Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: Comparison with dobutamine echocardiography and thallium-201 scintigraphy

There are currently no data on the accuracy of intravenous myocardial contrast echocardiography (MCE) in detecting myocardial hibernation in man and its comparative accuracy to dobutamine echocardiography (DE) or thallium 201 (Tl(201)) scintigraphy. Twenty patients with coronary artery disease and v...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2003-02, Vol.107 (4), p.538-544
Main Authors: SHIMONI, Sarah, FRANGOGIANNIS, Nikolaos G, REARDON, Michael J, ZOGHBI, William A, AGGELI, Constadina J, SHAN, Kesavan, VERANI, Mario S, QUINONES, Miguel A, ESPADA, Rafael, LETSOU, George V, LAWRIE, Gerald M, WINTERS, William L
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood Flow Velocity
Cardiology. Vascular system
Contrast Media - administration & dosage
Coronary Artery Disease - complications
Coronary Artery Disease - diagnosis
Coronary Artery Disease - surgery
Coronary Circulation
Coronary heart disease
Dobutamine
Echocardiography
Female
Heart
Humans
Injections, Intravenous
Male
Medical sciences
Middle Aged
Myocardial Contraction
Myocardial Stunning - diagnosis
Myocardial Stunning - diagnostic imaging
Observer Variation
Predictive Value of Tests
Radionuclide Imaging
Recovery of Function
ROC Curve
Sensitivity and Specificity
Thallium Radioisotopes
Ventricular Dysfunction - diagnosis
Ventricular Dysfunction - etiology
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Summary:There are currently no data on the accuracy of intravenous myocardial contrast echocardiography (MCE) in detecting myocardial hibernation in man and its comparative accuracy to dobutamine echocardiography (DE) or thallium 201 (Tl(201)) scintigraphy. Twenty patients with coronary artery disease and ventricular dysfunction underwent MCE 1 to 5 days before bypass surgery and repeat echocardiography at 3 to 4 months. Patients also underwent DE (n=18) and rest-redistribution Tl(201) tomography (n=16) before revascularization. MCE was performed using continuous Optison infusion (12 to 16 cc/h) with intermittent pulse inversion harmonics and incremental triggering (1:1 to 1:8). Myocardial contrast intensity (MCI) replenishment curves were constructed to derive quantitative MCE indices of blood velocity and flow. Recovery of function occurred in 38% of dysfunctional segments. MCE parameters of perfusion in hibernating myocardium were similar to segments with normal function and higher than dysfunctional myocardium without recovery of function (P or =60% (P1.5 dB/s for recovery of function was 90% and was similar to Tl(201) scintigraphy (92%) and any contractile reserve (80%); specificity was higher than for Tl(201) and DE (63%, 45%, and 54%, respectively; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000047211.53448.12