title: Second harmonic imaging improves sensitivity of dobutamine stress echocardiography for the diagnosis of coronary artery disease.
abstract: OBJECTIVE
  Our purpose was to assess the value of second harmonic imaging compared with fundamental imaging for the diagnosis of coronary artery disease during dobutamine stress echocardiography.
  
  
  METHODS
  Sixty-four patients underwent dobutamine stress echocardiography with both fundamental imaging and second harmonic imaging. Coronary angiography was performed within 3 months. Ischemia was defined as new or worsening wall motion abnormalities in > or = 1 segment during dobutamine stress echocardiography. Coronary artery disease was defined as a > or = 70% luminal diameter stenosis in > or = 1 coronary artery by coronary angiography.
  
  
  RESULTS
  There was a higher prevalence of segments with invisible border with fundamental compared with second harmonic imaging both at rest (11% vs 8%, P < .05) and at peak stress (17% vs 10%, P < .001). Significant coronary artery disease was present in 49 (77%) patients. The sensitivity of dobutamine stress echocardiography for detection of coronary artery disease by fundamental and second harmonic imaging was, respectively, 78% and 94% (P < .05), whereas specificity was similar (73% vs 73%). Second harmonic imaging had a particularly higher sensitivity for the diagnosis of 1-vessel disease (93% vs 50%, P < .05).
  
  
  CONCLUSIONS
  The use of second harmonic imaging improves the sensitivity of dobutamine stress echocardiography for the diagnosis of coronary artery disease compared with fundamental imaging, particularly for 1-vessel coronary artery disease, whereas specificity remains unchanged.
authors: Thoraxcentre, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: F B
authors: FB
authors: Sozzi
authors: D
authors: D
authors: Poldermans
authors: J J
authors: JJ
authors: Bax
authors: E
authors: E
authors: Boersma
authors: W B
authors: WB
authors: Vletter
authors: A
authors: A
authors: Elhendy
authors: A
authors: A
authors: Borghetti
authors: J R
authors: JR
authors: Roelandt
mesh_terms: D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D004280:Dobutamine