Key result
Stress echocardiography practice in 85 UK hospitals revealed that 37.6% of operators perform <100 procedures per year, and exercise and vasodilator SE are under-utilized.
Cross-Sectional (n=85)
Yes
A UK national survey reveals that while stress echocardiography is widely adopted, many operators perform fewer than the recommended annual volume, and modalities like exercise and vasodilator stress are underutilized.
Low operator volumes and modality underuse may affect stress echo reliability; leaves open effects on outcomes and training needs.
AIMS: Stress echocardiography (SE) is one of the leading modalities for the assessment of coronary artery disease and dynamic valvular heart disease. A wide range of different techniques have been established. There are no data which identify how current techniques have been integrated into clinical practice. METHODS AND RESULTS: An electronic questionnaire was devised to identify SE practice in five core areas: service demographics, indications, methods, reporting, and adverse events. The questionnaire was sent to 198 National Health Service hospitals. Eighty-five (71%) out of the 120 departments who perform SE responded. Each unit performed a median of 400 SE (inter-quartile range 175-600). Thirty-two (37.6%) operators performed <100 SE per year. Exercise, dobutamine, dipyridamole, adenosine, and pacing SE were available in 57 (67.1%), 85 (100%), 6 (7.1%), 11 (12.9%), and 34 (40%) units, respectively. Eighty-one (95.3%) units performed SE for the evaluation of low-flow, low-gradient aortic stenosis. Thirty-four (40%) and 32 (37.6%) performed SE for the evaluation of asymptomatic severe aortic stenosis and symptomatic moderate mitral regurgitation, respectively. Eighty-three (97.6%) administered contrast agents during SE. Additional analysis of perfusion and strain was performed in 9 (10.5%) and 13 (15.3%) units, respectively. CONCLUSION: SE has been incorporated into the majority of UK hospitals. A substantial proportion of operators perform less than the recommended number of procedures per year. The use of exercise SE, vasodilator SE, and SE for the evaluation of VHD are under-utilized. Penetration of new techniques is variable, contrast for left ventricular opacification has been almost universally adopted, while myocardial perfusion and mechanics are used much less.
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Bhattacharyya et al. (2013) conducted a cross-sectional in Stress echocardiography practice (n=85). Stress echocardiography was evaluated on Stress echocardiography practice patterns. Stress echocardiography practice in 85 UK hospitals revealed that 37.6% of operators perform <100 procedures per year, and exercise and vasodilator SE are under-utilized.
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