Introduction
Stress echocardiography (SE) using treadmill stress has been well validated for the detection of myocardial ischemia.1,2It is recommended for assessment of a wide variety of coronary artery disease (CAD) indications, including for the detection of myocardial ischemia, with a class I recommendation and a level of evidence B.1,2 It is “conceptually simple…. However, the simplicity of this concept contrasts with the technical difficulty posed by the practical performance of this technique.” 2
Left ventricular stroke volume (SV) and cardiac output (CO) can be readily estimated using echocardiography and have been shown to correlate well with thermodilution calculations in patients.3-5 The parameters of SV and CO can be affected secondary to myocardial ischemia. 6,7 The estimation of SV with Doppler techniques is straightforward and reproducible.8-10 A normal SV response has been shown utilising dobutamine stress echocardiography in patients with no wall motion abnormalities.11 This study was designed to assess the incremental value of estimating SV before and after treadmill testing in SE, with subsequent assessment of adverse prognostic cardiac events during patient follow up.