NEW DIAGNOSTIC METHODS FOR THE DETECTION OF MYOCARDIAL-ISCHEMIA (STRESS) ECHOCARDIOGRAPHY AND TROPONIN-T DETERMINATION

Stress-echocardiography represents a new non-invasive, alternative app roach in the assessment of patients with coronary artery disease. By m eans of dynamic or pharmacological stress or by atrial pacing regional wall motion abnormalities can be induced, which can be identified by 2D-echocardiography Beyond the indirect detection of ischemia this app roach allows a better quantification of the amount of ischemia and of global LV function, which is advantageous compared to stress ECG recor ding or myocardial scintigraphy. Disadvantageous is however, the subje ctive reading of the echo itself. In experienced hands stress-echocard iography has proven to be as sensitive and specific as myocardial scin tigraphy. Recently, in addition the diagnostic potential of myocardial cell injury has been improved by the detection of specific antibodies versus Troponin T. in comparison with conventional biochemical marker s of myocardial cell necrosis Troponin T analysis has been proven to b e superior in postoperative or traumatic cardiac damage or in the sett ing of acute myocardial infarction. In this situation the time window is improved by an earlier rise compared to CK and a longer detection r ate compared to lactate dehydrogenase.