[Author's reply].

Aten Primaria

Medicina Familiar y Comunitaria, Coordinador de la Unidad de Fibromialgia y Fatiga Cronica, Hospital de la Ribera, Subdirección Asistencial, Departamento de Salud de La Ribera, Alzira, Valencia, España.

Published: August 2016

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6983602PMC
http://dx.doi.org/10.1016/j.aprim.2014.11.011DOI Listing

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Stress echocardiography has evolved from the sole assessment of regional wall motion abnormalities (RWMAs) to the ABCDE protocol, as recommended by the recent clinical consensus statement from the European Association of Cardiovascular Imaging, reflecting the need for a more systematic patient assessment. Steps A, B, C, D, and E assess RWMAs, lung B-lines, left ventricular contractile reserve, coronary flow velocity reserve (CFVR) in mid-distal left anterior descending artery, and heart rate reserve, respectively. Impairment of CFVR is considered as the earliest abnormality in the ischaemic cascade.

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