Arq Bras Cardiol: Imagem cardiovasc. 2024; 37(3): e20240042
My Approach to Semi-Supine Bicycle Stress Echocardiography: Is It the Best Modality for Brazil?
DOI: 10.36660/abcimg.20240042i
Introduction
Physical stress echocardiography is a firmly established method in the diagnosis and prognosis of coronary artery disease.– Compared to pharmacological stress echocardiography, it is physiological, does not depend on venoclysis, and is free of side effects. Physical exercise preserves the normal electromechanical response and provides valuable prognostic information about a patient’s functional status. Therefore, physical stress is the test of choice for assessment of myocardial ischemia in patients who are capable of exercise. The main differences between methods are displayed in .
The most frequently used tools for this method are treadmill and cycle ergometer (ergometric bicycle or semi-supine bicycle). Echocardiography performed during physical exertion on a bicycle offers an advantage in relation to a treadmill, because it is possible to obtain images in real time, rather than after exercise. Continuous monitoring of myocardial contractility makes it possible to define the exact moment, that is, at which heart rate the change occurs in patients with a positive test. If this alteration occurs at low heart rates or low double product, the presence of severe coronary stenosis or multivessel disease is inferred, thus providing valuable prognostic information. A semi-supine bicycle offers advantages in relation to a supine bicycle due to its structure, which consists of coupling a cycle ergometer system to a hospital bed, where the patient can lie or sit to pedal while the doctor acquires the images.
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Keywords: Coronary Artery Disease; Echocardiography; Exercise
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