Document Detail


Detection of coronary artery disease with a continuous infusion of definity ultrasound contrast during adenosine stress real time perfusion echocardiography.
MedLine Citation:
PMID:  18001357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial perfusion imaging during adenosine stress is an accurate method of detecting physiologically relevant coronary artery disease. METHODS: Real time perfusion echocardiography (RTPE) was compared to nuclear scintigraphy (rest Thallium, stress Sestamibi) in 40 patients with intermediate to high pretest probability. RTPE was performed with a continuous infusion of intravenous microbubbles (Definity; Bristol Myers Squibb) and intermittent high mechanical index impulses, with visual examination of both the replenishment rate and plateau intensity of contrast. RESULTS: Of the 119 coronary artery territories compared, SPECT and RTPE were in agreement in 105 (88% agreement; kappa 0.67). In patients who went on to quantitative coronary arteriography (QCA), there were three who had normal appearing radionuclide SPECT during adenosine, but subendocardial perfusion defects with RTPE. In all three cases, QCA confirmed the presence of a >50% diameter stenosis in the abnormal territory. CONCLUSIONS: We conclude from this study that adenosine stress imaging with RTPE is an accurate method of detecting coronary artery disease. The higher resolution of RTPE may identify subendocardial defects that would otherwise have gone undetected with radionuclide imaging.
Authors:
Feng Xie; Jordan Hankins; Heidi A Mahrous; Thomas R Porter
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  24     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2008-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1044-50     Citation Subset:  IM    
Affiliation:
University of Nebraska Medical Center, Nebraska Medical Center, Omaha, Nebraska 68198-2265, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage,  diagnostic use*
Coronary Angiography
Coronary Circulation / physiology*
Coronary Disease / diagnosis*,  physiopathology
Echocardiography / methods*
Exercise Test / methods*
Female
Fluorocarbons / administration & dosage,  diagnostic use*
Follow-Up Studies
Humans
Infusions, Intravenous
Male
Microspheres
Middle Aged
Observer Variation
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Tomography, Emission-Computed, Single-Photon / methods
Vasodilator Agents / administration & dosage,  diagnostic use
Chemical
Reg. No./Substance:
0/Definity; 0/Fluorocarbons; 0/Vasodilator Agents; 58-61-7/Adenosine

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