Suzuki Kengo, Hirano Yutaka, Yamada Hirotsugu, Murata Mitsushige, Daimon Masao, Takeuchi Masaaki, Seo Yoshihiro, Izumi Chisato, Akaishi Makoto
Division of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan.
Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.
J Echocardiogr. 2018 Sep;16(3):105-129. doi: 10.1007/s12574-018-0382-8. Epub 2018 Jun 6.
Exercise stress testing has been widely undertaken for the diagnosis of heart diseases. The accurate assessment of clinical conditions can be conducted by comparing the findings obtained from the results of stress echocardiography with the changes in the blood/heart rate and electrocardiograms. Numerous overseas studies have reported the utility of stress echocardiography in diagnosing myocardial ischemia; in Japan, the use of this modality for this purpose was included in the national health insurance reimbursable list in 2012. Nevertheless, stress echocardiography is far from being a widespread practice in Japan. This might be due to insufficient equipment (e.g., ergometers, space for test implementation) at each medical institution, shortage of technicians and sonographers who are well experienced and who are responsible for obtaining images during stress testing. The other possible reasons include the limited evidence available in Japan and the lack of a standardized testing protocol. Further dissemination of the practice of exercise stress echocardiography in this country is deemed necessary to establish satisfactory evidence for the use of stress echocardiography in the Japanese population. To this end, efforts are underway to develop a standardized protocol and report format to be adopted throughout Japan. We here present a guideline created by the Guideline Development Committee of the Japanese Society of Echocardiography that describes safe and effective stress echocardiography protocols and report formats. The readers are encouraged to perform exercise stress echocardiography using the proposed template for consensus document and report attached to this guideline.
运动负荷试验已被广泛用于心脏病的诊断。通过将负荷超声心动图检查结果与心率、血压及心电图变化进行比较，可以准确评估临床状况。许多国外研究报告了负荷超声心动图在诊断心肌缺血方面的应用价值；在日本，该检查方法于2012年被纳入国家健康保险报销目录。然而，负荷超声心动图在日本远未得到广泛应用。这可能是由于各医疗机构设备不足（如测力计、检查实施空间），缺乏经验丰富且负责在负荷试验期间获取图像的技术人员和超声心动图检查人员。其他可能的原因包括日本可用的证据有限以及缺乏标准化的检查方案。为了在日本人群中为负荷超声心动图的应用建立充分的证据，有必要在该国进一步推广运动负荷超声心动图检查。为此，正在努力制定一项在全日本采用的标准化方案和报告格式。我们在此展示由日本超声心动图学会指南制定委员会创建的指南，该指南描述了安全有效的负荷超声心动图检查方案和报告格式。鼓励读者使用本指南所附的共识文件和报告的建议模板进行运动负荷超声心动图检查。
