Ensayos clínicos

Inclusion Criteria:

• Age 18+.
• Undergoing a clinically indicated stress echo, Capacity to consent.
• Prior diagnosis of the following:
• Coronary Artery Disease
  • Undergoing SE for one of the following indications:
    • For Assessment of chest pain or dyspnea;
    • For reassessment after an abnormal test or assessment of known CAD (previous acute coronary syndrome and/or previous myocardial revascularization, prior CAD by invasive or noninvasive coronary angiography);
    • For risk stratification prior to high risk non-cardiac vascular surgery (such as liver transplant or major non-cardiac vascular surgery) in patients with poor functional capacity (< 4 METS) and/or suspected cardiac symptoms, in presence of a revised cardiac risk index (Lee criteria)  ≥ 2 (high risk surgery;
    • CAD;
    • congestive heart failure;
    • cerebrovascular disease;
    • diabetes mellitus on insulin;
    • serum creatinine > 2mg/ml).
• Diastolic Heart Failure
  • Preserved EF;
  • Heart Failure score 1-5.
• Hypertrophic Cardiomyopathy
  • Phenocopies such as infiltrative/ storage disease (e.g., Fabry, amyloid) will be excluded.
• Post Chest Radio/Chemotherapy.
• Tetralogy of Fallot (TOF)
  • Repaired TOF, double-outlet right ventricle Fallot type, tetralogy of Fallot with pulmonary atresia;
  • At least 1 year post-surgical or percutaneous procedure
  • Height > 140 cm;
  • New York Heart Association class I or II.
• Mitral Regurgitation
  • Resting moderate mitral regurgitation (effective regurgitant orifice 0.2-0.39 cm^2, and regurgitant volume 30-59 ml) of ischemic origin.
• Valvular Heart Disease
  • Asymptomatic severe aortic stenosis;
  • Low-flow, low-gradient aortic stenosis with reduced ejection fraction;
  • Low-flow, low-gradient aortic stenosis with preserved ejection fraction;
  • Asymptomatic severe or symptomatic non-severe primary mitral insufficiency;
  • Asymptomatic severe or symptomatic non-severe aortic regurgitation;
  • Asymptomatic severe or symptomatic non-severe mitral stenosis;
  • Asymptomatic severe or symptomatic non-severe multivalvular disease;
  • Post heart valve procedures (prostheses and valvuloplasty).

Exclusion Criteria: 

• Under the age of 18.
• Unable to consent.