Feasibility of continuous venous infusion of SonoVue for qualitative assessment of reversible coronary perfusion defects in stress myocardial contrast echocardiography.
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.
Yip
Gabriel W
GW
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Chandrasekaran
Krishnaswamy
K
Miller
Todd D
TD
Hagen
Mary E
ME
Langins
Andrew P
AP
Khandheria
Bijoy K
BK
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
D003287:Contrast Media; D010743:Phospholipids; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C420843:contrast agent BR1; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; D013459:Sulfur Hexafluoride