Evaluation of restenosis and extent of coronary artery disease in patients with previous percutaneous coronary interventions by dobutamine stress real-time myocardial contrast perfusion imaging

Abdou Elhendy, J. M. Tsutsui, Edward Lewis O'Leary, Feng Xie, F. Majeed, Thomas Richard Porter

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6 Citations (Scopus)

Abstract

Objectives: To assess the accuracy of real-time myocardial contrast perfusion imaging (MCPI) for the diagnosis of restenosis and extent of coronary artery disease (CAD) in patients with previous percutaneous coronary intervention (PCI). Methods: 56 patients were studied 1.9 (SD 1.4) years after PCI. They underwent MCPI with commercially available ultrasound contrast agents (Optison or Definity) at rest and at peak dobutamine-atropine stress. Coronary angiography was performed within one month. Significant CAD was defined as ≥ 50% stenosis in ≥ 1 major epicardial coronary artery. Significant restenosis was defined as ≥ 50% stenosis in a coronary segment with previous intervention. Results: Reversible perfusion abnormalities were detected in 40 of 43 patients with significant CAD and in 4 of 13 patients without (overall sensitivity 93%, 95% CI 85% to 99%; specificity 69%, 95% CI 44% to 94%; and accuracy 88%, 95% CI 79% to 96%). Significant restenosis in ≥ 1 coronary artery with previous PCI was detected in 38 (68%) patients. Reversible perfusion abnormalities were present in 35 of them (sensitivity 92%, 95% CI 84% to 99%). Reversible perfusion abnormalities were detected in ≥ 2 vascular distributions in 20 of 28 patients with multivessel CAD and in 3 of 28 patients without (sensitivity 71%, 95% CI 55% to 88%; specificity 89%, 95% CI 78% to 99%; and accuracy 80%, 95% CI 70% to 91%). Restenosis was detected in 41 coronary arteries. Sensitivity of MCPI for regional diagnosis of restenosis was 73% (95% CI 60% to 87%), specificity was 75% (95% CI 60% to 90%), and accuracy was 74% (95% CI 64% to 84%). Conclusion: Dobutamine stress MCPI is a useful technique for the evaluation of restenosis and extent of CAD after PCI.

Original languageEnglish (US)
Pages (from-to)1480-1483
Number of pages4
JournalHeart
Volume92
Issue number10
DOIs
StatePublished - Oct 1 2006

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Myocardial Perfusion Imaging
Dobutamine
Percutaneous Coronary Intervention
Coronary Artery Disease
Coronary Vessels
Perfusion
Pathologic Constriction
Contrast Sensitivity
Coronary Angiography
Atropine
Contrast Media
Blood Vessels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{b0099506d8cc4e328c8fce10a76d25c0,
title = "Evaluation of restenosis and extent of coronary artery disease in patients with previous percutaneous coronary interventions by dobutamine stress real-time myocardial contrast perfusion imaging",
abstract = "Objectives: To assess the accuracy of real-time myocardial contrast perfusion imaging (MCPI) for the diagnosis of restenosis and extent of coronary artery disease (CAD) in patients with previous percutaneous coronary intervention (PCI). Methods: 56 patients were studied 1.9 (SD 1.4) years after PCI. They underwent MCPI with commercially available ultrasound contrast agents (Optison or Definity) at rest and at peak dobutamine-atropine stress. Coronary angiography was performed within one month. Significant CAD was defined as ≥ 50{\%} stenosis in ≥ 1 major epicardial coronary artery. Significant restenosis was defined as ≥ 50{\%} stenosis in a coronary segment with previous intervention. Results: Reversible perfusion abnormalities were detected in 40 of 43 patients with significant CAD and in 4 of 13 patients without (overall sensitivity 93{\%}, 95{\%} CI 85{\%} to 99{\%}; specificity 69{\%}, 95{\%} CI 44{\%} to 94{\%}; and accuracy 88{\%}, 95{\%} CI 79{\%} to 96{\%}). Significant restenosis in ≥ 1 coronary artery with previous PCI was detected in 38 (68{\%}) patients. Reversible perfusion abnormalities were present in 35 of them (sensitivity 92{\%}, 95{\%} CI 84{\%} to 99{\%}). Reversible perfusion abnormalities were detected in ≥ 2 vascular distributions in 20 of 28 patients with multivessel CAD and in 3 of 28 patients without (sensitivity 71{\%}, 95{\%} CI 55{\%} to 88{\%}; specificity 89{\%}, 95{\%} CI 78{\%} to 99{\%}; and accuracy 80{\%}, 95{\%} CI 70{\%} to 91{\%}). Restenosis was detected in 41 coronary arteries. Sensitivity of MCPI for regional diagnosis of restenosis was 73{\%} (95{\%} CI 60{\%} to 87{\%}), specificity was 75{\%} (95{\%} CI 60{\%} to 90{\%}), and accuracy was 74{\%} (95{\%} CI 64{\%} to 84{\%}). Conclusion: Dobutamine stress MCPI is a useful technique for the evaluation of restenosis and extent of CAD after PCI.",
author = "Abdou Elhendy and Tsutsui, {J. M.} and O'Leary, {Edward Lewis} and Feng Xie and F. Majeed and Porter, {Thomas Richard}",
year = "2006",
month = "10",
day = "1",
doi = "10.1136/hrt.2005.086140",
language = "English (US)",
volume = "92",
pages = "1480--1483",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
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TY - JOUR

T1 - Evaluation of restenosis and extent of coronary artery disease in patients with previous percutaneous coronary interventions by dobutamine stress real-time myocardial contrast perfusion imaging

AU - Elhendy, Abdou

AU - Tsutsui, J. M.

AU - O'Leary, Edward Lewis

AU - Xie, Feng

AU - Majeed, F.

AU - Porter, Thomas Richard

PY - 2006/10/1

Y1 - 2006/10/1

N2 - Objectives: To assess the accuracy of real-time myocardial contrast perfusion imaging (MCPI) for the diagnosis of restenosis and extent of coronary artery disease (CAD) in patients with previous percutaneous coronary intervention (PCI). Methods: 56 patients were studied 1.9 (SD 1.4) years after PCI. They underwent MCPI with commercially available ultrasound contrast agents (Optison or Definity) at rest and at peak dobutamine-atropine stress. Coronary angiography was performed within one month. Significant CAD was defined as ≥ 50% stenosis in ≥ 1 major epicardial coronary artery. Significant restenosis was defined as ≥ 50% stenosis in a coronary segment with previous intervention. Results: Reversible perfusion abnormalities were detected in 40 of 43 patients with significant CAD and in 4 of 13 patients without (overall sensitivity 93%, 95% CI 85% to 99%; specificity 69%, 95% CI 44% to 94%; and accuracy 88%, 95% CI 79% to 96%). Significant restenosis in ≥ 1 coronary artery with previous PCI was detected in 38 (68%) patients. Reversible perfusion abnormalities were present in 35 of them (sensitivity 92%, 95% CI 84% to 99%). Reversible perfusion abnormalities were detected in ≥ 2 vascular distributions in 20 of 28 patients with multivessel CAD and in 3 of 28 patients without (sensitivity 71%, 95% CI 55% to 88%; specificity 89%, 95% CI 78% to 99%; and accuracy 80%, 95% CI 70% to 91%). Restenosis was detected in 41 coronary arteries. Sensitivity of MCPI for regional diagnosis of restenosis was 73% (95% CI 60% to 87%), specificity was 75% (95% CI 60% to 90%), and accuracy was 74% (95% CI 64% to 84%). Conclusion: Dobutamine stress MCPI is a useful technique for the evaluation of restenosis and extent of CAD after PCI.

AB - Objectives: To assess the accuracy of real-time myocardial contrast perfusion imaging (MCPI) for the diagnosis of restenosis and extent of coronary artery disease (CAD) in patients with previous percutaneous coronary intervention (PCI). Methods: 56 patients were studied 1.9 (SD 1.4) years after PCI. They underwent MCPI with commercially available ultrasound contrast agents (Optison or Definity) at rest and at peak dobutamine-atropine stress. Coronary angiography was performed within one month. Significant CAD was defined as ≥ 50% stenosis in ≥ 1 major epicardial coronary artery. Significant restenosis was defined as ≥ 50% stenosis in a coronary segment with previous intervention. Results: Reversible perfusion abnormalities were detected in 40 of 43 patients with significant CAD and in 4 of 13 patients without (overall sensitivity 93%, 95% CI 85% to 99%; specificity 69%, 95% CI 44% to 94%; and accuracy 88%, 95% CI 79% to 96%). Significant restenosis in ≥ 1 coronary artery with previous PCI was detected in 38 (68%) patients. Reversible perfusion abnormalities were present in 35 of them (sensitivity 92%, 95% CI 84% to 99%). Reversible perfusion abnormalities were detected in ≥ 2 vascular distributions in 20 of 28 patients with multivessel CAD and in 3 of 28 patients without (sensitivity 71%, 95% CI 55% to 88%; specificity 89%, 95% CI 78% to 99%; and accuracy 80%, 95% CI 70% to 91%). Restenosis was detected in 41 coronary arteries. Sensitivity of MCPI for regional diagnosis of restenosis was 73% (95% CI 60% to 87%), specificity was 75% (95% CI 60% to 90%), and accuracy was 74% (95% CI 64% to 84%). Conclusion: Dobutamine stress MCPI is a useful technique for the evaluation of restenosis and extent of CAD after PCI.

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U2 - 10.1136/hrt.2005.086140

DO - 10.1136/hrt.2005.086140

M3 - Article

VL - 92

SP - 1480

EP - 1483

JO - Heart

JF - Heart

SN - 1355-6037

IS - 10

ER -