As dificuldades do Strain no Estresse.

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So, deformation stress echo appears feasible, is able to identify pathology with as good if not better sensitivity than traditional wall motion analysis, and does appear to offer additional prognostic information to that gained by wall motion assessment alone. However, stress echo by any method has a steep learning curve and significant experience is needed in order to maximize its sensitivity. Unfortunately, these new tools at present may not significantly reduce this as the advanced echo techniques themselves demand a degree of expertise. There is also the time factor to overcome, but some of the newer more automated techniques may help in both these regards. In addition, appropriate cut-off values for normality vs. different types of abnormality (ischaemia, viability, etc.) need to be defined from a detailed meta-analysis of the literature, as currently there are no clear definitions and each study has used their own values according to varying endpoints.

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