title: Stress echocardiography in paediatric cardiology.
abstract: Stress echocardiography is a well-established technique in adult cardiology and is mainly used for assessing regional myocardial function in patients with known or suspected coronary artery disease (CAD). Apart from detecting ischaemia, stress echocardiography has found its place in the assessment of the haemodynamic significance of valve disease, particularly in selected patients with aortic stenosis and mitral regurgitation. Also in the paediatric population, stress imaging is most commonly used for the detection of ischaemia in patients with CADs such as post heart transplantation, Kawasaki Disease, and abnormal origin of coronary arteries. Other paediatric indications include the haemodynamic and myocardial response in patients with different types of congenital heart disease, the early detection of myocardial dysfunction in specific populations such as patients after anthracycline exposure, and the evaluation of pulmonary artery pressures and the right ventricular functional response. Techniques have evolved over time and in different paediatric echocardiographic laboratories, exercise stress echocardiography is replacing dobutamine stress echocardiography in older children. Moreover, integrating tissue Doppler and strain technology with stress imaging allows a more quantitative analysis of regional and global systolic and diastolic function. Current clinical applications mainly include patients after transplant, suspected CAD, and hypertrophic cardiomyopathy.
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, The University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cifra
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, The University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8.
authors.forename: Andreea
authors.initials: A
authors.lastname: Dragulescu
authors.affiliation: Children's Healthcare of Atlanta Sibley Heart Center, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: William L
authors.initials: WL
authors.lastname: Border
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, The University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8 luc.mertens@sickkids.ca luc.mertens6@telenet.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Mertens
mesh_terms: D002318:Cardiovascular Diseases / Q000151:congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D025401:Echocardiography, Stress / Q000379:methods*; D006801:Humans
keywords: Children; Exercise echocardiography; Function