Non-invasive diagnostic and prognostic assessment of single-vessel coronary artery disease: Focus on stress echocardiography

Abstract

Aims: Revascularization procedures are increasingly applied in patients with single-vessel coronary artery disease in spite of the fact that a prognostic benefit has been proved only for soft end-points. This review summarizes the results of stress echocardiography in the diagnostic and prognostic assessment of these patients. Methods and Results: The diagnostic and prognostic assessment of patients with single-vessel disease using stress (exercise, dobutamine, adenosine and dipyridamole) echocardiography are focused upon in the light of pathophysiological considerations and the results of clinical studies. Factors affecting test accuracy are individually addressed and comparisons made with different stress testing modalities, including exercise electrocardiography and nuclear techniques. Finally, therapeutic options are discussed and the superior accuracy of the physiological assessment of coronary stenosis as compared to the simple anatomic evaluation emphasized. Conclusions: Patients with single-vessel disease represent an anatomically heterogeneous group. Although the sub-optimal performance of any technique in their evaluation has to be acknowledge, stress echocardiography can effectively contribute to selection of the management strategy.