THE 5 VIEW TECHNIQUE FOR STRESS ECHOCARDIOGRAPHY - A DESCRIPTION AND EVALUATION OF SEGMENTAL IMAGING AND REPORTED ANGIOGRAPHIC DATA

Stress echocardiography is an accurate means of evaluating ischemic he art disease with sensitivities and specificities equivalent to alterna te modalities. The sensitivities to disease of vessels with posterior wall distribution are, however, significantly lower. Studies establish ing these figures have used a 4 view digital imaging technique as stan dard. This study aimed to determine if the use of a 5 view template (4 views plus an apical 3 chamber (3ch) view) significantly improved ste ss echo results. One hundred consecutive stress echocardiograms using a 5 view format were analyzed by two independent observers. Nine thous and regional wall segments were graded quantitatively and qualitativel y and comparisons were made between the 4 and 5 view techniques. Repor ted angiographic sensitivities of the two techniques were analyzed and compared to the segmental imaging data. The 5 view template was found to increase overall segmental imaging by 30% and imaging of lateral a nd posterior walls was increased by 50% while the additional poststres s cycle teas acquired in under 13 seconds. Five view studies reported increased mean sensitivitities to left anterior descending coronary ar tery (LAD) disease of 29.7%, right coronary artery (RCA) disease of 25 .7%, and circumflex: coronary artery (Cx) disease of 51.6%. This study found that the 5 view technique significantly increased left ventricu lar segmental imaging, particularly of the posterior and lateral walls , and is associated with increased angiographically determined sensiti vity, particularly for vessels with posterior wall distribution when c ompared to the 4 view technique.