Possibilities of treadmill stress echocardiography in assessment of painless myocardial ischemia in patients with coronary heart disease

Aim. To study possibilities of treadmill stress echocardiography for assess ment of extent and severity of painless and symptomatic myocardial ischemia . Material. Fifty two patients (mean age 57,2+/-7,3 years) with angiographi c coronary artery stenoses without local derangements of myocardial contrac tility at rest but with obvious signs of myocardial ischemia during treadmi ll stress echocardiography. Results and conclusions. Myocardial ischemia du ring exercise was painless in 23 (44%) patients. Patients with and without painless ischemia had similar age, coronary artery lesions, and levels of m ain risk factors, while patients with painless ischemia performed greater t otal work during exercise test. Painless compared with symptomatic myocardi al ischemia was less frequently accompanied by impairment of regional myoca rdial contractility (65 and 90%, respectively, p<0,05) and was characterize d by smaller extent of regions of impaired contractility (2,4+/-2,2 and 5,3 +/-2,5 segments, respectively, p<0,001).