Stress echocardiography for the diagnosis of coronary artery disease: progress towards quantification.
OBJECTIVE
This review highlights recent progress in the quantitative approach to the interpretation of stress echocardiograms. Recent literature regarding the application of tissue Doppler and strain rate imaging for the diagnosis of coronary artery disease is summarized.


RESULTS
The high temporal and spatial resolution of tissue Doppler and strain rate imaging permit recognition of regional myocardial dysfunction. These techniques have been performed during low- and high-dose dobutamine stress echocardiography and have been applied to exercise echocardiography. During stress, the peak systolic velocity and early diastolic velocity increased to a greater degree in normal segments compared to ischemic segments. With tissue Doppler imaging, viable segments show increases in systolic velocities in contrast to infarcted segments. Presently, the feasibility of strain rate imaging is slightly less than that of conventional wall motion assessment. However, in preliminary studies, tissue Doppler parameters and especially strain rate parameters appear to offer advantages in accuracy compared to conventional wall motion assessment.


CONCLUSIONS
Tissue Doppler and strain rate imaging offer great promise for the accurate, reproducible quantification of regional myocardial function. Further studies are indicated to prove their accuracy, efficiency, and superiority over existing methods.
Pellikka
Patricia A
PA
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. pellikka.patricia@mayo.edu
D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods*; D005080:Exercise Test; D006321:Heart / Q000503:physiopathology; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results