Comparison of usefulness of dipyridamole stress myocardial contrast echocardiography to technetium-99m sestamibi single-photon emission computed tomography for detection of coronary artery disease (PB127 multicenter phase 2 trial results)

Kevin Wei, Linda Crouse, James Weiss, Flordeliza Villanueva, Nelson B. Schiller, Tasneem Z. Naqvi, Robert Siegel, Mark Monaghan, Jonathan Goldman, Paul Aggarwal, Harvey Feigenbaum, Anthony DeMaria

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

We hypothesized that assessment of hyperemic myocardial blood flow (MBF) velocity using myocardial contrast echocardiography (MCE) can detect coronary artery disease (CAD). We also postulated that only a single MCE study during stress is required for the detection of CAD in patients with normal function at rest. Patients with known or suspected CAD referred for dipyridamole stress technetium-99m sestamibi single-photon emission computed tomographic (SPECT) studies were enrolled. MCE was performed concurrently with SPECT using continuous infusions of PB127 during intermittent harmonic power Doppler imaging at multiple pulsing intervals. MCE and SPECT were compared in 43 of 54 patients who had adequate studies using both techniques. In 15 of the 43 patients, coronary angiography was performed within 30 days of the MCE/SPECT tests. Overall concordance for classification of patients as normal versus abnormal was 84% (κ = 0.63) between the 2 tests. When false-negative SPECT scans were corrected for results of angiography, concordance increased to 93% (κ = 0.82). For territorial analysis, concordance between MCE and SPECT for location of perfusion defects was 65% (κ = 0.41) and 74% (κ = 0.61) after SPECT was corrected by angiography. In patients with normal function at rest, a single stress MCE perfusion study allowed identification of CAD with the same concordance as rest/stress perfusion studies. In conclusion, visual assessment of regional differences in MBF velocity using PB127 allows detection of CAD with good concordance compared with technetium-99m sestamibi SPECT. In patients with normal left ventricular function at rest, a single stress PB127 MCE perfusion study is adequate for the detection of CAD.

Original languageEnglish (US)
Pages (from-to)1293-1298
Number of pages6
JournalAmerican Journal of Cardiology
Volume91
Issue number11
DOIs
StatePublished - Jun 1 2003

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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