A Head‐to‐Head Comparison of Infusion and Bolus Doses of Adenosine for Stress Myocardial Contrast Echocardiography

Abstract

Both adenosine infusion and adenosine bolus protocols are safe for MCE in humans and can be used for the diagnosis of CAD.

Detection of Coronary Artery Disease with a Continuous Infusion of Definity Ultrasound Contrast during Adenosine Stress Real Time Perfusion Echocardiography

“…This study, for the first time, correlated real time perfusion contrast echocardiography with radionuclide imaging in detecting coronary artery disease during adenosine stress imaging in prospective patients with intermediate to high pretest probability of coronary artery disease. The correlation of RTPE with radionuclide uptake was excellent, and similar to previous studies which utilized triggered imaging with harmonic power Doppler 10–12 . One of these studies 10 had more false positive perfusion abnormalities in the left circumflex coronary artery territory, which we did not observe when using RTPE.…”

“…The correlation of RTPE with radionuclide uptake was excellent, and similar to previous studies which utilized triggered imaging with harmonic power Doppler. [10][11][12] One of these studies 10 had more false positive perfusion abnormalities in the left circumflex coro- nary artery territory, which we did not observe when using RTPE. One potential reason for this is that we required two contiguous segments to exhibit reduced contrast enhancement before being diagnosed as abnormal.…”

“…In more recent studies, Karavidas et al have shown that MCE with adenosine had a higher diagnostic accuracy compared to SPECT for the detection of CAD when using angiography as a gold standard 11 . Nesser et al demonstrated that both adenosine infusion and adenosine bolus protocols were safe and accurate for the diagnosis of CAD 12 . All of these previous studies analyzed perfusion at a fixed time point (trigger mode) after a high MI impulse.…”

“…11 Nesser et al demonstrated that both adenosine infusion and adenosine bolus protocols were safe and accurate for the diagnosis of CAD. 12 All of these previous studies analyzed perfusion at a fixed time point (trigger mode) after a high MI impulse. Since we examined perfusion in real time using a continuous infusion of microbubbles, we benefited from examining the initial appearance of contrast enhancement following a destructive impulse, a technique which has improved the detection of perfusion abnormalities during vasodilator stress.…”