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 Richard Porter

Research output: Contribution to journalArticle

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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
StatePublished - Jan 1 2002

Fingerprint

Fluorocarbons
Microbubbles
Dipyridamole
Radioisotopes
Perfusion
Echocardiography
Single-Photon Emission-Computed Tomography
Coronary Artery Disease
Technetium
Chi-Square Distribution
Intravenous Infusions
Albumins
Glucose
Injections

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo. / Mele, Anibal A.; Camilletti, Jorge; Fabris, Nora; Portis, Marcelo; Escudero, Eduardo M.; Corneli, Diomedes B.; Ronderos, Ricardo E.; Otero, Fernando; Charlante, Carlos; Boskis, Mario; Rim, Se Joon; Ha, Jong W.; Chung, Namsik; Porter, Thomas Richard.

In: Clinical Cardiology, Vol. 25, No. 3, 01.01.2002, p. 103-111.

Research output: Contribution to journalArticle

Mele, AA, Camilletti, J, Fabris, N, Portis, M, Escudero, EM, Corneli, DB, Ronderos, RE, Otero, F, Charlante, C, Boskis, M, Rim, SJ, Ha, JW, Chung, N & Porter, TR 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, vol. 25, no. 3, pp. 103-111.
Mele, Anibal A. ; Camilletti, Jorge ; Fabris, Nora ; Portis, Marcelo ; Escudero, Eduardo M. ; Corneli, Diomedes B. ; Ronderos, Ricardo E. ; Otero, Fernando ; Charlante, Carlos ; Boskis, Mario ; Rim, Se Joon ; Ha, Jong W. ; Chung, Namsik ; Porter, Thomas Richard. / Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo. In: Clinical Cardiology. 2002 ; Vol. 25, No. 3. pp. 103-111.
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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.",
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author = "Mele, {Anibal A.} and Jorge Camilletti and Nora Fabris and Marcelo Portis and Escudero, {Eduardo M.} and Corneli, {Diomedes B.} and Ronderos, {Ricardo E.} and Fernando Otero and Carlos Charlante and Mario Boskis and Rim, {Se Joon} and Ha, {Jong W.} and Namsik Chung and Porter, {Thomas Richard}",
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T1 - Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo

AU - Mele, Anibal A.

AU - Camilletti, Jorge

AU - Fabris, Nora

AU - Portis, Marcelo

AU - Escudero, Eduardo M.

AU - Corneli, Diomedes B.

AU - Ronderos, Ricardo E.

AU - Otero, Fernando

AU - Charlante, Carlos

AU - Boskis, Mario

AU - Rim, Se Joon

AU - Ha, Jong W.

AU - Chung, Namsik

AU - Porter, Thomas Richard

PY - 2002/1/1

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N2 - 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.

AB - 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.

KW - Contrast echo

KW - Dipyridamole contrast echo

KW - Myocardial ischemia

KW - Stress echo

KW - Ultrasound contrast agents

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