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Clinical usefulness of low‐dose dobutamine stress real‐time myocardial contrast echocardiography for detection of viable myocardium
Author(s) -
Li Dongye,
Hao Ji,
Xia Yong,
Zhang Hui,
Xu Tongda,
Wang Xiaoping,
Zhang Yanbin,
Chen Junhong
Publication year - 2012
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20891
Subject(s) - medicine , cardiology , dobutamine , coronary artery disease , perfusion , stress echocardiography , ultrasound , percutaneous coronary intervention , nuclear medicine , radiology , myocardial infarction , hemodynamics
Objectives. To evaluate and compare the diagnostic accuracy of semi‐quantitative and quantitative real‐time myocardial contrast echocardiography (RT‐MCE) with low‐dose dobutamine stress echocardiography (LD‐DSE) in detecting viable myocardium. Methods. Thirty in‐patients with coronary artery disease and regional wall motion abnormalities underwent RT‐MCE without and with LD‐DSE. Percutaneous coronary intervention was performed within 1 week after RT‐MCE in all patients. Myocardial perfusion was evaluated from A, β, and A × β indices from microbubble replenishment curves. The motion of each myocardium segment was observed by routine echocardiography 1, 3, and 6 months after percutaneous coronary intervention and its improvement over time was the criterion of viable myocardium. Results. RT‐MCE sensitivity and specificity for the assessment of viable myocardium were 71.7% and 69.8%, rising to 81.3% and 76.7% ( p < 0.05) when combined with LD‐DSE. Using quantitative RT‐MCE with cutoff values of A, β, and A × β, the sensitivity and specificity were 75.6%, 78.8%, 82.1%, and 82.4%, 77.9%, 78.6%, respectively. When combined with LD‐DSE, the sensitivity and specificity were 86.0%, 83.2%; 88.9% and 84.1%; 89.6%, 79.9%, respectively. Conclusions. Quantitative RT‐MCE analysis yielded higher sensitivity and specificity than semi‐quantitative RT‐MCE with or without LD‐DSE for the detection of viable myocardium. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012