Adenosine Stress Myocardial Contrast Echocardiography for the Detection of Coronary Artery Disease

Arnold, Jayanth R.; Karamitsos, Theodoros D; Pegg, Tammy; Francis, Jane M; Olszewski, Robert; Searle, Nick; Senior, Roxy; Neubauer, Stefan; Becher, Harald; Selvanayagam, Joseph B.

doi:10.1016/j.jcmg.2010.06.011

Cited by 48 publications

(24 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,2 Real-time myocardial contrast echocardiography (RTMCE), using a continuous infusion of ultrasound contrast, has been shown to be effective for detection of myocardial perfusion abnormalities during either vasodilator or demand stress. [3][4][5][6][7][8][9][10][11][12][13] Although RTMCE has been used to detect coronary artery stenoses (CAD) with vasodilators such as dipyridamole and adenosine, 10 -13 its use with a direct A2A agonist bolus offers the potential to detect CAD within minutes at the bedside without the need for exposure to ionizing radiation or cumbersome infusion setups. 14,15 The purpose of the present study was to determine the sensitivity, specificity, and accuracy of RTMCE in the detection of CAD after a regadenoson bolus injection.…”

mentioning

confidence: 99%

Rapid Detection of Coronary Artery Stenoses With Real-Time Perfusion Echocardiography During Regadenoson Stress

Porter

Adolphson

High

et al. 2011

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

Background-Real-time myocardial contrast echocardiography permits the detection of myocardial perfusion abnormalities during stress echocardiography, which may improve the accuracy of the test in detecting coronary artery stenoses. We hypothesized that this technique could be used after a bolus injection of the selective A2A receptor agonist regadenoson to rapidly and safely detect coronary artery stenoses. Methods and Results-In 100 patients referred for quantitative coronary angiography, real-time myocardial contrast echocardiography was performed during a continuous intravenous infusion of 3% Definity at baseline and at 2-minute intervals for up to 6 minutes after a regadenoson bolus injection (400 g). Myocardial perfusion was assessed by examination of myocardial contrast replenishment after brief high mechanical index impulses. A perfusion defect was defined as a delay (Ͼ2 seconds) in myocardial contrast replenishment in 2 contiguous segments. Wall motion was also analyzed. The overall sensitivity/specificity/accuracy for myocardial perfusion analysis in detecting a Ͼ50% diameter stenosis was 80%/74%/78%, whereas for wall motion analysis it was 60%/72%/66% (PϽ0.001 for differences in sensitivity). Sensitivity for myocardial perfusion analysis was highest on images obtained during the first 2 minutes after regadenoson bolus (PϽ0.001 compared with wall motion), whereas wall motion sensitivity was highest at the 4-to-6 -minute period after the bolus. No significant side effects occurred after regadenoson bolus injection. Conclusions-Regadenoson

show abstract

mentioning

confidence: 99%

Rapid Detection of Coronary Artery Stenoses With Real-Time Perfusion Echocardiography During Regadenoson Stress

Porter

Adolphson

High

et al. 2011

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

show abstract

“…However in a recent study about interobserver variability of stress induced first-pass MR has showed only moderate agreement which has been influenced by experience and systematic reading criteria [16]. Reversible adenosine induced perfusion defects obtained from cardiac MR has found ificity, and accuracy of this modality compared to X-ray angiography and cardiac MR were 85%, 76% and 82% versus 85%, 74% and 79% respectively [25]. Although it has been documented that interobserver agreement is better in the contrast enhanced echocardiography however we employed a non-contrast protocol in our study [26].…”

Section: Discussionmentioning

confidence: 99%

Adenosine Stress Myocardial Perfusion Scintigraphy and Echocardiography Application with Same Infusion

Pinar¹,

Dağlı²,

Ansal³

et al. 2017

Int J Clin Cardiol

View full text Add to dashboard Cite

Objective: Stress Echocardiography (Echo) and Myocardial Perfusion Scintigraphy (MPS) are effective methods for identification of myocardial ischemia. Aim of this study was to compare adenosine stress MPS and Echo results with gold standard angiography. Methods:Twenty nine patients (18 F, 11 M; mean: 49, 62 ± 10, 9; 45, 5-53, 8-years-old) with suspicion of Coronary Artery Disease (CAD) were included into the study. After performance of basal Echo examination, adenosine infusion was started (140 µgr/kg/dk) and at the third minute after starting the infusion, intravenous Tc-99m MIBI injection was performed and stress Echo findings were recorded at the 10 th minute. Stress and rest imaging were performed at the same day. Stress Echo was performed by an experienced cardiologist and MPS results were interpreted by an experienced nuclear medicine physician who didn't know stress Echo results according to 17 segment models. Sixteen patients underwent coronary angiography. Ischemia territory size in both the adenosine stress Echo and MPS were recorded and compared in segment and in patient basis.Results: There were 34 ischemic segments in MPS and 46 in stress Echo among 493 segments of 29 patients. Both MPS and stress Echo pointed the same ischemic segments in 9 patients and tests were in agreement in 24 patients. Angiography confirmed two tests results in 13/16 patients. Three patients with severe ischemia in the MPS and stress Echo had slow flow pattern in the angiography. Conclusion:The results of both MPS and stress Echo with same adenosine infusion was in agreement especially in patients with angiography results. These findings can encourage simultaneous studies with same stress agent infusion.

show abstract

“…16,17 It may also occur with severe CAD. 18 Although only 1% of the patients underwent Figure 4 Incremental predictive values (depicted on the y axis as c 2 values) of resting LV function, WM assessment, and MP assessment over clinical variables, using sequential Cox regression models.…”

Section: Discussionmentioning

confidence: 99%

The Incremental Prognostic Value of the Incorporation of Myocardial Perfusion Assessment into Clinical Testing with Stress Echocardiography Study

Shah

Gonzalez-Gonzalez

Drakopoulou

et al. 2015

Journal of the American Society of Echocardiography

Self Cite

View full text Add to dashboard Cite

Adenosine Stress Myocardial Contrast Echocardiography for the Detection of Coronary Artery Disease

Abstract: Adenosine MCE achieved favorable diagnostic performance in identifying the presence and functional significance of coronary stenosis. Adenosine MCE may be useful in the clinical setting for evaluating patients with suspected CAD.

Cited by 48 publications

References 35 publications

Rapid Detection of Coronary Artery Stenoses With Real-Time Perfusion Echocardiography During Regadenoson Stress

Rapid Detection of Coronary Artery Stenoses With Real-Time Perfusion Echocardiography During Regadenoson Stress

Adenosine Stress Myocardial Perfusion Scintigraphy and Echocardiography Application with Same Infusion

The Incremental Prognostic Value of the Incorporation of Myocardial Perfusion Assessment into Clinical Testing with Stress Echocardiography Study

Contact Info

Product

Resources

About