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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EStress echocardiography better defined the probability of coronary artery disease than exercise treadmill testing in a retrospective review. Adding speckle tissue tracking to stress echocardiography appears to improve the evaluation of the myocardium; in patients with cardiac resynchronization therapy it provides more information about left ventricular synchrony and performance, and atrioventricular timing.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Estress echocardiography\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EECHO\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eexercise stress electrocardiography\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary artery disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary angiography\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elongitudinal strain\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eautomated function imaging\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eleft ventricular hypertrophy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eimaging modalities\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EStress echocardiography (ECHO) has a slightly higher specificity compared with stress nuclear testing and stress electrocardiography (ECG), according to Hossam El-Gendi, MD, Essex Cardiothoracic Centre, Essex, United Kingdom. A retrospective review that he conducted of 1000 patients showed that stress ECHO better defined the probability of coronary artery disease than exercise treadmill testing [Hopkinson SA, El-Gendi H. 2012].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EExercise ECG is no longer performed in the United Kingdom because it is seen as more harmful than beneficial, he stated. Exercise ECG compared with coronary angiography had a wide variability in its mean sensitivity (68%; range, 23 to 100) and mean specificity (77%; range, 17 to 100) in a meta-analysis of 147 consecutive studies with 24 074 patients conducted in the late 1980s.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EStress ECHO is limited to wall motion analysis, which captures only 30% of myocardial function, but determining the rate of strain between 2 points in the myocardium provides complementary data to determine the overall myocardial function. Longitudinal strain is an effective tool to evaluate the true systolic function of patients, for example in hypertrophic cardiomyopathy, which is characterized by a normal ejection fraction and decreased (by \u2264 20%) global longitudinal strain. Prof El-Gendi stated that speckle tissue tracking is reproducible, has less intraobserver and interobserver variability, and is a useful approach to judge ventricular function and rate of strain.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAutomated function imaging, based on 2D strain technology, has been documented to quantify myocardial motion and deformation under rest conditions and is the subject of global collaborative research to determine its best use to enhance clinical decision making. Automated function imaging provides a rapid, reproducible, quantitative tool for the assessment of segmental and global wall motion, said Prof El-Gendi.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EFurthermore, using speckle tissue tracking with stress ECHO is simple and can be used in daily practice to answer common clinical questions, stated Prof El-Gendi. In patients with cardiac resynchronization therapy, it provides more information about left ventricular synchrony and performance, and atrioventricular timing, to better manage hemodynamics in patients with heart failure. It can be used to assess coronary arteries, ischemia in the left anterior descending artery and inferior of the myocardium, left ventricular hypertrophy (LVH), hypertrophic obstructive cardiomyopathy, nonischemic cardiomyopathy, and cardiac amyloid. The strain presentation in LVH is characterized by a decrease in the basal strain segments, normal apical segments, and a strain bulls-eye \u201cdonut.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EStress ECHO with speckle tissue tracking is an emerging tool that should be used in clinical practice to master it, urged Prof El-Gendi, because it has opened the window to evaluate the myocardium from the inside to the outside.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/16\/13.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlk2q\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}