Stress-echocardiography has emerged as an important tool in cardiac functional imaging, thanks to its real-time imaging, high temporal resolution, high safety and very low cost. When stress-echocardiography is performed using ultrasound contrast media for endocardial border delineation in suboptimal cases, subjectivity is minimized, and with the use of coronary flow reserve measurements (left anterior descending coronary artery, stress/rest ratio reduced or normal, i.e. <>2.0) diagnostic sensitivity is increased.
The true competitor of any type of functional imaging, including stress-echocardiography, is nowadays coronary computed tomography angiography, which is a direct diagnostic method, the non-invasive assessment of coronary anatomy, and apparently the holy grail for any cardiologist. While the new 2019 Guidelines on chronic coronary syndrome of the European Society of Cardiology reflect the changing landscape of cardiac functional imaging in today’s clinical practice, they cannot clarify which type of test, functional or anatomic, should be first chosen in different clinical scenarios of suspected chronic coronary syndromes.
Therefore, we present a special issue regarding the prognostic value of stress-echocardiography and echocardiography in general, for the treatment of chronic coronary syndromes.
Prof. Nicola Gaibazzi
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