Real‐time perfusion adenosine stress echocardiography versus myocardial perfusion adenosine scintigraphy for the detection of myocardial ischaemia in patients with stable coronary artery disease

Abstract

Background Real-time perfusion (RTP) contrast echocardiography using low

Head to head comparisons of two modalities of perfusion adenosine stress echocardiography with simultaneous SPECT

“…As judged by SPECT, there were highly significant agreements for both AM and HR in detecting ischemia. The finding that RTP can be used to accurately detect ischemia is in line with previous investigations [ 11 - 15 , 17 , 18 ]. Although there were no significant differences between AM and HR in agreement, there were some differences worth discussing.…”

“…The similarities and differences between AM and HR were approximately similar in the sole perfusion analysis, as compared with the combined perfusion and wall motion analysis. This indicates that agreement with SPECT can be maintained using wall motion analysis in coronary areas with perfusion artifacts, as previously suggested [ 15 ]. This should be viewed in relation to the results of non-interpretable coronary areas; where the high number of non-interpretable coronary areas in the sole perfusion analysis clearly illustrates lower feasibility, compared to the combined perfusion and wall motion analysis.…”

“…The myocardial contrast echocardiography technique is still burdened with perfusion artifacts and echocardiographic shadowing, which limit the number of interpretable myocardial segments. These segments can in most cases, using RTP, still be interpreted with wall motion analysis, which therefore increases the usefulness of RTP-ASE without diminishing accuracy considerably [ 15 ]. Thus, combining perfusion and wall motion assessment, RTP-ASE has the potential of being as accurate and feasible as DSE and SPECT, and may be a swift, bedside-accessible, useful decision-making tool for risk assessment of patients with suspected myocardial ischemia.…”

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

“…CAD ϭ coronary artery disease; RCA ϭ right coronary artery; other abbreviations as in Figure 1. These studies reported 76% to 92% concordance with SPECT by territory, which is comparable to the 79% found in our study involving CMR (20,(22)(23)(24). Similarly, studies comparing MCE with coronary angiography have reported 71% to 92% diagnostic accuracy as compared with 82% in our study (20,21,24 -26).…”

Echocardiographic evaluation of coronary artery disease

“…Compared with nuclear myocardial perfusion imaging, stress echocardiography has slightly lower sensitivity (80 vs. 82%) and higher specificity (84 vs. 75%) for the diagnosis of coronary artery disease [41]. It also has greater versatility, lower cost, and no radiation exposure.…”