Myocardial contrast echocardiography in patients with suspected or known coronary artery disease: comparison with myocardial nuclear scintigraphy.
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.
Carrinho
Marcia
M
ECOR Ecocardiografia, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. mcarrinho@cardiol.br
Moraes
Alvaro
A
Morcerf
Fernando
F
Medeiros
Caio
C
Castier
Márcia
M
Romeo
Luis José Martins
LJ
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
D000418:Albumins; D003287:Contrast Media; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine