Myocardial work and left ventricular contractile reserve during stress echocardiography: An angiographic validation

Objective: This study sought to determine the contractile reserve (CR) response to exercise stress echocardiography (ESE) quantified by the novel parameter, non‐invasive myocardial work (MW), in subjects with angiographically proven coronary artery disease (CAD). Methods: CR was measured by the relative change in ejection fraction (EF), global longitudinal strain (GLS) and MW indices from rest to peak exercise in 304 patients referred for clinically indicated ESE. Positive ESE patients proceeded to coronary angiography and further risk stratified based on either percutaneous or surgical intervention. Results: CRGLS and global work index (CRGWI) significantly decreased with exercise induced ischemia and angiographically proven significant CAD (CRGLS −1.6±3.5%; CRGWI −8.6±511 mm Hg% decrement, p