Diagnostic value of stress echocardiography with exercise on a horizontal bicycle ergometer in patients with low-risk non-ST segment elevation acute coronary syndrome in a South American cohort.

Objective. To evaluate the diagnostic accuracy of exercise stress echocardiography(EchoCG) on a horizontal bicycle ergometer for the detection of obstructive coronary heart disease(oCAD) in patients with low-risk non-ST-segment elevation acute coronary syndrome(NSTEACS). Material and methods. The study included 95 patients, mean age 53 years, 58% of men hospitalized in the department of the regional vascular center with a diagnosis of NSTE-ACS were at low risk. Patients with known coronary heart disease and impaired left ventricular contractility at rest were not included. They underwent stress echocardiography on a horizontal bicycle ergometer according to standard methods of conduct and interpretation, and invasive or non-invasive coronary angiography(CAG). All values of coronary obstruction ≥70% were verified by invasive coronary angiography. The assessment of myocardial revascularization was observational in nature. Results. The result of stress echocardiography according to the criterion of impaired local contractility(ILC) was positive in 16%, negative in 28%, incomplete symptom-limited in 35% patients. Coronary artery stenosis ≥50%/≥70% was detected in 78/78% of cases in the subgroup with a positive result, in 29/11% with a negative result, 30/10% with a non-diagnostic result. The association of NLS with stenosis ≥70% was higher odds ratio 30.1vs8.5 for stenoses ≥50%. Conclusion Stress echocardiography with exercise on a horizontal bicycle ergometer in patients with low-risk NSTE-ACS is safe and feasible. The method has moderate sensitivity and high specificity and overall accuracy for identifying anatomically significant coronary artery stenoses.