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