Prediction of functional recovery of hibernating myocardium using harmonic power Doppler imaging and dobutamine stress echocardiography in patients with coronary artery disease

Aggeli, C.; Stefanadis, Christodoulos; Bonou, Μaria; Pitsavos, Christos; Theocharis, C. S.; Roussakis, G.; Chatzos, Constantinos; Brili, Stela; Toutouzas, Pavlos

doi:10.1016/s0002-9149(03)00391-6

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…In echocardiography, after their first use for Doppler signal enhancement,25 their applications have expanded to include left-ventricle opacification and the study of myocardial perfusion 26. Pharmacological echo-stress testing, on the other hand, is an established method for CAD diagnosis1 2 as well as for viability assessment,27 whose safety has been demonstrated in several settings 4 – 6. The use of increasingly aggressive dobutamine–atropine protocols allowed an impressive rise in the proportion of diagnostic tests, without a marked increase in complications 28.…”

Section: Discussionmentioning

confidence: 99%

Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies

Aggeli¹,

Γιαννόπουλος

Roussakis

et al. 2008

Heart

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Objective: The purpose of the present study was to provide evidence regarding the safety of real-time flashcontrast echocardiography combined with dobutamineatropine stress echo (DASE). Background: The combination of perfusion assessment using myocardial contrast echocardiography (MCE) with DASE has shown very promising results for the diagnosis of coronary artery disease. Concerns have, however, been expressed regarding the safety of the use of echocontrast agents in echocardiography. Design: 5250 individuals (70.8% men, aged 64.6 years (SD 10.6)) were submitted to DASE, with concurrent MCE using a low mechanical index technique with the administration of high-energy impulses in order to assess replenishment time. Results: No deaths or myocardial infarctions were observed. Sustained ventricular tachycardia (VT) or fibrillation requiring resuscitation occurred in two cases (0.04%). The incidence of other arrhythmic events was: sustained VT not requiring resuscitation, 10 (0.18%); nonsustained VT, 18 (0.34%); atrial tachycardia, 4 (0.08%); atrial fibrillation, 25 (0.48%). Other observed adverse events included: intense headache, 52 (1%); intense back pain, 26 (0.5%). Vagal reactions with marked systolic blood pressure falls were observed in 45 cases (0.9%). Hypersensitivity reactions were reported in 23 cases (0.44%), although no serious cases of hypersensitivity requiring hospitalisation were recorded. The sensitivity, specificity and overall accuracy of DASE/MCE were 92%, 61% and 85%, respectively. Conclusions: This report of safety data regarding stresscontrast echocardiography in a large series of subjects suggests that this is an exceptionally safe technique, given that in 5250 studies no study-related deaths or myocardial infarctions were encountered, whereas serious adverse events requiring hospitalisation were extremely rare (one in 2625 studies).

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Section: Discussionmentioning

confidence: 99%

Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies

Aggeli¹,

Γιαννόπουλος

Roussakis

et al. 2008

Heart

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“…Therefore wider adoption of MCE will surely bring further advancements to clinical patient care. Senior et al [64] Aggeli et al [42] Shimoni et al [46] Fernandes et al [65] Janardhanan et al [43] Choi et al [44] Abe et al [66] Kousouglou et al [67] …”

Section: Discussionmentioning

confidence: 99%

“…This can be performed with MCE by demonstrating microvascular integrity Fig. (5) or low-dose dobutamine which assesses left ventricular contractile reserve [41,42]. Several studies [43,44] have shown an excellent correlation between myocardial contrast echocardiography and CMR for the determination of scar extent in patients who sustained myocardial infarction.…”

Section: Myocardial Viabilitymentioning

confidence: 99%

Contrast Echocardiography: An Update on Clinical Applications

Aggeli

Felekos²,

Tsiamis³

et al. 2012

CPD

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Contrast echocardiography is considered by many as the Holy Grail for the assessment of heart disease, including coronary artery disease, structural abnormalities and cardiomyopathies. Although contrast agents have been severely criticized at times, they are now officially implemented into an extended variety of clinical applications, as illustrated by the American and European echocardiographic societies published consensus statements. The current review highlights contrast major clinical applications under the light of current literature data.

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“…Moreover, the predictive accuracy of MCE was similar to that of thallium scintigraphy. Lately, in two studies [57,58] intravenously MCE was applied at rest using triggering modality, followed by dobutamine stress echocardiography. Aggeli et al [57] reported that harmonic power Doppler imaging had similar accuracy (74%) to dobutamine stress test (79%) in predicting functional myocardial recovery after coronary bypass surgery in patients with depressed left ventricular function.…”

Section: Detection Of Hibernating Myocardium In Chronic Coronary Artementioning

confidence: 99%

“…Lately, in two studies [57,58] intravenously MCE was applied at rest using triggering modality, followed by dobutamine stress echocardiography. Aggeli et al [57] reported that harmonic power Doppler imaging had similar accuracy (74%) to dobutamine stress test (79%) in predicting functional myocardial recovery after coronary bypass surgery in patients with depressed left ventricular function. Moreover, Shimoni et al [58] published that when quantitative method of myocardial perfusion was used, the diagnostic accuracy of MCE increased, presenting high sensitivity 90% and moderate specificity 61%.…”

Section: Detection Of Hibernating Myocardium In Chronic Coronary Artementioning

confidence: 99%

Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease

Aggeli

Bonou

Stefanadis

2005

International Journal of Cardiology

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Prediction of functional recovery of hibernating myocardium using harmonic power Doppler imaging and dobutamine stress echocardiography in patients with coronary artery disease

Cited by 13 publications

References 18 publications

Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies

Safety of myocardial flash-contrast echocardiography in combination with dobutamine stress testing for the detection of ischaemia in 5250 studies

Contrast Echocardiography: An Update on Clinical Applications

Potential clinical applications of myocardial contrast echocardiography in evaluating myocardial perfusion in coronary artery disease

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