Contrast Stress Echocardiography for the Diagnosis of Coronary Artery Disease in Patients With Chest Pain but Without Acute Coronary Syndrome: Incremental Value of Myocardial Perfusion

Assessment of tissue perfusion by contrast-enhanced ultrasound

“…Myocardial contrast echocardiography offers real-time frame rates and the direct correlation between flow and wall motion. It has many potential advantages over conventional methods, particularly SPECT, with regard to both cost and exposure to ionising radiation [65], and could reduce the number of inappropriate admissions of patients with non-cardiac stress pain [66].…”

Resting Echocardiography for the Early Detection of Acute Coronary Syndromes in Chest Pain Unit Patients

“…Several investigations 14–16 highlight the resources of a cardiologist‐run CPU. These units allow for the implementation of a complete monitoring protocol including resting echocardiography, exercise stress testing, pharmacologic stress echocardiography, 23,25 contrast stress echocardiography, 9,22 quantitative tissue Doppler echocardiography, 21 64‐slice multi‐detector cardiac computed tomography angiography, 14 and rest myocardial perfusion imaging utilizing technetium‐99m sestamibi 14–16 . However, the use of echocardiography in the CPU requires prompt interpretation to affect patient decision making 7 .…”

Imaging functional stress test for stable chest pain symptoms in patients at low pretest probability of coronary artery disease: Current practice and long‐term outcome

“…Hypertension was defined as blood pressure > 140/90 mm Hg or use of antihypertensive medication. Because of the uncertain image quality at peak stress, dip‐SE studies at Parma institution are performed with ultrasound contrast to guarantee optimal endocardial border enhancement, even when rest segmental wall motion is deemed optimally interpretable, higher quality imaging in any case translating into a diagnostic and prognostic advantage during SE . The study complies with the Declaration of Helsinki, and the research protocol was approved by the locally appointed ethics committee.…”

“…Patients had to refrain from caffeine, methylxanthine‐containing substances for at least 12 hours before testing. Stress and rest SPECT examinations were performed according to accepted guidelines, using the 17‐segment left ventricle segmentation . Briefly, either 1‐ or 2‐day protocol was used; a weight‐adjusted dose of 99m Tc‐Sestamibi tracer (approximately 740 + 740 MBq in 2 days protocol and 300 + 900 MBq in one day protocol) was injected intravenously at rest and 2 minutes after the end of dipyridamole infusion.…”