title: Inter- and intra-study reproducibility of contrast echocardiography for assessment of interventricular septal wall perfusion rate in humans.
abstract: OBJECTIVE
  To assess inter- and intra-study reproducibility of myocardial contrast echocardiography (MCE) imaging for quantitative measurement of myocardial perfusion rate in humans in ambulatory setting.
  
  
  RESULTS
  In 20 subjects, we performed 2 MCE tests 20-40 min apart on the same day under the same standardized protocol, and evaluated single-reader between-study and between-reading reproducibility of assessment of indicators of myocardial perfusion rate, such as the slope of video-intensity change k, and the factors A (peak video-intensity) and B (background video-intensity after bubble destruction) and the product k X A. The region of interest was placed at the mid-posterior interventricular septal wall visualized in apical 4-chamber view. In a sub-analysis, we evaluated indicators of myocardial perfusion rate comparing subjects with normal vs. those with subnormal ejection fraction (EF). Inter-study reproducibility of assessment of k was relatively low (intraclass correlation coefficient = 0.36), whereas intra-study reproducibility was fair (intraclass correlation coefficient = 0.61). The parameters k X A and B showed higher reproducibility than the k (inter- and intra-study intraclass correlation coefficients 0.64 and 0.75, 0.74 and 0.91, respectively). For reference, reproducibility data of the depth of the region of interest, of EF and CO were excellent. k and k X A were lower in subjects with low vs. those with normal EF. Only k and k X A were lower in subjects with subnormal than in those with normal EF.
  
  
  CONCLUSIONS
  The MCE-derived indicator of myocardial perfusion rate k X A showed fairly good between-study and between-reading reproducibility.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University Hospital, School of Medicine, Naples, Italy. vpalmier@med.cornell.edu
authors.forename: Vittorio
authors.initials: V
authors.lastname: Palmieri
authors.forename: Emma
authors.initials: E
authors.lastname: Arezzi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pezzullo
authors.forename: Maria
authors.initials: M
authors.lastname: Sabatella
authors.forename: Aldo
authors.initials: A
authors.lastname: Celentano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D003287:Contrast Media; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D010743:Phospholipids; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride