title: Clinical usefulness of low-dose dobutamine stress real-time myocardial contrast echocardiography for detection of viable myocardium.
abstract: OBJECTIVE
  To evaluate and compare the diagnostic accuracy of semi-quantitative and quantitative real-time myocardial contrast echocardiography (RT-MCE) with low-dose dobutamine stress echocardiography (LD-DSE) in detecting viable myocardium.
  
  
  METHODS
  Thirty in-patients with coronary artery disease and regional wall motion abnormalities underwent RT-MCE without and with LD-DSE. Percutaneous coronary intervention was performed within 1 week after RT-MCE in all patients. Myocardial perfusion was evaluated from A, β, and A × β indices from microbubble replenishment curves. The motion of each myocardium segment was observed by routine echocardiography 1, 3, and 6 months after percutaneous coronary intervention and its improvement over time was the criterion of viable myocardium.
  
  
  RESULTS
  RT-MCE sensitivity and specificity for the assessment of viable myocardium were 71.7% and 69.8%, rising to 81.3% and 76.7% (p < 0.05) when combined with LD-DSE. Using quantitative RT-MCE with cutoff values of A, β, and A × β, the sensitivity and specificity were 75.6%, 78.8%, 82.1%, and 82.4%, 77.9%, 78.6%, respectively. When combined with LD-DSE, the sensitivity and specificity were 86.0%, 83.2%; 88.9% and 84.1%; 89.6%, 79.9%, respectively.
  
  
  CONCLUSIONS
  Quantitative RT-MCE analysis yielded higher sensitivity and specificity than semi-quantitative RT-MCE with or without LD-DSE for the detection of viable myocardium.
authors.affiliation: Cardiovascular Disease Institute of Xuzhou Medical College, China.
authors.forename: Dong-Ye
authors.initials: DY
authors.lastname: Li
authors.forename: Ji
authors.initials: J
authors.lastname: Hao
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Tong-da
authors.initials: TD
authors.lastname: Xu
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Wang
authors.forename: Yan-Bin
authors.initials: YB
authors.lastname: Zhang
authors.forename: Jun-Hong
authors.initials: JH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004280:Dobutamine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology*; D009206:Myocardium; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine