Ecocardiograma de estrés

Contreras, Eduardo; Zuluaga, Sandra Ximena; Sánchez, Jairo

doi:10.1016/S0120-3347(08)62004-3

Información del artículo

Resumen

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RESUMEN

Objetivo.

El objetivo del presente trabajo se dirige a revisar las indicaciones, protocolos y aplicaciones del ecocardiograma de estrés.

Materiales y métodos.

Con las palabras clave "ecocardiograma de estrés", "ecocardiograma de esfuerzo" y "prueba de estres farmacológico" se hizo una búsqueda de información en la bases de datos de Pubmed/Medline, Cochrane, SciELO, y en referencias de artículos de revistas y textos, principalmente de los últimos cinco años en inglés y en español. El resultado de esta búsqueda arrojó 203 referencias, de las cuales se tomaron las 46 más relevantes, teniendo en cuentra principalmente metanálisis, artículos de revision, actualizaciones, estudios aleatorios doble ciego y guías clínicas.

Resultados

Los datos obtenidos de la función ventricular regional o global en el pico máximo de ejercicio son factores predictores importantes de eventos cardíacos, además de las variables clínicas, en el seguimiento de los pacientes. Un puntaje de motilidad parietal de esfuerzo mayor de 1,4 o una fracción de eyección de esfuerzo menor de 50%, implican un pronóstico significativamente adverso. Por otra parte, los indicadores de viabilidad miocárdica, mediante el estímulo farmacológico del miocardio, predicen la recuperación de la función cardiaca luego de los procedimientos de revascularización.

Conclusión.

El ecocardiograma de estrés es una técnica complementaria, útil para el diagnóstico y pronóstico del paciente con enfermedad coronaria. El fundamento de su uso consiste en que, al desencadenar isquemia, se produce una alteración de la motilidad parietal distal a la lesión coronaria obstructiva. Además, puede emplearse para evaluar la gravedad de una valvulopatía y para establecer el diagnóstico de la hipertensión pulmonar oculta.

Key words:

stress echocardiogram

effort echocardiogram

pharmachologyc stress test

Palabras clave:

ecocardiograma de estrés

ecocardiograma de esfuerzo

prueba de estrés farmacológico

SUMMARY

Objective

the objective of this Project is to review the indications, protocols and applications of the stress echocardiogram

Methods and materials

research on the following words was done in the PUBMED/Medline, Cochrane, SciELO databases, as well as in references in journal articles and texts mainly from texts from the last five years in English and in Spanish: stress echocardiogram, effort echocardiogram and pharmacological stress test. The result of this search returned 203 references, 46 of which were taken as the most relevant, taking into consideration mainly, meth analysis, revision articles, state of the art, random studies, DOBLE CIEGO, and clinical guides.

Results

The data obtained from the regional ventricular function in the maximum peak of exercise, are important predictors of cardiac events; this, in addition to all of the clinical variables during patient follow up. A score of parietal motility, higher than 1.4, or a ejection fraction lower than 50%, imply a significant adverse forecast. On the other hand, the myocardial an viability indicators, through the pharmacologic stimulus of the myocardium, predict the recovery of the cardiac function after revascularization procedures.

Conclusion

The stress echocardiogram (ECO) is a complementary technique, useful for the diagnose and forecast fo patients with coronary disease. The principles of its use consist on the basics that upon the creation of ischemia, an alteration in the distal parietal motility will be produced to the obstructive coronary injury. Furthermore, it can be used to evaluate the severity of a vulvopathy and to establish the diagnose of the hidden pulmonary hypertension.

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