Conclusions
Stress echocardiography is a well-established technique for the
detection of myocardial ischemia but is very technically difficult to
perform and interpret. An estimation of stroke volume before and after
treadmill exercise is feasible, quick and readily performed. In the
setting of adequate augmentation of SV (>10ml), the
negative predictive value for detection of ischemia and adverse cardiac
events is very high, improving the diagnostic value of SE as a rule out
test. It has practical and prognostic incremental value in the setting
of ischemic and non-ischemic tests. These data show that this remarkably
simple technique is a very powerful predictor of outcome. It is
biologically plausible. It would appear to provide a new benchmark for
the non-invasive detection and exclusion of ischemia. Adding stroke
volume measurements before and after exertion can improve outcome
prediction for stress echocardiography.
The authors attest that they are in compliance with human studies
committees of the authors’ institutions and international guidelines
including patient consent. No animals were used as part of this
research.
This research did not receive any specific grant from funding agencies
in the public, commercial, or not-for-profit sectors.
Conflict of interest: None