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Physiologic Assessment of Left Anterior Descending Coronary Artery Stenosis by Quantitative Intravenous Myocardial Contrast Echocardiography in Humans: Comparison With Exercise Single‐Photon Emission Computed Tomography
Author(s) -
Fukuda Shota,
Muro Takashi,
Hozumi Takeshi,
Watanabe Hiroyuki,
Yamagishi Hiroyuki,
Yoshiyama Minoru,
Takeuchi Kazuhide,
Yoshikawa Junichi
Publication year - 2003
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1046/j.1540-8175.2003.03088.x
Subject(s) - medicine , cardiology , stenosis , radiology , computed tomography , contrast (vision) , single photon emission computed tomography , artery , physics , optics
Objective: To clarify the potential of quantitative intravenous myocardial contrast echocardiography (MCE) for physiologic assessment of the left anterior descending artery (LAD) stenosis. Methods: We studied 38 patients with suspected coronary artery disease. MCE was performed by continuous infusion of Levovist and intermittent ultrasonic exposure. Images were obtained from the apical four‐chamber view at rest and after dipyridamole infusion. The background‐subtracted intensity versus pulsing interval plots were fitted to an exponential function,Y = A (1 e −ß ), to obtain the plateau level (A) and rate of rise (ß) of background‐subtracted intensity both at rest and after dipyridamole infusion. We compared the results with those of exercise thallium‐201 single‐photon emission computed tomography (SPECT). Results: Of the 38 patients, 18 patients exhibited redistribution in the LAD territories with SPECT (group A), although 20 did not (group B). The ß reserve (DIP/rest) in group A was significantly lower than those in group B (0.8 ± 0.5versus2.0 ± 1.1, P < 0.001), while the A reserve did not differ between the two groups (1.2 ± 0.6versus1.0 ± 0.5, P = NS). The ß reserve <1.1, which was the optimal cutoff value, provided sensitivity of 79% and specificity of 84% for the presence of redistribution in SPECT. Conclusions: Quantitative intravenous MCE allows us to estimate physiologic severity of the LAD stenosis in the clinical setting. (ECHOCARDIOGRAPHY, Volume 20, August 2003)