EUGENIO PICANO STRESS ECHOCARDIOGRAPHY PDF

Editorial Reviews. Review. From reviews of the previous editions: “Dr. Picano, one of the Buy Stress Echocardiography: Read 1 Books Reviews – Amazon. com. The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol. Eugenio Picano, corresponding author. Eugenio Picano, corresponding author 1 Sabrina .. Picano E. Stress echocardiography: from pathophysiological toy to diagnostic tool. Point of.

Author: Akishakar Mugrel
Country: Burkina Faso
Language: English (Spanish)
Genre: Relationship
Published (Last): 21 May 2009
Pages: 293
PDF File Size: 8.30 Mb
ePub File Size: 16.30 Mb
ISBN: 232-5-39862-321-3
Downloads: 92700
Price: Free* [*Free Regsitration Required]
Uploader: Gunris

The prognostic value of pharmacologic stress echo is affected by concomitant anti-ischemic therapy at the time of testing.

Stress Echocardiography

Conclusion When state-of-the art protocols are considered, dipyridamole and dobutamine stress echo have similar accuracy, specificity and — most importantly — sensitivity for detection of CAD. Quality control of regional wall motion analysis in stress Echo Conclusion Stress echo is changing.

Dipyridamole in myocardial ischemia: One ton of CO 2 emissions costs 50 US dollars in indirect costs, including contribution to climate change and ozone layer destruction. Regarding image quality degradation during stress, only 2 studies — both not included in the present metaanalysis since the high dipyridamole dose without atropine was used — addressed semi-quantitatively [ 23 ] or qualitatively [ 21 ] the issue of image degradation during stress.

Juni et al showed that studies should not be excluded based on composite quality scores because many quality scales are more closely related to reporting quality than to the internal validity of the studies [ 52 ].

From pathophysiologic toy to diagnostic tool.

The limited value of RWMA outside CAD The population of patients arriving to the SE lab is changing, with a greater percentage of patients with HF, valvular heart disease, adult congenital heart disease, pulmonary hypertension, extreme physiology [ 33 ].

SE and the road to sustainability The prescription of a single individual cardiac stress imaging test has a large economic, environmental and public health impact since around 10 million stress cardiac imaging test are performed each year in USA only.

  ALVISE VIDOLIN PDF

In terms of population burden, the almost 8 million stress myocardial scintigraphy scans per year in the USA translate into a population risk of about 8 thousand new cancers in the lifetime [ 18 ], which represent also an extra-cost of around 50, US dollars per cancer [ 17 ].

The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: The predictive value of the test depends upon the prevalence of the disease in the population under study.

It is therefore not only important the value, but also the cost and the risk of what we are doing in the cardiac imaging lab. Notes Ethics approval and consent to participate Not applicable. A specific and challenging aspect for SE is the diagnosis of diastolic dysfunction. Italy and Finland totalling patients with coronary angiography for evaluation of diagnostic accuracy [ 31 – 35 ]. Journal List Cardiovasc Ultrasound v. RWMA are linked to stress-induced subendocardial hypoperfusion, usually caused by a critical reduction in coronary flow reserve due to an anatomically and physiologically significant epicardial artery stenosis [ 1 ].

The difference further widens if we include – as we should – indirect costs due to environmental impact on planet and long-tem costs due to cancer [ ehgenio ]. American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography.

The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol

As a versatile smart-phone with multiple applications, stress echo today uses many signs for different pathophysiological and clinical targets. All these studies concluded that dipyridamole has a higher specificity than dobutamine, with a trend to lower sensitivity in less severe forms of single vessel disease. A gatekeeper for the gatekeeper: The considered items are: Background Utilization trends of stress echo Stress echocardiography SE is since decades an established technique for coronary artery disease CAD detection and risk stratification [ 1 ], with a recognized position in expert recommendations of scientific societies [ 23 ] and general cardiology guidelines [ 45 ].

  CONVERTIR PKT A PDF

Coronary flow reserve in stress-echo lab. The intermediate risk associated with a negative test for RWMA The risk associated with a negative test is intermediate, not low, and significantly higher than that associated with the negativity of a myocardial perfusion stress test.

Stress Echocardiography : Eugenio Picano :

The ABCD protocol in diastolic stress echocardiography A specific and challenging aspect for SE is the diagnosis of diastolic dysfunction. Please review our privacy policy. When state-of-the art protocols are considered, dipyridamole and dobutamine stress echo have similar accuracy, specificity and — most importantly — sensitivity for detection of CAD. Meta-analysis, editorials, letters have been excluded.

Today, stress echo shows increasing piacno of utilization due to growing concerns for radiation risk, higher cost and stronger environmental impact of competing techniques. Utilization trends of stress echo. Accuracy values for individual studies and cumulative analysis. The main interest in CFVR is therefore for risk stratification. Received May 30; Accepted Jun When true ischemia and regional wall motion abnormalities are the diagnostic end-point, we need high dipyridamole doses 0.

The utilization trends of stress echo compared eugennio myocardial stress scintigraphy in Australia, years — redrawn from Fonseca et al. Pathophysiology RWMA are linked to stress-induced subendocardial hypoperfusion, usually caused by a critical reduction in coronary flow reserve due to an anatomically and physiologically significant epicardial artery stenosis [ 1 ].

Author: admin