches.

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Exercise two‐dimensional echocardiography: A technique for improving ultrasound images during exercise stress

Simard¹,

Heng

Udhoji³

et al. 1983

Clinical Cardiology

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Summary:A system of exercise stress echocardiography was developcd in which, during exercise on a bicycle ergometer in a semirecumbent position, the echocardiographic transducer is held by a special device which maintains ;I rclatively constant position between the transducer and the heart. The system was evaluated in 2 I healthy subjects and technically satisfactory studies were obtained in 20. In thcsc, thc resolution and relative position of the cardiac image remained stable throughout exercise. Blood pressure and heart rate increased appropriatcly with our protocol with supine exercise; 95% of the subjects reached 9W0 of their predicted maximum heart rate for age. Ejection fraction measured by echocardiography incrcascd from 54f1% to 70fl%. I t is concluded that the use of our transducer-holding device in subjects performing exercise in the supine position significantly improves ultrasonic image quality and should enhance the clinical usefulness of exercise stress echocardiography .

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Exercise cross-sectional echocardiographic diagnosis of coronary artery disease

Cited by 114 publications

References 17 publications

State-of-the-Art of Myocardial Perfusion by CMR: A Practical View

State-of-the-Art of Myocardial Perfusion by CMR: A Practical View

A concise history of echocardiography: timeline, pioneers, and landmark publications

Exercise two‐dimensional echocardiography: A technique for improving ultrasound images during exercise stress

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