Can myocardial contrast echo provide incremental benefit to exercise echo? Implications of the intensity and duration of hyperaemia

Moir, W. S., Haluska, B. A., Jenkins, C., Lim, R., Cox, S., Garrahy, P. and Marwick, T. H. (2004). Can myocardial contrast echo provide incremental benefit to exercise echo? Implications of the intensity and duration of hyperaemia. In: Franklin Rosenfeldt, Heart Lung and Circulation: The Cardiac Society of Australia and New Zealand, New Zealand Annual Scientific Meeting 2004 Cardiology Bench to Bedside: The Science and The Practice. The Cardiac Society of Australia and New Zealand, New Zealand Annual Scientific Meeting 2004 Cardiology Bench to Bedside: The Science and The Practice, Brisbane, Australia, (S101-S101). 7-11 August 2004. doi:10.1016/j.hlc.2004.05.001


Author Moir, W. S.
Haluska, B. A.
Jenkins, C.
Lim, R.
Cox, S.
Garrahy, P.
Marwick, T. H.
Title of paper Can myocardial contrast echo provide incremental benefit to exercise echo? Implications of the intensity and duration of hyperaemia
Conference name The Cardiac Society of Australia and New Zealand, New Zealand Annual Scientific Meeting 2004 Cardiology Bench to Bedside: The Science and The Practice
Conference location Brisbane, Australia
Conference dates 7-11 August 2004
Proceedings title Heart Lung and Circulation: The Cardiac Society of Australia and New Zealand, New Zealand Annual Scientific Meeting 2004 Cardiology Bench to Bedside: The Science and The Practice   Check publisher's open access policy
Place of Publication Australia
Publisher Blackwell Publishing Asia
Publication Year 2004
DOI 10.1016/j.hlc.2004.05.001
ISSN 1443-9506
Editor Franklin Rosenfeldt
Volume 13
Issue Supplement 2
Start page S101
End page S101
Total pages 1
Collection year 2004
Language eng
Abstract/Summary Background. Stress myocardial contrast echo (MCE) is technically challenging with exercise (Ex) because of cardiacmovementandshort duration ofhyperemia.Vasodilators solve these limitations, but are less potent for inducing abnormal wall motion (WM). We sought whether a combined dipyridamole (DI; 0.56 mg/kg i.v. 4 min) and Ex stress protocol would enable MCE to provide incremental benefit toWManalysis for detection of CAD. Methods. Standard echo images were followed by real time MCE at rest and following stress in 85 pts, 70 undergoing quantitative coronary angiography and 15 low risk pts.WMAfrom standard and LVopacification images, and then myocardial perfusion were assessed sequentially in a blinded fashion. A subgroup of 13 pts also underwent Ex alone, to assess the contribution of DI to quantitative myocardial flow reserve (MFR). Results. Significant (>50%) stenoses were present in 43 pts, involving 69 territories. Addition of MCE improved SE sensitivity for detection of CAD (91% versus 74%, P = 0.02) and better appreciation of disease extent (87% versus 65%territories, P=0.003), with a non-significant reduction in specificity. In 55 territories subtended by a significant stenosis, but with no resting WM abnormality, ability to identify ischemia was also significantly increased by MCE (82% versus 60%, P = 0.002). MFR was less with Ex alone than with DIEx stress (2.4 ± 1.6 versus 4.0 ± 1.9, P = 0.05), suggesting prolongation of hyperaemia with DI may be essential to the results. Conclusions. Dipyridamole-exercise MCE adds significant incremental benefit to standard SE, with improved diagnostic sensitivity and more accurate estimation of extent of CAD.
Subjects EX
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Q-Index Code EX

 
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Created: Thu, 23 Aug 2007, 19:18:39 EST