A head-to-head comparison of infusion and bolus doses of adenosine for stress myocardial contrast echocardiography.
BACKGROUND
This study was a head-to-head, intraindividual comparison of the diagnostic accuracy and side effect profile of bolus and infusion administration of adenosine for stress myocardial contrast echocardiography (MCE).


METHODS
Adenosine MCE was performed in 64 subjects, referred for stress thallium-201 single-photon emission computed tomography (SPECT) for known or suspected CAD. Each patient received adenosine by multiple boluses (6-12 mg/bolus) and infusion (140 mug/kg per min for 6 min) forms in random order, given at least 20 minutes apart.


RESULTS
No prolonged or serious adverse events occurred during either adenosine bolus or infusion. Compared to SPECT imaging, the sensitivity, specificity, and concordance for the diagnosis of CAD were 77%, 87%, and 82% for adenosine infusion MCE and 81%, 90%, and 86% for adenosine bolus MCE, respectively.


CONCLUSIONS
Both adenosine infusion and adenosine bolus protocols are safe for MCE in humans and can be used for the diagnosis of CAD.
Nesser
Hans Joachim
HJ
IInd Department of Medicine, Cardiology, KH der Elisabethinen Hospital, Linz, Austria. hans-joachim.nesser@elisabethinen.or.at
Yao
Jiefen
J
Soman
Prem
P
Tkalec
Wolfgang
W
Ebner
Christian
C
Steringer-Mascherbauer
Regina
R
Markt
Bernhard
B
Samenuk
David
D
Ng
Choi-Keung
CK
Morcerf
Fernando
F
Udelson
James E
JE
Pandian
Natesa G
NG
D000241:Adenosine / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons; D014665:Vasodilator Agents; D000241:Adenosine