https://doi.org/10.1093%2Feurheartjsupp%2Fsuad008
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stress-induced regional wall motion abnormality (RWMA) is recommended with a class 1 indication for the diagnosis of chronic coronary syndromes in the guidelines of the European Society of Cardiology
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However, SE based on RWMA applied in contemporary populations with suspected coronary artery disease showed two major limitations: (1) a decrease in positivity rate (<10% compared with >60% in 1990s) probably due to the current dominant policy of stress testing under full anti-ischemic therapy in patients with atypical symptoms and multiple comorbidities; and (2) the declining prognostic value of the negative test for RWMA when only hard endpoints are considered, likely due to more extensive coronary revascularization.
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Nevertheless, myocardial ischemia assessment (evaluating RWMA alone with SE) is no longer enough for a comprehensive diagnosis and risk stratification in contemporary patients.
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A solução é complicar o exame? O futuro é limitar o número de ecocardiografistas capazes de realizar todos os passos?
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Quantos pacientes serão excluídos por problemas técnicos no mundo real?
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Não há futuro para o Ecoestresse no formato proposto.