Figure 4

Exercise stress echo. Systolic (pink lines) and diastolic (black lines) times as a function of HR. Upper panel, a normal subject: systolic duration plotted as a function of HR demonstrates a slight linear decrease; duration of diastole demonstrates the most significant change. Middle panel, a patient with severe mitral regurgitation and stress induced severe pulmonary hypertension; the test was stopped at low stress load due to limiting dyspnoea without stress induced ischemia: prolonged systolic time with systolic/diastolic time reversal occurred during stress. Lower panel, a patient with stress induced ischemia at low stress load: at ischemia systole lengthens with systolic/diastolic time reversal.