Echocardiography in the Era of Multimodality Cardiovascular Imaging

Table 2

Contemporary indications for stress echocardiography.

Indication	Parameter(s) measured
Coronary applications
Myocardial ischaemia	Wall thickening at rest versus stress
Myocardial viability	Wall thickening at rest, low-dose, and peak stress
Noncoronary applications
(A) Valve disease
Asymptomatic severe AS	Exercise-induced change in mean transaortic gradient; Exercise-induced change in peak transtricuspid gradient
Low-flow low-gradient AS	LVOT and AoV VTI at rest and low-dose dobutamine stress
Symptomatic mild/moderate MS	Exercise-induced change in mean transmitral and transtricuspid gradients
Symptomatic moderate MR	Exercise-induced changes in EROA and pulmonary pressures
(B) Cardiomyopathy
HCM	Exercise-induced dynamic LVOT obstruction
DCM	Contractile reserve in response to low-dose dobutamine
ICM	Assessment of global LV contractile reserve; Assessment of viability in posterolateral walls (for guiding LV lead placement); Assess exercise capacity objectively; Assess inducibility of tachyarrhythmias

(AS: aortic stenosis; MS: mitral stenosis; MR: mitral regurgitation; LVOT: left ventricular outflow tract; AoV: aortic valve; EROA: effective regurgitant orifice area; VTI: velocity time integral; HCM: hypertrophic cardiomyopathy; DCM: dilated cardiomyopathy; ICM: ischaemic cardiomyopathy).