Comparison of exercise echocardiography with myocardial perfusion scintigraphy for the diagnosis of coronary artery disease

The rationale of exercise echocardiography for the diagnosis of coronary artery disease is based on the detection of exercise-induced wall motion abnormalities by ultrasound. Some of the problems that had previously limited the widespread application of the test have been solved by the development of digital recording and side by side cine loop display of two-dimensional echocardiograms: thus, respiratory artifacts can be eliminated, the examination is faster, and the comparison between rest and stress images has become practical and reliable improving sensitivity. The sensitivity and specificity of exercise echocardiography vary from 70 to 100%, according to patient selection, the protocol, and the gold standard used. Few studies studied the value of exercise echocardiography as compared to the more established nuclear cardiology imaging. Data from these comparative evaluations show a strong correlation between the two techniques for identifying and localizing myocardial ischemia. With good equipment and after proper training, exercise echocardiography can provide both diagnostic and prognostic information for routine clinical care.