Efficacy of Myocardial Contrast Echocardiography in the Diagnosis and Risk Stratification of Acute Coronary Syndrome

Kang, Duk Hyun; Kang, Soo Jin; Song, Jong Min; Choi, Kee Jun; Hong, Myeong Ki; Song, Jae Kwan; Park, Seong Wook; Park, Seung Jung

doi:10.1016/j.amjcard.2005.07.057

Cited by 21 publications

(19 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…22 Kang and colleagues found that MCE is more sensitive for diagnosing ACS (77%) compared to ST changes (28%), troponin I (34%) and regional wall motion abnormalities (49%). 23 The surprisingly low sensitivity of the troponin would likely not hold true with current generation high sensitivity assays. Interestingly the use of MCE may help curb the trepidation caused by the epidemic of "troponinitis" due to these high sensitivity assays.…”

Section: Evaluation Of Acute Coronary Syndrome (Acs)mentioning

confidence: 98%

Myocardial Perfusion Imaging Using Contrast Echocardiography

Pathan

Marwick

2015

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

Section: Evaluation Of Acute Coronary Syndrome (Acs)mentioning

confidence: 98%

Myocardial Perfusion Imaging Using Contrast Echocardiography

Pathan

Marwick

2015

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

“…Thus, myocardial contrast echocardiography (MCE) can determine whether patients with acute chest pain are suffering from an acute coronary syndrome (ACS). In a prospective study of 114 patients presenting to the emergency room with "suspected cardiac chest pain", myocardial perfusion defects demonstrated 77% sensitivity for the detection of ACS compared to 28% and 34% respectively with ECG and troponin while maintaining similar specificity (89-96%) 25). Abnormal myocardial perfusion was the only independent variable for diagnosing an ACS (odds ratio = 87, p < 0.001).…”

Section: Applications Of Molecular Imagingmentioning

confidence: 98%

Future Applications of Contrast Ultrasound

Wei

2011

J Cardiovasc Ultrasound

View full text Add to dashboard Cite

Contrast agents are currently used during echocardiography for enhancement of structure and function, as well as for perfusion imaging. The next frontiers in contrast ultrasonography are targeted imaging, and using microbubbles for therapeutic purposes. Targeted imaging is the detection of specific components of cardiovascular disease in vivo, with microbubbles which may non-specifically attach to diseased endothelial cells, or with microbubbles which have been specifically designed to detect a pathologic process. Therapeutic applications of contrast ultrasonography include the use of microbubbles to enhance delivery of agents (like drugs, genes, growth factors, etc.) to the endothelium or perivascular cells. This review will discuss differences in contrast agents used for current applications versus targeted imaging, technical considerations required to achieve site-specific imaging, and potential applications of this technology. The potential for contrast ultrasonography to enhance drug and gene delivery to tissue will also be discussed.

show abstract

“…19)20) We have previously reported that the sensitivity of MCE (77%) for the detection of ACS is significantly higher than that of ECG change (28%), troponin I (34%) and regional wall motion abnormalities (49%), with similar specificities of 85% to 96%. 16) Although a prospective, multicenter study comparing MCE with resting technetium-99m sestamibi MPI found a 77% concordance between these two methods, suggesting both may be useful in diagnosing adverse cardiac events, their diagnostic accuracy in perfusion assessment was not compared. 20) In addition, unstable angina was excluded in evaluating events.…”

Section: Discussionmentioning

confidence: 99%

“…If perfusion defects were consistent with a typical ischemic territory of a coronary artery, observed in the subendocardial area, or associated with wall motion abnormalities of the same area, or if the severity of perfusion defects improved according to the lengthening triggering interval, perfusion defects were regarded as true myocardial perfusion defects and not artifacts. 16) Myocardial perfusion defects present in at least one coronary territory were considered positive ( Fig. 1A).…”

Section: Myocardial Contrast Echocardiographymentioning

confidence: 99%

Comparison of Myocardial Contrast Echocardiography Versus Rest Sestamibi Myocardial Perfusion Imaging in the Early Diagnosis of Acute Coronary Syndrome

Kang

Song

et al. 2010

J Cardiovasc Ultrasound

Self Cite

View full text Add to dashboard Cite

C Co om mp pa ar ri is so on n o of f M My yo oc ca ar rd di ia al l C Co on nt tr ra as st t E Ec ch ho oc ca ar rd di io og gr ra ap ph hy y V Ve er rs su us s R Re es st t S Se es st ta am mi ib bi i M My yo oc ca ar rd di ia al l P Pe er rf fu us si io on n I Im ma ag gi in ng g i in n t th he e E Ea ar rl ly y D Di ia ag gn no os si is s o of f A Ac cu ut te e C Co or ro on na ar ry y S Sy yn nd dr ro om me e It remains unclear whether myocardial contrast echocardiography (MCE) is as accurate as myocardial perfusion imaging with technetium-99m sestamibi (MPI) for the diagnosis of acute coronary syndrome (ACS). We sought to directly compare the diagnostic accuracy of MCE with resting MPI in a head-to-head fashion. M Me et th ho od ds s: : We prospectively enrolled 98 consecutive patients (mean age; 59±9 years, 68 males) who presented to the emergency department with chest pain suggestive of acute myocardial ischemia. Early MCE was performed by using continuous infusion of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) during intermittent power Doppler harmonic imaging. Myocardial perfusion defects observed in at least one coronary territory were considered positive. Sestamibi was injected immediately after MCE and MPI was obtained within 6 hours of tracer injection. R Re es su ul lt ts s: : ACS was confirmed in 67 patients. There were 32 patients with acute myocardial infarction (AMI) and 35 patients with unstable angina requiring urgent revascularization. The sensitivities of MCE and MPI for the diagnosis of ACS were 72% and 61%, respectively, which were significantly higher than those of ST segment change (24%, p<0.001 vs. MCE and vs. MPI) and troponin I (27%, p<0.001 vs. MCE and vs. MPI), with similar specificities of 90% to 100%. On a receiveroperating characteristics curve demonstrating diagnostic accuracy for ACS, the area under the curve of MCE was significantly larger than that of MPI (0.86 vs. 0.77, respectively; p=0.019). C Co on nc cl lu us si io on n: : MCE and MPI overcome the low sensitivity of routine triage tests for detecting ACS, and MCE is more accurate than MPI for the diagnosis of ACS in the emergency department.

show abstract

Efficacy of Myocardial Contrast Echocardiography in the Diagnosis and Risk Stratification of Acute Coronary Syndrome

Cited by 21 publications

References 18 publications

Myocardial Perfusion Imaging Using Contrast Echocardiography

Myocardial Perfusion Imaging Using Contrast Echocardiography

Future Applications of Contrast Ultrasound

Comparison of Myocardial Contrast Echocardiography Versus Rest Sestamibi Myocardial Perfusion Imaging in the Early Diagnosis of Acute Coronary Syndrome

Contact Info

Product

Resources

About