title: Feasibility of using a real-time 3-dimensional technique for contrast dobutamine stress echocardiography.
abstract: This is the first feasibility study using real-time 3-dimensional (3D) (RT3D) transthoracic contrast echocardiography with full-volume acquisition to evaluate left ventricular wall motion in patients undergoing dobutamine stress echocardiography. RT3D contrast and noncontrast 3D images were obtained at rest and peak dose dobutamine infusion and reviewed for image quality. A total of 14 patients underwent complete rest and stress RT3D contrast and noncontrast imaging. Ultrasound contrast significantly increased the proportion of segments adequately visualized during rest and peak dobutamine infusion (91%-98%, P = .001, and 87%-99%, P = .001, respectively). With contrast there was almost complete concordance between observers (96.9% at rest and 98.2% at peak stress with almost no interobserver variability), whereas noncontrast studies had much lower agreement (84.4% at rest and 79.9% at peak stress with kappa values < 0.4). Three-dimensional contrast studies compared favorably with standard 2-dimensional imaging. Time for acquisition of all data sets with and without contrast was less than 90 seconds. RT3D dobutamine contrast stress echocardiography is feasible, greatly improves image quality compared with noncontrast images, and quickly acquires full data sets for subsequent analysis.
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University, New York, New York, USA. tcp2003@columbia.edu
authors.forename: Todd
authors.initials: T
authors.lastname: Pulerwitz
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.forename: Ryo
authors.initials: R
authors.lastname: Otsuka
authors.forename: Susan
authors.initials: S
authors.lastname: Herz
authors.forename: Kazue
authors.initials: K
authors.lastname: Okajima
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
mesh_terms: D003199:Computer Systems; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D014665:Vasodilator Agents; D004280:Dobutamine