Schartl M, Beckmann S, Bocksch W
Abteilung für Kardiologie und Pulmologie, Universitätsklinikums Rudolf Virchow, Standort Charlottenburg, Freien Universität Berlin.
Z Kardiol. 1994 Aug;83(8):531-47.
Exercise echocardiography, a versatile, noninvasive diagnostic test of left ventricular wall motion performed at rest and under induced stress, enables the cardiologist to detect and assess coronary artery disease. Stress-induced ischemia is thereby expressed as left ventricular regional wall motion abnormality. By using various physical (bicycle or treadmill exercise) and pharmacological (dipyridamole, dobutamine, adenosine) stress inducers, the test provides information about the localization and extent of coronary artery disease in addition to detecting stress-induced coronary insufficiency. As regards diagnostic accuracy in detecting coronary artery disease, stress echocardiography is superior to exercise electrocardiography and, according to the available data, it is comparable to perfusion scintigraphic testing. Studies have demonstrated the clinical value of stress echocardiography in detecting residual stenosis after angioplasty, for diagnosing bypass dysfunction after heart surgery, for preoperative risk assessment in noncardiac surgeries, and for obtaining prognostic information, e.g., after myocardial infarction. Preliminary studies have shown that pharmacological exercise echocardiography is able to identify viable myocardium in the early phases after acute myocardial infarction. Furthermore, it is able to predict the functional success of revascularization in chronic regional left ventricular dysfunction. In addition to the wide range of diagnostic possibilities in coronary artery disease, other notable applications include stress testing for assessment of global left ventricular pump function in patients with aortic regurgitation or cardiomyopathy.
运动超声心动图是一种在静息状态和诱发应激状态下对左心室壁运动进行的多功能、非侵入性诊断测试，能使心脏病专家检测和评估冠状动脉疾病。应激诱发的缺血表现为左心室局部壁运动异常。通过使用各种物理（自行车或跑步机运动）和药物（双嘧达莫、多巴酚丁胺、腺苷）应激诱导剂，该测试除了能检测应激诱发的冠状动脉供血不足外，还能提供有关冠状动脉疾病的定位和范围的信息。就检测冠状动脉疾病的诊断准确性而言，应激超声心动图优于运动心电图，并且根据现有数据，它与灌注闪烁扫描测试相当。研究已经证明了应激超声心动图在检测血管成形术后残余狭窄、诊断心脏手术后旁路功能障碍、非心脏手术术前风险评估以及获取预后信息（例如心肌梗死后）方面的临床价值。初步研究表明，药物运动超声心动图能够在急性心肌梗死后的早期阶段识别存活心肌。此外，它能够预测慢性局部左心室功能障碍患者血管重建的功能成功率。除了在冠状动脉疾病中广泛的诊断可能性外，其他显著应用还包括对主动脉瓣反流或心肌病患者进行应激测试以评估整体左心室泵功能。
