title: Adenosine triphosphate stress myocardial contrast echocardiography detects coronary artery stenosis with greater sensitivity than wall-motion abnormality measurements.
abstract: BACKGROUND
  Although stress myocardial contrast echocardiography (MCE) can be used to detect coronary stenosis, its efficacy relative to other methods, such as detection of wall-motion abnormalities, remains unknown. Thus, the goal of this study was to compare the sensitivity of MCE versus wall-motion abnormality detection in the assessment of coronary artery stenosis.
  
  
  METHODS
  Nine dogs with severe but nonflow limiting stenosis in the circumflex coronary artery underwent evaluation with real-time MCE along the short-axis view during infusion of Optison. The equation of y = a (1 - e -betat ) + c, which fits the replenishment curve of MCE, was calculated in the midseptum (normal region) and in the lateral wall (ischemic region) before and during adenosine triphosphate infusion. Wall-motion abnormalities were also evaluated by visual assessment and by measurement of wall thickening.
  
  
  RESULTS
  Area under the receiver operating characteristic curve in beta- and A x beta-value, and percent wall thickening, was 0.963, 0.963, and 0.889, respectively, indicating that the diagnostic accuracy for detecting the coronary artery stenosis by real-time MCE was higher than that by the wall-motion assessment.
  
  
  CONCLUSIONS
  Real-time MCE has higher sensitivity in detecting coronary stenosis during adenosine triphosphate stress test when compared with wall-motion assessment.
authors.affiliation: Department of Medical Physics, School of Allied Health Sciences, Faculty of Medicine, Osaka University, Suita, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Otani
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Toshida
authors.forename: Akiko
authors.initials: A
authors.lastname: Iwata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Asanuma
authors.forename: Fuminobu
authors.initials: F
authors.lastname: Ishikura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Beppu
mesh_terms: D000255:Adenosine Triphosphate; D000818:Animals; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004285:Dogs; D004452:Echocardiography; D025401:Echocardiography, Stress; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
chemical_list: D000255:Adenosine Triphosphate