title: Value of real-time three-dimensional adenosine stress contrast echocardiography in patients with known or suspected coronary artery disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility of myocardial wall-motion and perfusion assessment using contrast echocardiography during real-time three-dimensional (RT3D) adenosine stress test, and compare its diagnostic accuracy with the two-dimensional (2D) method using coronary angiography as reference.
  
  
  RESULTS
  Patients with known or suspected coronary artery disease (CAD) have been submitted to adenosine stress contrast echocardiography and coronary angiography, within a 1-month period. Two-dimensional apical four, two, and three chamber, as well as three-dimensional (3D) pyramidal full-volume data sets were acquired at rest and at peak stress. The 17-segment division of the left ventricle was used and each segment was evaluated based on wall motion and perfusion. Sixty patients (age: 60.1 ± 8.5 years, 38 men) were enrolled, i.e. 1020 segments were evaluated at rest and at peak stress. Wall-motion analysis per patient revealed that the sensitivity and specificity of 2D to detect CAD were 80 and 82% and of RT3D echocardiography were 82 and 64%, respectively, whereas in the per patient perfusion analysis the respective percentages were 88, 64% for 2D and 90, 73% for RT3D. Regarding left anterior descending artery and right coronary system, there seems to be no statistical significant difference in terms of wall-motion and perfusion evaluation between the two modalities.
  
  
  CONCLUSIONS
  Real-time 3D adenosine stress echocardiography is a feasible and valuable technique to evaluate myocardial wall motion and perfusion in patients with suspected CAD, despite existing problems concerning lower spatial and temporal resolution when compared with 2D echocardiography.
authors.affiliation: 1st Department of Cardiology, University of Athens Medical School, Hippokration Hospital, 63, Kasomouli St, N.Kosmos, 11744 Athens, Greece.
authors.forename: Constantina
authors.initials: C
authors.lastname: Aggeli
authors.forename: Ioannis
authors.initials: I
authors.lastname: Felekos
authors.forename: George
authors.initials: G
authors.lastname: Roussakis
authors.forename: Christina
authors.initials: C
authors.lastname: Kazazaki
authors.forename: Stauroula
authors.initials: S
authors.lastname: Lagoudakou
authors.forename: Panagiota
authors.initials: P
authors.lastname: Pietri
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000241:Adenosine; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D025401:Echocardiography, Stress; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D012680:Sensitivity and Specificity
chemical_list: D000241:Adenosine