DIAGNOSTIC-VALUE OF STRESS ECHOCARDIOGRAP HY .1.

Significant coronary artery disease may be assessed by two-dimensional echocardiographic detection of left ventricular wall motion abnormali ties, which are absent during rest conditions and are induced by physi ologic (treadmill, bicycle, handgrip exercise) or pharmacologic stress (dipyridamole, dobutamine, ergonovine, adenosine) or by atrial pacing . The sensitivity and specificity of exercise echocardiography vary fr om 70 to 100%, according to patient selection, the protocol, and the g old standard used. Exercise echocardiography can provide both diagnost ic and prognostic information for routine clinical care. Most studies confirm its superiority to exercise electrocardiography alone and its equivalent accuracy to thallium perfusion imaging for the diagnosis of coronary artery disease and identifying and localizing myocardial isc hemia. The Doppler echocardiographically registered velocity curves of mitral flow characterize the temporal changes of diastolic function o f the left ventricle under rest and stress conditions. Myocardial rela xation and ventricular compliance disturbances have inverse influence on the mitral flow profile and the left ventricular filling is additio nally subject to other factors. The inflow profile alone is not suffic ient to provide conclusive assessment of myocardial relaxation or comp liance. To define the diagnostic value of Doppler echocardiography und er stress conditions it will require further studies.