Myocardial perfusion assessment in patients with medium probability of coronary artery disease and no prior myocardial infarction: comparison of myocardial contrast echocardiography with 99mTc single-photon emission computed tomography

Senior, Roxy; Lepper, W.; Pasquet, Agnès; Chung, George K.T.; Hoffman, Rainer; Vanoverschelde, Jean-Louis; Cerqueira, Manuel D.; Kaul, Sanjiv

doi:10.1016/j.ahj.2003.12.030

Cited by 80 publications

(46 citation statements)

References 15 publications

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“…However, resting myocardial blood volume and perfusion are preserved despite a reduction in WT and function. Preservation of septal myocardial perfusion in patients with LBBB also was shown in recent positron emission tomography studies using 15 0 Ϫ water and 13 N-NH 3 , which are robust markers of MBF, as blood flow tracers. 19,20 In addition, our study demonstrated that MBFR is reduced, although homogeneously, throughout the LV.…”

Section: Discussionmentioning

confidence: 93%

“…A reversible perfusion defect was considered present when a contrast defect was observed 1 second after destructive imaging after vasodilator stress with the presence of a transmural defect filling from the subepicardium to subendocardium during subsequent cardiac cycles. 15 CAD was considered to be present when 2 contiguous segments demonstrated perfusion defects (rest or stress). Multivessel disease was considered present when perfusion defects were noted in Ͼ1 vascular territory.…”

Section: Mce Studiesmentioning

confidence: 99%

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Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

et al. 2008

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Background-We aimed to investigate the cardiac effects of left bundle-branch block (LBBB) using myocardial contrast echocardiography (MCE) to ascertain the value of MCE for detecting coronary artery disease (CAD) and to uncover the mechanism that affects the accuracy of single-photon emission computed tomography (SPECT) in these patients. Methods and Results-Sixty-three symptomatic LBBB patients (group A), 10 left ventricular ejection fraction-matched control subjects without LBBB and no CAD (group B), and 10 normal control subjects (group C) underwent resting echocardiography. Rest and vasodilator MCE and SPECT were undertaken in LBBB patients. Septal (SW) and posterior wall (PW) thickness, thickening, quantitative myocardial blood flow (MBF), and MBF reserve were measured. SW/PW thickness and percentage thickening ratios were lower (PϽ0.01 and PϽ0.05, respectively) in group A compared with both groups B and C, but resting SW/PW MBF and MBF reserve ratios were similar in all 3 groups. MBF reserve but not MBF was reduced in groups A and B (2.2Ϯ0.7 versus 2.2Ϯ0.2; Pϭ0.98) compared with group C (3.1Ϯ0.5; PϽ0.01). SW thickness was an independent predictor (Pϭ0.006) of SPECT perfusion defects in LBBB patients without CAD. MCE (92%) had a sensitivity similar to SPECT (92%); however, the specificity of MCE (95%) was superior (PϽ0.0001) to SPECT (47%) for the detection of CAD. Conclusions-Despite asymmetrical reduction in SW thickness and function, MBF is preserved and MBF reserve is homogeneously reduced in LBBB patients with left ventricular systolic dysfunction. Because of partial volume effects, the accuracy of SPECT for detecting CAD was significantly compromised compared with MCE in this patient cohort.

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Section: Discussionmentioning

confidence: 93%

Section: Mce Studiesmentioning

confidence: 99%

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

et al. 2008

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“…It has been shown to be accurate in detecting flow-limiting CAD in patients with suspected CAD. [4][5][6] Recent studies have shown that SCMP is associated with dysfunction of the microvascular perfusion rather than obstruction of an epicardial coronary artery. 7 Therefore, we hypothesized that MCE may also be able to accurately distinguish SCMP from AMI.…”

Section: Tress-induced Cardiomyopathy (Scmp) Is Characterizedmentioning

confidence: 99%

Clinical Usefulness of Myocardial Contrast Echocardiography to Detect Stress-Induced Cardiomyopathy in the Emergency Department

Choi

Nam

Jangwon

et al. 2012

Circ J

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“…68 Thus, their resting function and perfusion were normal. From a clinical perspective, it is in these patients that the ability to diagnose CAD is most relevant.…”

Section: Mce For Cad Detectionmentioning

confidence: 99%

Myocardial Contrast Echocardiography

Kaul

2008

Circulation

Self Cite

117

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Myocardial perfusion assessment in patients with medium probability of coronary artery disease and no prior myocardial infarction: comparison of myocardial contrast echocardiography with 99mTc single-photon emission computed tomography

Cited by 80 publications

References 15 publications

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

Effects of Left Bundle-Branch Block on Cardiac Structure, Function, Perfusion, and Perfusion Reserve

Clinical Usefulness of Myocardial Contrast Echocardiography to Detect Stress-Induced Cardiomyopathy in the Emergency Department

Myocardial Contrast Echocardiography

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