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Stress echocardiography as a tool for diagnosing atherosclerotic changes in the coronary arteries in patients with stable coronary heart disease

https://doi.org/10.52727/2078-256X-2025-21-3-289-295

Abstract

Evaluation of the capabilities of stress echocardiography (stress EchoCG) in predicting the presence of hemodynamically significant coronary artery stenoses.
Materials and methods. The study included 1529 people with stable coronary heart disease (CHD). All patients underwent stress echocardiography with pharmacological (dobutamine) or physical (bicycle ergometer (BEM), treadmill) load to assess the condition of the myocardium, before the study, each patient had their blood pressure measured to determine the presence of hypertension. Some patients – 1212 (79.27 %) underwent coronary angiography.
Results. Arterial hypertension of varying degrees was detected in 53.83 % of the examined patients. According to the results of stress echocardiography, 996 (65.17 %) patients had a positive test (no increase in contractility), coronary artery stenosis of more than 50% was detected in 530 (53.21 %) of them. The majority also had diastolic dysfunction of the left ventricle (98.41 %). Normal diastolic function was detected in 1.59 % of the examined patients, only twelve of them underwent coronary angiography, according to the results of which stenosis of the anterior interventricular branch was detected. The accuracy of the method was 92.72 %, sensitivity – 93.81 %, specificity – 72.02 %.
Conclusions. Stress echocardiography has demonstrated a fairly high level of accuracy, sensitivity and specificity, which indicates the need to perform this procedure in all patients with suspected coronary heart disease with an average and high pre-test probability in order to reduce the number of coronary angiographic studies.

About the Authors

O. V. Surnina
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic; Izhevsk State Medical Academy
Russian Federation

Olga V. Surnina, doctor of medical sciences, аssociate зrofessor of the department of topographic anatomy and operative surgery, ultrasound diagnostic doctor, head of ultrasound diagnostic department

17, Truda st., Izhevsk, 426067

281, Kommunarov st., Izhevsk, 426034



I. A. Ponomareva
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Inga A. Ponomareva, ultrasound diagnostic doctor

17, Truda st., Izhevsk, 426067



D. S. Zaitsev
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Dmitry S. Zaitsev, ultrasound diagnostic doctor

17, Truda st., Izhevsk, 426067



M. Yu. Smetanin
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Mikhail Yu. Smetanin, candidate of medical sciences, ultrasound diagnostic doctor

17, Truda st., Izhevsk, 426067



M. S. Sosnovskikh
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Maksim S. Sosnovskikh, functional diagnostic doctor

17, Truda st., Izhevsk, 426067



I. E. Lamonova
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Irina E. Lamonova, functional diagnostic doctor

17, Truda st., Izhevsk, 426067



A. M. Sedelnikov
The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic
Russian Federation

Aleksandr M. Sedelnikov, functional diagnostic doctor

17, Truda st., Izhevsk, 426067



Yu. D. Efremova
Izhevsk State Medical Academy
Russian Federation

Yulia D. Efremova, student of the faculty of general medicine

281, Kommunarov st., Izhevsk, 426034



D. R. Osipov
Izhevsk State Medical Academy
Russian Federation

Daniil R. Osipov, student of the faculty of general medicine

281, Kommunarov st., Izhevsk, 426034



References

1. Kalandarov D.M. Modern possibilities of stress echocardiography in examination of patients with ischemic heart disease. Economy and Society, 2021; 6: 78–96. (In Russ.). doi: 10.18087/cardio.2019.3.10244

2. Donal E., Panis V., Kosmala W. Exercise stress echocardiography: a great tool that can be adapted to the clinical question? Open Heart, 2021; 8 (1): 1–2. doi: 10.1136/openhrt-2021-001641

3. Ivanov S.I., Alekhin M.N. Practical application of non-invasive left ventricular functional parameters in diagnosis of stable coronary artery disease. Russian Journal of Cardiology and Cardiovascular Surgery, 2023; 16 (1): 12–16. (In Russ.). doi: 10.17116/kardio20231601112

4. Cotrim C.A., Café H., João I., Cotrim N., Guardado J., Cordeiro P., Cotrim H., Baquero L. Exercise stress echocardiography: Where are we now? World J. Cardiol., 2022; 14 (2): 64–82. doi: 10.4330/wjc.v14.i2.64

5. Elkanova M.M., Shitov V.N., Botvina U.V., Lopukhova V.V., Saidova M.A., Karpov Yu.A. Stress echocardiography in the assessment of long-term outcomes after percutaneous coronary intervention in patients with stable coronary heart disease. Cardiology, 2017; 57 (7): 13–19. (In Russ.). doi: 10.18087/cardio.2017.7.10001

6. Hirasawa K., Izumo M., Akashi Y.J. Stress echocardiography in valvular heart disease. Front. Cardiovasc. Med., 2023; 10: 1233924. doi: 10.3389/fcvm.2023.1233924

7. Clinical practice guidelines “Stable coronary artery disease”. Available at: https://russjcardiol.elpub.ru/jour/article/view/6110 (In Russ.).

8. Dong L., Liu J., Qin Y., Yang W.J., Nie L., Liu H.N., Hu Q.H., Sun Y., Cao W.Y. Relationship between ambulatory arterial stiffness index and the severity of angiographic atherosclerosis in patients with H-type hypertension and coronary artery disease. Clin. Exp. Hypertens., 2023; 45 (1): 2228517. doi: 10.1080/10641963.2023.2228517

9. Clinical practice guidelines “Stress echocardiography: the agreed opinion of the EEA experts”. Available at: https://scardio.ru/content/Guidelines/stress_aeho_2013.pdf (In Russ.).

10. Ovchinnikov A.G., Ageev F.T., Alekhin M.N., Belenkov Yu.N., Vasyuk Yu.A., Galyavich A.S., Gilyarevskiy S.R., Lopatin Yu.M., Mareev V.Yu., Mareev Yu.V., Mitkov V.V., Potekhina A.V., Prostakova T.S., Rybakova M.K., Saidova M.A., Khadzegova A.B., Chernov M.Yu., Yuschuk E.N., Boytsov S.A. The role of diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation. Expert consensus developed under the auspices of the National Medical Research Center of Cardiology, Society of Experts in Heart Failure (SEHF), and Russian Association of Experts in Ultrasound Diagnosis in Medicine (REUDM). Cardiology, 2020; 60 (12): 48–63. (In Russ.). doi: 10.18087/cardio.2020.12.n1219

11. Galderisi M. Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects. Cardiovasc. Ultrasound, 2005; 3: 9. doi: 10.1186/1476-7120-3-9

12. Ovchinnikov A.G., Potekhina A.V., Ozhereljeva M.V., Ageev F.T. Left ventricular dysfunction in hypertensive heart: Current view of the pathogenesis and treatment. Cardiology, 2017; 57 (S2): 367–382. (In Russ.). doi: 10.18087/cardio.2393

13. Dehghani P., Culig J., Patel D., Kraushaar G., Schulte P. Arteriovenous fistula as a complication of transradial coronary angiography: a case report. J. Med. Case Reports, 2013; 7 (21): 1–4. doi: 10.1186/1752-1947-7-21

14. Sitko I.G., Bazanov I.S., Molokhoev E.B., Rudenko B.A., Lokshina M.V., Zakaryan N.V., Ardashev V.N. Complications in places of percutaneous coronary interventions: comparison of manual compression and clip application devices to achieve hemostasis. Clinical Medicine, 2020; 98 (5): 349–355. (In Russ.). doi: 10.30629/0023-2149-2020-98-5-349-355


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For citations:


Surnina O.V., Ponomareva I.A., Zaitsev D.S., Smetanin M.Yu., Sosnovskikh M.S., Lamonova I.E., Sedelnikov A.M., Efremova Yu.D., Osipov D.R. Stress echocardiography as a tool for diagnosing atherosclerotic changes in the coronary arteries in patients with stable coronary heart disease. Ateroscleroz. 2025;21(3):289-295. (In Russ.) https://doi.org/10.52727/2078-256X-2025-21-3-289-295

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ISSN 2078-256X (Print)
ISSN 2949-3633 (Online)