title: Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC).
abstract: Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of myocardial ischemia is the induction of a transient worsening in regional function during stress. Stress echocardiography provides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging, but at a substantially lower cost, without environmental impact, and with no biohazards for the patient and the physician. Among different stresses of comparable diagnostic and prognostic accuracy, semisupine exercise is the most used, dobutamine the best test for viability, and dipyridamole the safest and simplest pharmacological stress and the most suitable for combined wall motion coronary flow reserve assessment. The additional clinical benefit of myocardial perfusion contrast echocardiography and myocardial velocity imaging has been inconsistent to date, whereas the potential of adding - coronary flow reserve evaluation of left anterior descending coronary artery by transthoracic Doppler echocardiography adds another potentially important dimension to stress echocardiography. New emerging fields of application taking advantage from the versatility of the technique are Doppler stress echo in valvular heart disease and in dilated cardiomyopathy. In spite of its dependence upon operator's training, stress echocardiography is today the best (most cost-effective and risk-effective) possible imaging choice to achieve the still elusive target of sustainable cardiac imaging in the field of noninvasive diagnosis of coronary artery disease.
authors.affiliation: Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy. rosas@ifc.cnr.it
authors.forename: Rosa
authors.initials: R
authors.lastname: Sicari
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
authors.forename: Arturo
authors.initials: A
authors.lastname: Evangelista
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Kasprzak
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.forename: Don
authors.initials: D
authors.lastname: Poldermans
authors.forename: Jen-Uwe
authors.initials: JU
authors.lastname: Voigt
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D002985:Clinical Protocols; D025401:Echocardiography, Stress / Q000379:methods / Q000592:standards*; D005060:Europe; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011379:Prognosis; D015203:Reproducibility of Results