title: Myocardial contrast echocardiography for the detection of coronary artery stenosis: a prospective multicenter study in comparison with single-photon emission computed tomography.
abstract: OBJECTIVE
  The purpose of this study was to compare myocardial contrast echocardiography (MCE) with single-photon emission computed tomography (SPECT) for the detection of significant coronary artery disease (CAD) in patients with symptoms suggestive of CAD.
  
  
  BACKGROUND
  Single-photon emission computed tomography is a well-established method of assessing patients with CAD. Myocardial contrast echocardiography is a new technique allowing bedside assessment of myocardial perfusion. We hypothesized that MCE was comparable to SPECT in the assessment of patients with known or suspected CAD.
  
  
  METHODS
  A total of 123 patients scheduled for coronary angiography underwent intermediate (mechanical index 0.5) triggered replenishment MCE and SPECT imaging at rest and after vasodilator stress. Coronary angiography was performed within four weeks of stress imaging.
  
  
  RESULTS
  In total, 96 of 123 (78%) patients demonstrated CAD (stenosis >/=50%). There was no difference in the sensitivity of MCE compared with SPECT in the detection of CAD (84% vs. 82%; p = NS), and both demonstrated similar specificity (56% vs. 52%, respectively). In patients with multivessel disease, MCE and SPECT also demonstrated similar sensitivity (91% and 88%, respectively) for the detection of CAD. Agreement between MCE and SPECT for the presence or absence of CAD was 73%.
  
  
  CONCLUSIONS
  Myocardial contrast echocardiography is comparable to SPECT in the detection of CAD not only on a patient basis but also in the localization of disease by vascular territory in a relatively high-risk population.
authors.affiliation: Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, Middlesex, United Kingdom.
authors.forename: Paramjit
authors.initials: P
authors.lastname: Jeetley
authors.forename: Michael
authors.initials: M
authors.lastname: Hickman
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
authors.forename: Mani A
authors.initials: MA
authors.lastname: Vannan
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Vanoverschelde
authors.forename: Poll A
authors.initials: PA
authors.lastname: van der Wouw
authors.forename: Roxy
authors.initials: R
authors.lastname: Senior
mesh_terms: D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004176:Dipyridamole / Q000008:administration & dosage; D004452:Echocardiography; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007501:Iron; D008297:Male; D008875:Middle Aged; D010087:Oxides; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D004176:Dipyridamole; D007501:Iron