Picano E.Ciampi Q.Arbucci R.Zagatina A.Kalinina E.Padang R.Kane G.C.Villarraga H.R.Arruda‑Olson A.M.Vazquez J.P.Boshchenko A.Zhuravleva O.Ryabova T.Sviazova N.Celutkiené J.Balkevičienė L.Saad A.Bursi F.Djordjevic‑Dikic A.Kobal S.Lisi M.Merli E.Manganelli F.Borguezan‑Daros C.Rodriguez‑Zanella H.D’Alfonso M.G.Mori F.Gaibazzi N.Kasprzak J.D.Safarova A.Timofeeva T.Mosto H.Wierzbowska‑Drabik K.Ratanasit N.C.Costantino M.F.Colonna P.Preradović T.K.Ostojic M.Cortigiani L.Varga A.Nikolic A.Cocchia R.Palinkas A.Palinkas E.D.Rigo F.Benfari G.Valente F.X.Soulis D.Wang Y.Yin L.Van de Heyning C.M.Mazzi A.Lowenstein J.Lowenstein Haber D.M.Marconi S.Barbieri A.Mantovani F.Tripepi G.L.De Nes M.Bartolacelli Y.Villari B.Pepi M.Carerj S.Pellikka P.A.Mahidol University2025-05-092025-05-092025-01-01Journal of Cardiovascular Echography Vol.35 No.1 (2025) , 1-722114122https://repository.li.mahidol.ac.th/handle/123456789/109993Over the past decade, stress echocardiography has evolved from a test for assessing epicardial artery stenosis to a comprehensive functional test, targeting multiple cardiovascular parameters. The new approach includes several structured steps: (a) evaluating regional wall motion abnormalities to detect epicardial artery stenosis or vasospasm; (b) assessing pulmonary congestion and diastolic function via B‑lines with lung ultrasound; (c) gauging preload and contractile reserve with volumetric echocardiography; (d) measuring coronary microvascular reserve using Doppler‑based coronary flow velocity in the middistal left anterior descending artery; and (e) determining cardiac sympathetic reserve by tracking heart rate reserve on an ECG. This evolution was supported extensively by the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI), whichMedicineReviewSCOPUS10.4103/jcecho.jcecho_2_252-s2.0-1050039401492347193X