title: Myocardial contrast echocardiography in patients with suspected or known coronary artery disease: comparison with myocardial nuclear scintigraphy.
abstract: OBJECTIVE
  To compare myocardial contrast echocardiography (MCE) using PESDA and adenosine in bolus (ADN) with myocardial nuclear scintigraphy (NS) in patients (pts) undergoing routine investigation with a high probability of having coronary artery disease.
  
  
  METHODS
  This study comprised 125 pts (85 men) with 58.4 +/- 10.6 years, who underwent MCE and NS within 4 weeks. MCE was performed with PESDA in a continuous infusion at rest and after administration of an adenosine bolus. The LV walls was divided into 3 territories related to the coronary arteries, in a total of 375 territories. MCE was normal when an increase in contrast intensity occurred after ADN. The reduction in contrast intensity at rest or after ADN was defined as an abnormal MCE result. NS was performed according to classical protocols. When compared per patient, both examinations were considered concordant when they were normal or abnormal, independent of its location. The comparison by territory was considered concordant when perfusion defects existed or not in the same territory. The chi-square test was used to determine the significance of concordance.
  
  
  RESULTS
  In 106/125 pts, MCE and NS were concordant (84.8% - P < 0.001). Concordance occurred in 342/375 territories (91.2% - P < 0.001). For the LAD territory, concordance was 87.2%; for the RCA, 93.6%; and for the CX, 92.8% (P < 0.001).
  
  
  CONCLUSIONS
  An excellent concordance exists between MCE and NS in assessing pts for coronary artery disease; therefore, MCE may represent a good alternative for assessing myocardial perfusion.
authors.affiliation: ECOR Ecocardiografia, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. mcarrinho@cardiol.br
authors.forename: Marcia
authors.initials: M
authors.lastname: Carrinho
authors.forename: Alvaro
authors.initials: A
authors.lastname: Moraes
authors.forename: Fernando
authors.initials: F
authors.lastname: Morcerf
authors.forename: Caio
authors.initials: C
authors.lastname: Medeiros
authors.forename: Márcia
authors.initials: M
authors.lastname: Castier
authors.forename: Luis José Martins
authors.initials: LJ
authors.lastname: Romeo
mesh_terms: D000241:Adenosine; D000418:Albumins; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi
chemical_list: D000418:Albumins; D003287:Contrast Media; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine