Document Detail


Comparison of real-time myocardial contrast echocardiography for the assessment of myocardial viability with fluorodeoxyglucose-18 positron emission tomography and dobutamine stress echocardiography.
MedLine Citation:
PMID:  15342285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Little is known about the diagnostic value of real-time myocardial contrast echocardiography (MCE) for the assessment of myocardial viability. We compared the diagnostic accuracy of MCE with that of low-dose dobutamine stress echocardiography (DSE) and of combined technetium-99 sestamibi single-photon emission computed tomography and fluorodeoxyglucose-18 positron emission tomography and investigated whether quantitative assessment of myocardial blood flow could increase its diagnostic value. Cardiac imaging was performed with these 3 methods in 41 patients who had ischemic heart disease (ejection fraction < 40%) and were being considered for revascularization. Follow-up echocardiograms were obtained after 3 to 6 months in revascularized patients, and increased regional function served as a standard reference for assessment of myocardial viability. A control group of 25 patients who had no coronary artery disease underwent MCE to assess normal values of myocardial perfusion parameters. Recovery of myocardial function was predicted by MCE with a sensitivity of 86% and a specificity of 43%. Nuclear imaging was comparably sensitive (90%) and specific (44%), whereas low-dose DSE was similarly sensitive (83%) but more specific (76%). Normalization of myocardial signal intensity to that of the control group significantly increased the specificity of MCE from 43% to 64% and the accuracy from 73% to 81%. A combination of quantitative MCE and DSE provided the best diagnostic characteristics, with a sensitivity of 96%, a specificity of 63%, and an accuracy of 83%. Thus, MCE is useful for assessing myocardial viability. Normalization of contrast intensity to that of a reference control group is a valid approach for detection of myocardial viability and expands on information obtained from visual MCE and DSE.
Authors:
Grigorios Korosoglou; Alexander Hansen; Johannes Hoffend; Goran Gavrilovic; David Wolf; Joerg Zehelein; Uwe Haberkorn; Helmut Kuecherer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  94     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-02     Completed Date:  2004-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  570-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2004 Excerpta Medica, Inc.
Affiliation:
Department of Department, University of Heidelberg, Germany. grigorios_korosoglou@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cell Survival / physiology*
Echocardiography / methods*
Echocardiography, Stress / methods
Female
Fluorodeoxyglucose F18 / diagnostic use
Heart / physiopathology*
Humans
Male
Middle Aged
Myocardial Ischemia / physiopathology*,  radionuclide imaging,  ultrasonography
Myocardium / cytology
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 63503-12-8/Fluorodeoxyglucose F18

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