Journal Title
Title of Journal: Heart Vessels
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Abbravation: Heart and Vessels
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Authors: Sahar S Abdelmoneim Mathieu Bernier Abhijeet Dhoble Stuart Moir Mary E Hagen Sue Ann C Ness Patricia A Pellikka Samir S AbdelKader Sharon L Mulvagh
Publish Date: 2010/03/26
Volume: 25, Issue: 2, Pages: 121-130
Abstract
Myocardial contrast echocardiography MCE utilizes compressible microbubbles behaving similarly to red blood cells Destruction of microbubbles and observation of the gradual refill into the myocardium are key to evaluating perfusion using realtime MCE We aimed to assess the feasibility and diagnostic accuracy of qualitative MCE utilizing a 17segment model for localization of myocardial perfusion abnormalities compared with simultaneous technetium99 m sestamibi singlephoton emission computed tomography SPECT From July 2005 through August 2007 97 patients with known or suspected coronary artery disease underwent simultaneous SPECT and realtime MCE during adenosine stress Qualitative MCE and tracer uptake were analyzed visually using a 17segment model in a blinded manner Diagnostic accuracy and 95 confidence interval CI were determined Myocardial contrast echocardiography was completed in 91 patients age mean SD 693 109 years body mass index 300 63 59 males 65 Myocardial contrast echocardiography analysis was feasible in 88 97 patients 261 of 264 99 territories 1299 of 1497 87 segments At patient level MCE sensitivity was 88 95 CI 79–94 specificity was 85 77–90 For disease detection in individual coronary territories sensitivity and specificity were 84 71–92 and 79 72–84 for the left anterior descending artery 62 38–80 and 88 83–91 for the left circumflex artery and 73 57–82 and 94 89–97 for the right coronary artery For MCE combined with wallmotion analysis concordance with SPECT improved from 80 to 86 Myocardial contrast echocardiography interobserver concordance was 81 κ SE 0611 078 Myocardial contrast echocardiography accuracy was comparable in patients classified in accordance with presence of diabetes mellitus myocardial infarction hypertension or percutaneous coronary intervention Improved MCE specificity in detecting perfusion defects was seen in patients with no history of coronary bypass graft surgery P = 0005 Realtime MCE with a 17segment model for analysis has good feasibility and accuracy in evaluation of myocardial perfusion during adenosine stress
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