Stress echo in Italy: state-of-the-art 2015
Stress echocardiography is now recognized by guidelines as an efficient and cost-effective option for diagnosis and risk stratification in ischemic heart disease,1,2 with emerging applications that go beyond coronary artery disease (CAD), including valvular, cardiomyopathy, and congenital heart disease.3,4 The real patterns of practice vary widely across nations because of differences in culture, tradition, reimbursement model, drug cost, commercial availability, training opportunities, and cardiology core curriculum.5–7 A description of stress echocardiography practice may provide insight into the quality of the stress echocardiography infrastructure across the country and is also a prerequisite for any cultural and/or scientific intervention aimed at modifying and improving it, if deemed necessary. Recently, the stress echocardiography 2020 study was launched, with the aim of validating and disseminating stress echocardiography applications within ischemic heart disease above regional wall motion and beyond CAD.8
Prior to starting stress echocardiography 2020, the Italian Society of Cardiovascular Echography (SIEC) thought it appropriate to have an accurate characterization of the actual stress echocardiography situation in the country in 2015. This was achieved via an electronic survey based on a simple structured questionnaire circulated among Italian echocardiography laboratories. The primary aim of the study was to describe the routine everyday practice of stress echocardiography in Italy in 2015. The secondary aim was to identify active centers potentially interested in joining stress echocardiography 2020.