Comparison of contrast enhanced three dimensional echocardiography with MIBI gated SPECT for the evaluation of left ventricular function |
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Authors: | Bernard Cosyns David Haberman Steven Droogmans Sandrine Warzée Philippe Mahieu Eric Laurent Marie Moonen Sophie Hernot Patrizio Lancellotti |
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Institution: | 1. Department of Biomedical Laboratory Science, Malm? University, Malm?, Sweden 2. Department of Cardiology, Karolinska University Hospital Huddinge, Stockholm, Sweden 3. Department of Clinical Physiology, Karolinska University Hospital Huddinge, Stockholm, Sweden 4. Department of Clinical Physiology, Lund University, Malm? University Hospital, Malm?, Sweden 5. Department of Cardiology, Lund University, Malm? University Hospital, Malm?, Sweden 6. Department of Clinical Sciences, Medicine/Cardiology, Lund University, Malm? University Hospital, Malm?, Sweden 7. Heart Health Group, Malm?, Sweden
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Abstract: | Background Real-time perfusion (RTP) contrast echocardiography can be used during adenosine stress echocardiography (ASE) to evaluate myocardial ischemia. We compared two different types of RTP power modulation techniques, angiomode (AM) and high-resolution grayscale (HR), with99mTc-tetrofosmin single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia. Methods Patients with known or suspected coronary artery disease (CAD), admitted to SPECT, were prospectively invited to participate. Patients underwent RTP imaging (SONOS 5500) using AM and HR during Sonovue® infusion, before and throughout the adenosine stress, also used for SPECT. Analysis of myocardial perfusion and wall motion by RTP-ASE were done for AM and HR at different time points, blinded to one another and to SPECT. Each segment was attributed to one of the three main coronary vessel areas of interest. Results In 50 patients, 150 coronary areas were analyzed by SPECT and RTP-ASE AM and HR. SPECT showed evidence of ischemia in 13 out of 50 patients. There was no significant difference between AM and HR in detecting ischemia (p = 0.08). The agreement for AM and HR, compared to SPECT, was 93% and 96%, with Kappa values of 0.67 and 0.75, respectively (p < 0.001). Conclusion There was no significant difference between AM and HR in correctly detecting myocardial ischemia as judged by SPECT. This suggests that different types of RTP modalities give comparable data during RTP-ASE in patients with known or suspected CAD. |
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