Exercise two-dimensional echocardiography: a technique for improving ultrasound images during exercise stress.

A system of exercise stress echocardiography was developed in which, during exercise on a bicycle ergometer in a semirecumbent position, the echocardiographic transducer is held by a special device which maintains a relatively constant position between the transducer and the heart. The system was evaluated in 21 healthy subjects and technically satisfactory studies were obtained in 20. In these, the resolution and relative position of the cardiac image remained stable throughout exercise. Blood pressure and heart rate increased appropriately with our protocol with supine exercise; 95% of the subjects reached 90% of their predicted maximum heart rate for age. Ejection fraction measured by echocardiography increased from 54 +/- 1% to 70 +/- 1%. It is concluded that the use of our transducer-holding device in subjects performing exercise in the supine position significantly improves ultrasonic image quality and should enhance the clinical usefulness of exercise stress echocardiography.