Document Detail


Accelerated stress real-time myocardial contrast echocardiography for the detection of coronary artery disease: comparison with 99mTc single photon emission computed tomography.
MedLine Citation:
PMID:  18385014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aims of this prospective study were to compare the diagnostic value of accelerated vasodilator stress real-time myocardial contrast echocardiography (MCE) and single photon emission computed tomography (SPECT) against coronary angiography and to evaluate whether the addition of MCE perfusion data improves the diagnostic accuracy of stress echocardiography. METHODS: A total of 103 patients with suspected or known stable coronary artery disease (CAD) underwent SPECT and accelerated high-dose dipyridamole (0.84 mg/kg intravenously for 4 minutes) atropine (up to 1 mg intravenously) stress real-time qualitative MCE. The presence of CAD was detected by coronary angiography. RESULTS: CAD defined as >or= 70% stenosis was detected in 77% of patients, whereas 86% of patients had CAD defined as >or= 50% stenosis. In a territory-by-territory analysis, the concordance between MCE and SPECT in detecting perfusion defects varied from 72.8% (kappa = 0.386) to 89.3% (kappa = 0.642). There were no significant differences between MCE and SPECT in sensitivity, specificity, and diagnostic accuracy for identifying patients with CAD. Combining MCE and wall motion abnormality analysis significantly improved the sensitivity of the test compared with wall motion abnormality analysis alone. CONCLUSIONS: Accelerated vasodilator stress real-time MCE yields a good concordance with SPECT in detection of perfusion defects and a similar diagnostic value for the detection of CAD. The addition of MCE perfusion data improves the diagnostic value of stress echocardiography.
Authors:
Piotr Lipiec; Paulina Wejner-Mik; Maria Krzemińska-Pakuła; Jacek Kuśmierek; Anna Płachcińska; Remigiusz Szumiński; Jan Z Peruga; Jarosław D Kasprzak
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-02
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  941-7     Citation Subset:  IM    
Affiliation:
Second Department of Cardiology, Medical University of Łódź, Poland. lipiec@ptkardio.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Albumins / diagnostic use*
Contrast Media
Coronary Artery Disease / diagnosis*
Echocardiography / methods*
Exercise Test / methods*
Female
Fluorocarbons / diagnostic use*
Humans
Male
Middle Aged
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Vasodilator Agents / diagnostic use*
Chemical
Reg. No./Substance:
0/Albumins; 0/Contrast Media; 0/FS 069; 0/Fluorocarbons; 0/Radiopharmaceuticals; 0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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