%0 Journal Article
%T Stress echocardiography in heart failure
%A Eustachio Agricola
%A Michele Oppizzi
%A Matteo Pisani
%A Alberto Margonato
%J Cardiovascular Ultrasound
%D 2004
%I BioMed Central
%R 10.1186/1476-7120-2-11
%X The identification of viable hibernating myocardium in patients with coronary artery disease and chronic left ventricular (LV) dysfunction is, up to today, the most common use of stress echocardiography in patients with heart failure. However, to search viable myocardium or the presence of contractile reserve is only one of plugs of the physiopathologic puzzle in a failing heart (Figure 1 and 2). If we consider the ability of echocardiography to provide valuable haemodynamic information accurately and non-invasively, it is ideally suited for application during stress testing to objectively assess other physiopathologic components of heart failure. These include the study of exercise physiology, the presence and the behaviour of concomitant mitral regurgitation (MR), the prediction of response to resynchronization therapy etc.Therefore, the present review will detail some important potential applications of stress echocardiography in patients with heart failure in the evaluation of the different clinical and physiopathologic aspects of heart failure syndrome.The most common cause of heart failure in the Western world is coronary artery disease, accounting for up to 60% of cases [1]. In patients with coronary artery disease and chronic LV dysfunction, it is crucial to distinguish between viable and fibrotic tissue to make adequate clinical decisions. Noncontractile but viable myocardium may correspond to different states that are important but difficult to distinguish, i.e., ischemia, stunning, nontransmural infarction, or hibernation and in individual patients these pictures may coexist [2].After brief episodes of coronary occlusion and reflow a reversible global LV dysfunction can occur. This phenomenon was called myocardial stunning [3]. It is characterized as prolonged mechanical dysfunction after coronary reflow despite resumption of normal perfusion and lack of permanent tissue damage. Stunning seems to result from alterations in contractile proteins in response
%K stress echocardiography
%K heart failure
%K diastolic dysfunction
%K mitral regurgitation
%U http://www.cardiovascularultrasound.com/content/2/1/11