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

Roxy Senior, Wolfgang Lepper, Agnes Pasquet, George Chung, Rainer Hoffman, Jean Louis Vanoverschelde, Manuel Cerqueira, Sanjiv Kaul

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Abstract

Background No previous studies have compared myocardial contrast echocardiography (MCE) and single-photon emission computerized tomography (SPECT) for the detection of coronary artery disease (CAD) in patients with a medium likelihood of CAD. This study was developed to test the hypothesis that MCE is superior to SPECT for the detection of CAD. Methods Fifty-five patients with a medium probability of CAD and no previous myocardial infarction were recruited. Results of MCE and SPECT were compared to quantitative coronary arteriography, where CAD was defined as >50% stenosis. Each patient was examined for the anterior and posterior circulations. Results On a coronary circulation basis (n = 110), the sensitivity of MCE was significantly greater than that of SPECT for the detection of CAD (86% vs 43%, P <.0001). However, the specificities were similar (88% and 93%, P = .52). Both techniques were marginally more accurate in the anterior compared to the posterior circulation (88% vs 76%, P = .07 for MCE and 79% vs 63%, P = .19, for SPECT). On a patient basis (n = 55), MCE had a higher sensitivity than SPECT for the detection of CAD (83% vs 49%, P <.05). Although specificity tended to be higher for SPECT than MCE (92% vs 58%), it was not significant (P = .33). When CAD was defined as >40% coronary stenosis, the specificity of MCE increased to 83% without any change in sensitivity. Conclusion In this preliminary study, MCE was found to be superior to SPECT during dipyridamole stress for the diagnosis of CAD in patients with a medium pretest probability of CAD. Larger studies are required to confirm these findings.

Original languageEnglish (US)
Pages (from-to)1100-1105
Number of pages6
JournalAmerican Heart Journal
Volume147
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

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Single-Photon Emission-Computed Tomography
Echocardiography
Coronary Artery Disease
Perfusion
Myocardial Infarction
Coronary Circulation
Dipyridamole
Coronary Stenosis
Angiography
Pathologic Constriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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, Wolfgang; Pasquet, Agnes; Chung, George; Hoffman, Rainer; Vanoverschelde, Jean Louis; Cerqueira, Manuel; Kaul, Sanjiv.

In: American Heart Journal, Vol. 147, No. 6, 06.2004, p. 1100-1105.

Research output: Contribution to journalArticle

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title = "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",
abstract = "Background No previous studies have compared myocardial contrast echocardiography (MCE) and single-photon emission computerized tomography (SPECT) for the detection of coronary artery disease (CAD) in patients with a medium likelihood of CAD. This study was developed to test the hypothesis that MCE is superior to SPECT for the detection of CAD. Methods Fifty-five patients with a medium probability of CAD and no previous myocardial infarction were recruited. Results of MCE and SPECT were compared to quantitative coronary arteriography, where CAD was defined as >50{\%} stenosis. Each patient was examined for the anterior and posterior circulations. Results On a coronary circulation basis (n = 110), the sensitivity of MCE was significantly greater than that of SPECT for the detection of CAD (86{\%} vs 43{\%}, P <.0001). However, the specificities were similar (88{\%} and 93{\%}, P = .52). Both techniques were marginally more accurate in the anterior compared to the posterior circulation (88{\%} vs 76{\%}, P = .07 for MCE and 79{\%} vs 63{\%}, P = .19, for SPECT). On a patient basis (n = 55), MCE had a higher sensitivity than SPECT for the detection of CAD (83{\%} vs 49{\%}, P <.05). Although specificity tended to be higher for SPECT than MCE (92{\%} vs 58{\%}), it was not significant (P = .33). When CAD was defined as >40{\%} coronary stenosis, the specificity of MCE increased to 83{\%} without any change in sensitivity. Conclusion In this preliminary study, MCE was found to be superior to SPECT during dipyridamole stress for the diagnosis of CAD in patients with a medium pretest probability of CAD. Larger studies are required to confirm these findings.",
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T2 - Comparison of myocardial contrast echocardiography with 99mTc single-photon emission computed tomography

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AU - Lepper, Wolfgang

AU - Pasquet, Agnes

AU - Chung, George

AU - Hoffman, Rainer

AU - Vanoverschelde, Jean Louis

AU - Cerqueira, Manuel

AU - Kaul, Sanjiv

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N2 - Background No previous studies have compared myocardial contrast echocardiography (MCE) and single-photon emission computerized tomography (SPECT) for the detection of coronary artery disease (CAD) in patients with a medium likelihood of CAD. This study was developed to test the hypothesis that MCE is superior to SPECT for the detection of CAD. Methods Fifty-five patients with a medium probability of CAD and no previous myocardial infarction were recruited. Results of MCE and SPECT were compared to quantitative coronary arteriography, where CAD was defined as >50% stenosis. Each patient was examined for the anterior and posterior circulations. Results On a coronary circulation basis (n = 110), the sensitivity of MCE was significantly greater than that of SPECT for the detection of CAD (86% vs 43%, P <.0001). However, the specificities were similar (88% and 93%, P = .52). Both techniques were marginally more accurate in the anterior compared to the posterior circulation (88% vs 76%, P = .07 for MCE and 79% vs 63%, P = .19, for SPECT). On a patient basis (n = 55), MCE had a higher sensitivity than SPECT for the detection of CAD (83% vs 49%, P <.05). Although specificity tended to be higher for SPECT than MCE (92% vs 58%), it was not significant (P = .33). When CAD was defined as >40% coronary stenosis, the specificity of MCE increased to 83% without any change in sensitivity. Conclusion In this preliminary study, MCE was found to be superior to SPECT during dipyridamole stress for the diagnosis of CAD in patients with a medium pretest probability of CAD. Larger studies are required to confirm these findings.

AB - Background No previous studies have compared myocardial contrast echocardiography (MCE) and single-photon emission computerized tomography (SPECT) for the detection of coronary artery disease (CAD) in patients with a medium likelihood of CAD. This study was developed to test the hypothesis that MCE is superior to SPECT for the detection of CAD. Methods Fifty-five patients with a medium probability of CAD and no previous myocardial infarction were recruited. Results of MCE and SPECT were compared to quantitative coronary arteriography, where CAD was defined as >50% stenosis. Each patient was examined for the anterior and posterior circulations. Results On a coronary circulation basis (n = 110), the sensitivity of MCE was significantly greater than that of SPECT for the detection of CAD (86% vs 43%, P <.0001). However, the specificities were similar (88% and 93%, P = .52). Both techniques were marginally more accurate in the anterior compared to the posterior circulation (88% vs 76%, P = .07 for MCE and 79% vs 63%, P = .19, for SPECT). On a patient basis (n = 55), MCE had a higher sensitivity than SPECT for the detection of CAD (83% vs 49%, P <.05). Although specificity tended to be higher for SPECT than MCE (92% vs 58%), it was not significant (P = .33). When CAD was defined as >40% coronary stenosis, the specificity of MCE increased to 83% without any change in sensitivity. Conclusion In this preliminary study, MCE was found to be superior to SPECT during dipyridamole stress for the diagnosis of CAD in patients with a medium pretest probability of CAD. Larger studies are required to confirm these findings.

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