Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo

Anibal A. Mele, Jorge Camilletti, Nora Fabris, Marcelo Portis, Eduardo M. Escudero, Diomedes B. Corneli, Ricardo E. Ronderos, Fernando Otero, Carlos Charlante, Mario Boskis, Se Joon Rim, Jong W. Ha, Namsik Chung, Thomas R. Porter

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background: The clinical accuracy of myocardial contrast echocardiography (MCE) using intermittent harmonic imaging and intravenous perfluorocarbon containing microbubbles during dipyridamole stress has not been evaluated in a multi-center setting. Hypothesis: The accuracy of dipyridamole stress contrast echo in the detection of coronary artery disease (CAD) using myocardial perfusion images is high in comparison with technetium-99 (99Tc) sestamibi single-photon emission computed tomography (MIBI SPECT) and increases the accuracy of wall motion data. Methods: In 68 consecutive nonselected patients (46 men; mean age 66 years) from three different institutions in two countries, dipyridamole stress echo and SPECT with 99mTc MIBI were compared. Continuous intravenous (IV) infusion of perfluorocarbon exposed sonicated dextrose albumin (PESDA) (2-5 cc/min) was administered for baseline myocardial perfusion using triggered harmonic end systolic frames. Real-time digitized images were used for wall motion analysis. Dipyridamole was then injected in two steps: (1) 0.56 mg/kg for 3 min; (2) 0.28 mg/kg for 1 min, if the first step was negative for an inducible wall motion abnormality. After dipyridamole injection, myocardial contrast enhancement and wall motion were analyzed again by the same methodology. Results: There were 35 patients with perfusion defects by SPECT. Wall motion was abnormal in 22, while MCE was abnormal in 32. Wall motion and MCE each had one false positive. The proportion of correctly assigned patients was significantly better with MCE than with wall motion (p = 0.03; chi square test). Conclusions: Myocardial contrast echocardiography, using intermittent harmonic imaging and intravenous perfluorocarbon containing microbubbles, is a very effective method for detecting coronary artery disease during dipyridamole stress echo.

Original languageEnglish (US)
Pages (from-to)103-111
Number of pages9
JournalClinical Cardiology
Volume25
Issue number3
DOIs
StatePublished - 2002

Keywords

  • Contrast echo
  • Dipyridamole contrast echo
  • Myocardial ischemia
  • Stress echo
  • Ultrasound contrast agents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Mele, A. A., Camilletti, J., Fabris, N., Portis, M., Escudero, E. M., Corneli, D. B., Ronderos, R. E., Otero, F., Charlante, C., Boskis, M., Rim, S. J., Ha, J. W., Chung, N., & Porter, T. R. (2002). Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo. Clinical Cardiology, 25(3), 103-111. https://doi.org/10.1002/clc.4960250305