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.