title: Feasibility of continuous venous infusion of SonoVue for qualitative assessment of reversible coronary perfusion defects in stress myocardial contrast echocardiography.
abstract: OBJECTIVE
  To study the feasibility of continuous intravenous SonoVue contrast echocardiography for qualitative assessment of reversible myocardial perfusion in dipyridamole stress tests.
  
  
  METHODS
  Eleven patients (10 male and 1 female, mean age 66 years) with a history of chest pain and a clinical indication for stress sestamibi single photon emission computed tomography (SPECT) underwent concurrent SonoVue 99mTc myocardial contrast echocardiography (MCE).
  
  
  RESULTS
  Of the total 176 segments obtained, 53 (30%) were regarded as indeterminate, 39 (22%) as discordant, and 84 (48%) as concordant between MCE and SPECT imaging. Two patients had abnormal SPECT results. The overall feasibility and specificity of MCE were 70 and 74%, respectively. The concordant (p = 0.59) and discordant (p = 0.55) segments were comparable with either MCE technique. However, continuous low-mechanical-index imaging produced fewer indeterminate segments (17 segments, 32%) than intermittent harmonic B-mode imaging (36 segments, 68%) (p = 0.04). Significantly more indeterminate segments were found in the left anterior descending artery territory. However, the overall concordance was similar (p = 0.5) in all three coronary artery territories. The concordance and discordance rates at different left ventricular levels (i.e., basal, mid, and apical) were similar (p = 0.50 and 0.08, respectively).
  
  
  CONCLUSIONS
  Continuous-infusion SonoVue contrast echocardiography is feasible, with high specificity, for detecting myocardial perfusion defects as assessed by dipyridamole SPECT.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Gabriel W
authors.initials: GW
authors.lastname: Yip
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Chandrasekaran
authors.forename: Todd D
authors.initials: TD
authors.lastname: Miller
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hagen
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Langins
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Khandheria
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage*; D003326:Coronary Circulation; D004176:Dipyridamole; D025401:Echocardiography, Stress / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018709:Statistics, Nonparametric; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
chemical_list: D003287:Contrast Media; D010743:Phospholipids; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C420843:contrast agent BR1; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; D013459:Sulfur Hexafluoride