Document Detail

Incremental value of perfusion over wall-motion abnormalities with the use of dobutamine-atropine stress myocardial contrast echocardiography and magnetic resonance imaging for detecting coronary artery disease.
MedLine Citation:
PMID:  23006451     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recently, multimodality imaging has been demonstrated to improve the sensitivity of dobutamine stress for the diagnosis of coronary artery disease (CAD).
OBJECTIVE: We sought to determine the additional value of myocardial perfusion (MP) over wall-motion (WM) analysis for detecting CAD, using real time myocardial contrast echocardiography (RTMCE) and cardiovascular magnetic resonance (CMR), in the same group of patients.
METHODS: We studied 42 patients who underwent RTMCE and CMR during high-dose dobutamine stress with early injection of atropine.
RESULTS: No difference was observed in the diagnostic accuracy of RTMCE and CMR for detecting angiographically significant CAD when considering WM analysis alone (73% [95% CI, 65-81] and 78% [95% CI, 70-84], respectively; P = NS) or combined analysis of WM and MP (80% [95% CI, 73-97] and 83% [95% CI, 77-90], respectively; P = NS). Combined analysis of WM and MP had higher sensitivity than the analysis of WM alone by RTMCE (88% [95% CI, 75-100] vs. 72% [95% CI, 54-90]) and by CMR (92% [95% CI, 81-100] vs. 80% [95% CI, 64-96]) with no differences in specificity. The association of abnormal WM and MP abnormalities during high-dose dobutamine-atropine stress had additional value for detecting CAD over the analysis of WM alone, both by RTMCE (χ(2) = 16.16-24.13; P = 0.005) and CMR (χ(2) = 12.73-27.41; P = 0.001).
CONCLUSION: RTMCE and CMR using the same dobutamine-atropine stress protocol had comparable diagnostic accuracies for the detection of angiographically significant CAD. MP imaging had additional value over WM analysis for the diagnosis of CAD, both at RTMCE and CMR.
Sandra Nivea dos Reis Saraiva Falcão; Carlos Eduardo Rochitte; Wilson Mathias Junior; Luiz Quaglia; Pedro Alves Lemos; João César Nunes Sbano; José Antonio Franchini Ramires; Roberto Kalil Filho; Jeane Mike Tsutsui
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-25
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  30     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-09     Completed Date:  2013-07-09     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-54     Citation Subset:  IM    
Copyright Information:
© 2012, Wiley Periodicals, Inc.
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MeSH Terms
Atropine / diagnostic use*
Cardiotonic Agents / diagnostic use
Contrast Media
Coronary Artery Disease / diagnosis*
Dobutamine / diagnostic use*
Echocardiography / methods*
Exercise Test
Magnetic Resonance Angiography / methods*
Middle Aged
Myocardial Perfusion Imaging
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique*
Reg. No./Substance:
0/Cardiotonic Agents; 0/Contrast Media; 3S12J47372/Dobutamine; 7C0697DR9I/Atropine

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

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