Ryan T, Feigenbaum H
Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis 46202-4800.
Am J Cardiol. 1992 Jun 18;69(20):82H-89H. doi: 10.1016/0002-9149(92)90650-n.
Exercise echocardiography is a versatile, noninvasive diagnostic test that involves the recording and interpretation of 2-dimensional echocardiograms prior to, during, and after exercise. By analyzing and comparing wall motion at each stage, a prediction about the presence or absence of coronary artery disease can be made. The development of a wall motion abnormality is both sensitive and specific for the presence of a significant coronary stenosis. Changes in regional systolic function during exercise enable the clinician to distinguish between infarction and ischemia. Thus, the test yields information on the presence, extent, severity, and location of coronary artery disease. Echocardiography can be adapted to almost any form of stress, although treadmill or bicycle exercise are most commonly employed. An advantage of bicycle stress echocardiography is the opportunity to image during exercise, rather than relying on postexercise recording. This contributes to enhanced sensitivity, although false-positive results may increase due to the difficulties of analyzing wall motion during strenuous exercise. Exercise echocardiography increases the diagnostic accuracy of stress testing in a manner similar to radionuclide perfusion imaging. It is particularly useful in the setting of an ambiguous stress electrocardiography (ECG) or when a false-negative or false-positive result is suspected. It has been successfully applied to patients following revascularization and yields useful prognostic data in a variety of clinical situations. Exercise echocardiography is being increasingly utilized as a safe and accurate test in patients with known or suspected coronary artery disease.
运动超声心动图是一种多功能的非侵入性诊断测试，它涉及在运动前、运动期间和运动后记录和解读二维超声心动图。通过分析和比较每个阶段的室壁运动，可以对冠状动脉疾病的存在与否做出预测。室壁运动异常的出现对于显著冠状动脉狭窄的存在既敏感又具有特异性。运动期间局部收缩功能的变化使临床医生能够区分梗死和缺血。因此，该测试可提供有关冠状动脉疾病的存在、范围、严重程度和位置的信息。超声心动图几乎可以适应任何形式的应激，不过最常采用的是跑步机或自行车运动。自行车运动负荷超声心动图的一个优点是有机会在运动期间成像，而不是依赖运动后的记录。这有助于提高敏感性，尽管由于剧烈运动期间分析室壁运动存在困难，假阳性结果可能会增加。运动超声心动图以与放射性核素灌注成像类似的方式提高了负荷试验的诊断准确性。它在负荷心电图（ECG）不明确的情况下或怀疑有假阴性或假阳性结果时特别有用。它已成功应用于血管重建术后的患者，并在各种临床情况下产生有用的预后数据。运动超声心动图正越来越多地被用作已知或疑似冠状动脉疾病患者的一种安全且准确的测试。
