Stress ECHO beyond coronary artery disease. Is it the holy grail of cardiovascular imaging?

Abstract

Stress echocardiography (SE) is a very useful method in clinical practice, because it offers important information of both the patient's functional status and hemodynamic changes during stress. Therefore, SE provides strong diagnostic and prognostic data in a wide spectrum of cardiovascular diseases. This review summarizes the clinical applications of SE in conditions beyond coronary artery disease (CAD) and highlights practical recommendations and key issues for each condition that need further investigation. SE is an established method for the evaluation of symptomatic and asymptomatic patients with valvular heart disease (VHD) and cardiomyopathies, and provides important information regarding prognosis and management of patients with congenital heart disease, pulmonary hypertension or diastolic dysfunction. Moreover, when one or multiple VHD and cardiomyopathy or CAD coexist in one patient, SE is a very useful clinical tool for the evaluation of etiology and symptomatology.

Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

“…In contrast to CFR, exercise and pharmacological SE are the two main methods used in clinical practice to assess for myocardial ischemia. Dobutamine is the most commonly used agent for pharmacological SE [154]. It increases heart rate 2-to 3-fold, systolic BP 2-fold, and contractility 4-fold through activation of β-1 receptors.…”

Cardiac Imaging in Liver Transplantation Candidates: Current Knowledge and Future Perspectives

“…Diastolic SE with supine bicycle reveals worsening of diastolic dysfunction in patients with reduced diastolic reserve and can possibly exacerbate symptoms of heart failure when they are masked at rest [85]. During diastolic SE, parameters like diastolic transmitral flow (E, A waves), mitral annulus TDI indices (e'), and systolic pulmonary artery pressure are measured and their alterations with values at rest are evaluated [86].…”