A Head‐to‐Head Comparison of Infusion and Bolus Doses of Adenosine for Stress Myocardial Contrast Echocardiography

Background: This study was a head‐to‐head, intraindividual comparison of the diagnostic accuracy and side effect profile of bolus and infusion administration of adenosine for stress myocardial contrast echocardiography (MCE). Methods: Adenosine MCE was performed in 64 subjects, referred for stress thallium‐201 single‐photon emission computed tomography (SPECT) for known or suspected CAD. Each patient received adenosine by multiple boluses (6–12 mg/bolus) and infusion (140 μg/kg per min for 6 min) forms in random order, given at least 20 minutes apart. Results: No prolonged or serious adverse events occurred during either adenosine bolus or infusion. Compared to SPECT imaging, the sensitivity, specificity, and concordance for the diagnosis of CAD were 77%, 87%, and 82% for adenosine infusion MCE and 81%, 90%, and 86% for adenosine bolus MCE, respectively. Conclusions: Both adenosine infusion and adenosine bolus protocols are safe for MCE in humans and can be used for the diagnosis of CAD.