Detection of coronary artery disease with a continuous infusion of definity ultrasound contrast during adenosine stress real time perfusion echocardiography

Feng Xie, Jordan Hankins, Heidi A. Mahrous, Thomas R. Porter

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1044-1050
Number of pages7
JournalEchocardiography
Volume24
Issue number10
DOIs
StatePublished - Nov 2007

Keywords

  • Coronary artery disease
  • Microbubbles
  • Myocardial perfusion
  • Real time imaging technique

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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