title: Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous perfluorocarbon microbubbles and radioisotope imaging during high-dose dipyridamole stress echo.
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 multicenter setting.
  
  
  OBJECTIVE
  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.
authors.affiliation: Instituto de Cardiologia La Plata, Buenos Aires, Argentina. iclp@netverk.com.ar
authors.forename: Ricardo E
authors.initials: RE
authors.lastname: Ronderos
authors.forename: Mario
authors.initials: M
authors.lastname: Boskis
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Diomedes B
authors.initials: DB
authors.lastname: Corneli
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Escudero
authors.forename: Jong W
authors.initials: JW
authors.lastname: Ha
authors.forename: Carlos
authors.initials: C
authors.lastname: Charlante
authors.forename: Se-Joon
authors.initials: SJ
authors.lastname: Rim
authors.forename: Marcelo
authors.initials: M
authors.lastname: Portis
authors.forename: N
authors.initials: N
authors.lastname: Fabris
authors.forename: Jorge
authors.initials: J
authors.lastname: Camilletti
authors.forename: Anibal A
authors.initials: AA
authors.lastname: Mele
authors.forename: Fernando
authors.initials: F
authors.lastname: Otero
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Porter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000648:ultrastructure; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi