Stress echocardiography as a tool for diagnosing atherosclerotic changes in the coronary arteries in patients with stable coronary heart disease

Evaluation of the capabilities of stress echocardiography (stress EchoCG) in predicting the presence of hemodynamically significant coronary artery stenoses. Materials and methods . The study included 1529 people with stable coronary heart disease (CHD). All patients underwent stress echocardiography with pharmacological (dobutamine) or physical (bicycle ergometer (BEM), treadmill) load to assess the condition of the myocardium, before the study, each patient had their blood pressure measured to determine the presence of hypertension. Some patients – 1212 (79.27 %) underwent coronary angiography. Results . Arterial hypertension of varying degrees was detected in 53.83 % of the examined patients. According to the results of stress echocardiography, 996 (65.17 %) patients had a positive test (no increase in contractility), coronary artery stenosis of more than 50% was detected in 530 (53.21 %) of them. The majority also had diastolic dysfunction of the left ventricle (98.41 %). Normal diastolic function was detected in 1.59 % of the examined patients, only twelve of them underwent coronary angiography, according to the results of which stenosis of the anterior interventricular branch was detected. The accuracy of the method was 92.72 %, sensitivity – 93.81 %, specificity – 72.02 %. Conclusions . Stress echocardiography has demonstrated a fairly high level of accuracy, sensitivity and specificity, which indicates the need to perform this procedure in all patients with suspected coronary heart disease with an average and high pre-test probability in order to reduce the number of coronary angiographic studies.