title: [Stress echocardiography with physical burden using step-climbing for the diagnosis of ischemia].
abstract: OBJECTIVE
  To ascertain the reliability of stress echocardiography (SEG) with a standardized step-climbing test in predicting significant coronary heart disease (CHD) in patients suspected of having CHD, subsequently verified by coronary angiography.
  
  
  METHODS
  174 consecutive patients (116 men, 58 women; average age 60 years) suspected of having CHD or with suspected progression of known CHD were included.
  
  
  RESULTS
  Compared with coronary angiography SEG had a sensitivity of 81% for the recognition of ischaemia in patients with coronary artery stenosis of 50% or more, with a specificity of 74%. The positive and negative predictive values were 81% and 73%, respectively. Multi-vessel disease was better recognized then single-vessel involvement. Abnormal perfusion in the region supplied by the left anterior descending artery (LAD) was diagnosed with a higher sensitivity than those of the circumflex branch (CXB) and the right coronary artery (RCA/CXB). For 50% stenoses in the LAD distribution the sensitivity was 76%, specificity 79%; for the combined RCA/CXB and CXB areas the sensitivity was 52%, specificity 84%. When comparing the SEG findings with coronary stenoses of 50%, the sensitivity for diagnosing ischaemia rose to 86%, specificity 70%. Positive and negative predictive values were 83% and 75%, respectively. Ischaemia in the LAD distribution area was recognized with a sensitivity of 79%, specificity 72%, ischaemia in the combined RCA/CXB and CXB areas with a sensitivity of 56%, specificity 82%.
  
  
  CONCLUSIONS
  Stress echocardiography with stair-climbing can achieve acceptable results in the diagnosis of coronary heart disease.
authors.affiliation: Herzzentrum und Rotes Kreuz Krankenhaus Frankfurt.
authors.forename: I
authors.initials: I
authors.lastname: Becht
authors.forename: S
authors.initials: S
authors.lastname: Göhring
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
vernacular_title: Stress-Echokardiographie mit körperlicher Belastung an der Kletterstufe zur Ischämiediagnostik.