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European Heart Journal Advance Access originally published online on November 11, 2008
European Heart Journal 2009 30(3):278-289; doi:10.1093/eurheartj/ehn492
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© 2008 The European Society of Cardiology, European Association for Cardio-Thoracic Surgery, and Europa Edition, All rights reserved. For permissions please email: journals.permissions@oxfordjournals.org

Stress Echocardiography Expert Consensus Statement—Executive Summary

European Association of Echocardiography (EAE) (a registered branch of the ESC)

Rosa Sicari1,*, Petros Nihoyannopoulos2, Arturo Evangelista3, Jaroslav Kasprzak4, Patrizio Lancellotti5, Don Poldermans6, Jens-Uwe Voigt7, Jose Luis Zamorano8 on behalf of the European Association of Echocardiography

1 Institute of Clinical Physiology, Pisa, Italy
2 Hammersmith Hospital, NHLI, Imperial College, London, UK
3 Hospital Vall d'Hebron, Barcelona, Spain
4 Department of Cardiology, Medical University of Lodz, Lodz, Poland
5 Department of Cardiology, University Hospital Sart Tilman, Liège, Belgium
6 Erasmus Medical Center, Rotterdam, The Netherlands
7 Catholic University, Leuven, Belgium
8 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain

* Corresponding author. Tel: +39 0503152397, Fax: +39 0503152374, E-mail: rosas@ifc.cnr.it

The first 150 words of the full text of this article appear below.

Stress echocardiography is the combination of echocardiography with a physical, pharmacological, or electrical stress. The diagnostic endpoint for the detection of myocardial ischaemia is the induction of a transient worsening in regional function during stress. Stress echocardiography provides similar diagnostic and prognostic accuracy to 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 possibility of performing coronary flow reserve evaluation of the left anterior descending coronary artery by transthoracic Doppler echocardiography adds another potentially important . . . [Full Text of this Article]


   Stress echo: a historical and socio-economic perspective
 

   Pathophysiological mechanisms
 

   Ischaemic stressors
 

   Diagnostic criteria
 

   Diagnostic accuracy
 

   Prognostic value of inducible myocardial ischaemia
 

   Indications and prognostic value of myocardial viability assessment
 

   Safety of pharmacological stress echocardiography
 

   Indication for stress echo
 

   New technologies applied to stress echocardiography
 

   Comparison with competing techniques: cost and risk assessment
 

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