179 Five years of adenosine contrast echocardiography: lessons from 1750 consecutive studies in a single center (original) (raw)
2003, European Journal of Echocardiography
In experimental studies myocardial contrast echo (MCE) parameters of regional mycardial perfusion show a good correlation with the severity of coronary lesions, but clinical data on coronary pts are still scarce. Purpose: 1)To assess the correlation between parameters of regional myocardial perfusion derived from real-time MCE and severity of coronary lesions by quantitative coronary angiography (QCA) in pts with or without left anterior descending (LAD) disease. 2)To determine the sensitivity and specificity of MCE parameters in detecting critical LAD stenosis. Methods: 38 pts, 21 males, aged 60±7 years, 24 with ≥50% LAD stenosis, and 14 with normal or ≤50% stenosis of LAD underwent real-time MCE with Sonovue using Power Doppler Harmonic Imaging (Vivid 7 GE) at baseline and during dipyridamole(D) stress (0.84 mg/Kg in 4'). MCE time-intensity data in 2 regions of interest [proximal (SP) and distal septum (SD)] were fitted to the exponential function y= A (1-e-bt)+c, where A is the peak plateau signal intensity, b the rate of signal increase and the product A x b is proportional to myocardial blood flow. Baseline and peak stress MCE parameters were correlated with minimal luminal diameter (MLD) and % diameter stenosis (DS) of LAD by QCA. Results: See table. The product A x b in DS at peak stress was significantly related with MLD (r=.52, p=.0025) and %DS of LAD (r=.58, p=.0001)and b in DS at peak was related with %DS(r=.53, p=.0007). By ROC analysis a value of A x b < 2.45 for a >50% LAD stenosis had a 86% sensitivity and 74% specificity; for a > 70% LAD stenosis a cut-off of Axb <1,99 had a 89% sensitivity and a 68% specificity, with an area under the ROC curve >.80 for both values.
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