Figure 1: Apical 4 chamber (top panels) and 2 chamber (bottom panels) of rest (left panels) and stress (right panels) comparison images.
(High Quality Version 0.6MB WMV)


Figure 2: Example of Mitral valve inflow for evaluation of Left ventricular filling pressures for rest (left panel) and stress (right panel).

The Cardiovascular Imaging Research Group has made significant contributions to the evidence base that supports the role of stress echocardiography as a valuable tool in the diagnosis and prognostication of patients with ischemic heart disease and heart failure. Our main interests in this field currently relate to quantification and application to non-coronary heart disease.

The analysis of stress echocardiograms (Figure 1) is currently qualitative, causing limited reproducibility between observers and mandating a learning curve.  Our group has a significant commitment to quantitation of resting and peak stress images, and the most effective approach to date has been the assessment of myocardial deformation during stress (see strain). These quantitative approaches may improve the detection of myocardial viability and peri-infarct ischaemia.

The non-coronary applications include the assessment of contractile reserve in regurgitant valve lesions, and the evaluation of LV filling pressure with stress. The “diastolic stress test” validated by our group against invasive pressures  may improve the attribution of exertional dyspnea to diastolic dysfunction rather than other myriad causes of dyspnea, Figure 2.

Personnel

• Rodel Leano (sonographer)
• Carly Jenkins (sonographer)
• Malcolm Burgess (Postdoctoral scholar)
• Professor Tom Marwick