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  1. stress echocardiography, including test protocols, standards for inter- pretation (including quantitative methods of assessment and applica- tion of strain rate imaging), appropriateness of testing, comparison

  2. Three-dimensional echocardiography, through the en face view, allows all three leaflets to be evaluated concurrently, as well as assessment of the RVoutflow tract and main pulmonary ar-tery. This has improved quantitative assessment of pulmonary regur-gitation and stenosis.

  3. Three-dimensional (3D) echocardiographic (3DE) imaging represents a major innovation in cardiovascular ultrasound. Advancements in computer and transducer technologies permit real-time 3DE acquisition and presentation of cardiac structures from any spatial point of view.

  4. In the last 5 years, a major innovation changed the face and the diagnostic content of stress echocardiography: dual imaging of wall motion and coronary flow reserve with pulsed-Doppler imaging of the middistal left anterior descending coronary artery.

  5. Innovative technologies are taking advantage of the enhanced spatial and temporal resolution afforded by 3DE by creating improved tools for communication and patient management. These include fusion of 3DE with CT angiography or stress echocardiography, 3D printing, virtual reality, and holography.

  6. Three-dimensional (3D) echocardiography allows the real-time acquisition of volumes containing entire cardiac structures. The analysis of 3D volumes does not require any assumptions as to the shape of structures.

  7. Real-time three-dimensional (3D) stress echocardiography offers advantages in acquisition of all images from one echo window in a single capture, with the technique relatively easy to master. The current review will describe the 3D stress echocardiography technique, its advantages, and limitations.

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