Contrast echocardiography; Left ventricular function; Stress echocardiography; Myocardial perfusion
Abstract :
[en] Aims: Myocardial contrast perfusion echocardiography (MCE) allows simultaneous assessment of perfusion and function. However, low frame rate during MCE may reduce the viewer's ability to discern contractile dysfunction. This study sought to compare MCE and left ventricular opacification (LVO) settings with regard to wall motion abnormalities (WMA) at rest and during dobutamine stress echocardiography (DSE).
Methods and results: In 50 patients scheduled for coronary angiography and with poor baseline image quality, MCE and LVO were performed during DSE. Regional wall motion was assessed and inter-observer agreement was determined for each imaging modality. The endocardial border score index was similar for both modalities. The wall motion score index (WMSCI) at peak stress using MCE was well correlated with WMSCI obtained with LVO (r2 = 0.9, P < 0.001). However, WMSCI at peak stress was underestimated by MCE (1.66 ± 0.58 with DSE-LVO vs. 1.535 ± 0.50 with DSE-MCE; P < 0.001). Inter-observer agreement on the presence of WMA was 0.65 for MCE and 0.67 for LVO at peak stress.
Conclusion: Myocardial contrast perfusion echocardiography provides equal endocardial border delineation compared with LVO modality. Although the inter-observer agreement is slightly higher with LVO compared with MCE, it is not significantly different with MCE at peak stress. Despite the similar improvement in endocardial border delineation, LVO settings allow the detection of more WMA than MCE at peak stress, leading to a significantly higher accuracy for the detection of ischaemia in patients suspected of coronary artery disease when only wall motion is taken into account.
Disciplines :
General & internal medicine
Author, co-author :
Cosyns, Bernard; UZ Brussel > Cardiology department
Van Camp, Guy
Droogmans, Sophie
Weytjens, Caroline
Schoors, Danny
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie
Language :
English
Title :
Analysis of regional wall motion during contrast-enhanced dobutamine stress echocardiography: effect of contrast imaging settings.
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Bibliography
Malm S, Frigstad S, Sagberg E, Larsson H, Skjaerpe T. Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. J Am Coll Cardiol 2004;44:1030-1035
Hoffmann R, Von Bardeleben S, Kasprzak JD, Borges AC, Ten Cate F, Firschke C et al. Analysis of regional left ventricular function by cineventriculography, cardiac magnetic resonance imaging, and unenhanced and contrast-enhanced echocardiography: a multicenter comparison of methods. J Am Coll Cardiol 2006;47:121-128
Hundley WG, Kizilbash AM, Afridi I, Franco F, Peshock RM, Grayburn PA. Effect of contrast enhancement on transthoracic echocardiographic assessment of left ventricular regional wall motion. Am J Cardiol 1999; 84:1365-1368 A8-9.
Dolan MS, Riad K, El-Shafei A, Puri S, Tamirisa K, Bierig M et al. Effect of intravenous contrast for left ventricular opacification and border definition on sensitivity and specificity of dobutamine stress echocardiography compared with coronary angiography in technically difficult patients. Am Heart J 2001;142:908-915
Porter TR, Xie F, Kricsfeld A, Chiou A, Dabestani A. Improved endocardial border resolution during dobutamine stress echocardiography with intravenous sonicated dextrose albumin. J Am Coll Cardiol 1994;23:1440-1443
Cosyns B, Lancellotti P, Van Camp G, Droogmans S, Schoors D. Head to head comparison of transesophageal and transthoracic contrastenhanced echocardiography during dobutamine administration for the detection of coronary artery disease. Int J Cardiol 2008;129:105-110
Leong-Poi H, Rim SJ, Le DE, Fisher NG, Wei K, Kaul S. Perfusion versus function: the ischemic cascade in demand ischemia: implications of single-vessel versus multivessel stenosis. Circulation 2002;105:987-992
Dawson D, Rinkevich D, Belcik T, Jayaweera AR, Rafter P, Kaul S et al. Measurement of myocardial blood flow velocity reserve with myocardial contrast echocardiography in patients with suspected coronary artery disease: comparison with quantitative gated technetium 99m sestamibi single photon emission computed tomography. J Am Soc Echocardiogr 2003;16:1171-1177
Kaul S, Senior R, Dittrich H, Raval U, Khattar R, Lahiri A. Detection of coronary artery disease with myocardial contrast echocardiography: comparison with 99mTc-sestamibi single-photon emission computed tomography. Circulation 1997;96:785-792
Porter TR, Xie F, Silver M, Kricsfeld D, Oleary E. Real-time perfusion imaging with low mechanical index pulse inversion Doppler imaging. J Am Coll Cardiol 2001;37:748-753
Malm S, Frigstad S, Torp H, Wiseth R, Skjarpe T. Quantitative adenosine real-time myocardial contrast echocardiography for detection of angiographically significant coronary artery disease. J Am Soc Echocardiogr 2006;19:365-372
Cwajg J, Xie F, O'Leary E, Kricsfeld D, Dittrich H, Porter TR. Detection of angiographically significant coronary artery disease with accelerated intermittent imaging after intravenous administration of ultrasound contrast material. Am Heart J 2000;139:675-683
Hoffmann R, Borges AC, Kasprzak JD, Von Bardeleben S, Firschke C, Greis C et al. Analysis of myocardial perfusion or myocardial function for detection of regional myocardial abnormalities. An echocardiographic multicenter comparison study using myocardial contrast echocardiography and 2D echocardiography. Eur J Echocardiogr 2007;8:438-448
Peltier M, Vancraeynest D, Pasquet A, Ay T, Roelants V, D'Hondt A M et al. Assessment of the physiologic significance of coronary disease with dipyridamole real-time myocardial contrast echocardiography. Comparison with technetium-99m sestamibi single-photon emission computed tomography and quantitative coronary angiography. J Am Coll Cardiol 2004;43:257-264 (Pubitemid 38201153)
Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two- Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358-367
Reed JF III. Homogeneity of kappa statistics in multiple samples. Comput Methods Programs Biomed 2000;63:43-46
Kuecherer HF, Kee LL, Modin G, Cheitlin MD, Schiller NB. Echocardiography in serial evaluation of left ventricular systolic and diastolic function: importance of image acquisition, quantitation, and physiologic variability in clinical and investigational applications. J Am Soc Echocardiogr 1991; 4:203-214
Bellenger NG, Burgess MI, Ray SG, Lahiri A, Coats AJ, Cleland JG et al. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable? Eur Heart J 2000;21:1387-1396
Erbel R, Schweizer P, Meyer J, Krebs W, Effert S. Quantification of the function of the left ventricle using 2-dimensional echocardiography. Ultraschall Med 1983;4:228-236
Thomson HL, Basmadjian A-J, Rainbird AJ, Razavi M, Avierinos J-F, Pellikka PA et al. Contrast echocardiography improves the accuracy and reproducibility of left ventricular remodeling measurements-a prospective, randomly assigned, blinded study. J Am Coll Cardiol 2001;38: 867-875
Hoffmann R, Von Bardeleben S, Ten Cate F. Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography. ACC Curr J Rev 2005;14:33.
Cosyns B, Lancellotti P, Van Camp G, Droogmans S, Schoors D. Head to head comparison of transesophageal and transthoracic contrastenhanced echocardiography during dobutamine administration for the detection of coronary artery disease. Int J Cardiol 2008;129:105-110
Dijkmans PA, Senior R, Becher H, Porter TR, Wei K, Visser CA et al. Myocardial contrast echocardiography evolving as a clinically feasible technique for accurate, rapid, and safe assessment of myocardial perfusion: the evidence so far. J Am Coll Cardiol 2006;48:2168-2177
Elhendy A, O'Leary EL, Xie F, McGrain AC, Anderson JR, Porter TR. Comparative accuracy of real-time myocardial contrast perfusion imaging and wall motion analysis during dobutamine stress echocardiography for the diagnosis of coronary artery disease. J Am Coll Cardiol 2004;44:2185-2191
Tsutsui JM, Elhendy A, Anderson JR, Xie F, McGrain AC, Porter TR. Prognostic value of dobutamine stress myocardial contrast perfusion echocardiography. Circulation 2005;112:1444-1450 (Pubitemid 41291770)
Moir S, Haluska BA, Jenkins C, Fathi R, Marwick TH. Incremental benefit of myocardial contrast to combined dipyridamole-exercise stress echocardiography for the assessment of coronary artery disease. ACC Curr J Rev 2005;14:28-29
Vlassak I, Rubin DN, Odabashian JA, Garcia MJ, King LM, Lin SS et al. Contrast and harmonic imaging improves accuracy and efficiency of novice readers for dobutamine stress echocardiography. Echocardiography 2002;19:483-488
Mor-Avi V, Collins KA, Korcarz CE, Shah M, Spencer KT, Lang RM. Detection of regional temporal abnormalities in left ventricular function during acute myocardial ischemia. Am J Physiol Heart Circ Physiol 2001;280: H1770-81.
Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL et al. Contrast echocardiography: evidence-based recommendations by European Association of Echocardiography. Eur J Echocardiogr 2009;10: 194-212.
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