Stress Echocardiography (eBook)

The author is Director of the Pisa Institute of Clinical Physiology of the Italian National Research Council. He is/was present or past editorial board member or guest editor of Circulation, Journal American College of Cardiology, European Journal Echocardiography, Journal of American Society of Echocardiography. He is founder and editor-in-chief of the Biomed Central, ISI-tracked, journal Cardiovascular Ultrasound.

Preface 5
Contents 7
List of Contributors 19
Section 1 Basic Principles, Methodology and Pathophysiology 22
Stress Echocardiography: A Historical and Societal Perspective 23
Anatomical and Functional Targets of Stress Testing 39
Symptoms and Signs of Myocardial Ischemia 50
Rational Basis of Stress Echocardiography 62
Pathogenetic Mechanisms of Stress 75
Echocardiographic Signs of Ischemia 92
Segmentation of the Left Ventricle 107
Dynamic and Pharmacologic Right Heart Stress Echocardiography: Right Ventricular Function, Right Coronary Artery Flow, Pulmonary Pressure, and Alveolar– Capillary Membrane Testing in the Echocardiography Laboratory 121
Coronary Flow Reserve 140
Technology and Training Requirements 160
Section 2 Stresses: How, When and Why 171
Exercise Echocardiography 172
Dobutamine Stress Echocardiography 188
Dipyridamole Stress Echocardiography 202
Adenosine Stress Echocardiography 220
Pacing Stress Echocardiography 233
Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina 241
Hyperventilation Test 252
Grading of Ischemic Response 258
Diagnostic Results and Indications 270
Myocardial Viability 284
Diagnostic Flowcharts 306
Prognosis 314
Section 3 New Technologies and New Diagnostic Targets 327
New Ultrasound Technologies for Quantitative Assessment of Left Ventricular Function 328
Contrast Stress Echocardiography 352
Diastolic Stress Echocardiography 369
Endothelial Function in the Stress Echocardiography Laboratory 382
Section 4 In Front of The Patient: Clinical Applications in Different Patient Subsets 400
Special Subsets of Angiographically Defined Patients: Normal Coronary Arteries, Single-Vessel Disease, Left Main Coronary Artery Disease, Patients Undergoing Coronary Revascularization 401
Special Subsets of Electrocardiographically Defined Patients: Left Bundle Branch Block, Right Bundle Branch Block, Atrial Fibrillation 410
Special Subsets of Clinically Defined Patients: Elderly, Women, Outpatients, Chest Pain Unit, Noncardiac Vascular Surgery 417
Microvascular Disease 432
Hypertension 450
Diabetes 459
Stress Echocardiography in Dilated Cardiomyopathy 467
Stress Echocardiography in Hypertrophic Cardiomyopathy 480
Stress Echocardiography After Cardiac Transplantation 488
The Emerging Role of Exercise Testing and Stress Echocardiography in Valvular Heart Disease 499
Stress Echocardiography in Children 522
Section 5 Comparison with Other Imaging Techniques 535
Stress Echocardiography Versus Stress Perfusion Scintigraphy 536
Stress Echocardiography Versus Cardiac CT 549
Stress Echocardiography Versus Stress CMR 564
Appropriateness in the Stress Echocardiography Laboratory 579
Index 591