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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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| Published in: | Circulation (New York, N.Y.) N.Y.), 2003-02, Vol.107 (4), p.538-544 |
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| container_title | Circulation (New York, N.Y.) |
| container_volume | 107 |
| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1161/01.CIR.0000047211.53448.12 |
| format | article |
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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<0.001). The best MCE parameter for predicting functional recovery was Peak MCIxbeta, an index of myocardial blood flow (area under the curve, 0.83). MCE parameters were higher in segments with contractile reserve and Tl(201) uptake > or =60% (P<0.05) and identified viable segments without contractile reserve by DE. The sensitivity of Peak MCIxbeta >1.5 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<0.05).
MCE with intravenous contrast identifies myocardial hibernation in humans. Prediction of viable myocardium with MCE is best using quantification of myocardial blood flow and provides improved accuracy compared with DE and Tl(201) scintigraphy.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.0000047211.53448.12</identifier><identifier>PMID: 12566363</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>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</subject><ispartof>Circulation (New York, N.Y.), 2003-02, Vol.107 (4), p.538-544</ispartof><rights>2003 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Feb 4 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-1248343efe5713b0809a93df055cc4775e1aec0395bb0be3d1a21158314b8f003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14542583$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12566363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SHIMONI, Sarah</creatorcontrib><creatorcontrib>FRANGOGIANNIS, Nikolaos G</creatorcontrib><creatorcontrib>REARDON, Michael J</creatorcontrib><creatorcontrib>ZOGHBI, William A</creatorcontrib><creatorcontrib>AGGELI, Constadina J</creatorcontrib><creatorcontrib>SHAN, Kesavan</creatorcontrib><creatorcontrib>VERANI, Mario S</creatorcontrib><creatorcontrib>QUINONES, Miguel A</creatorcontrib><creatorcontrib>ESPADA, Rafael</creatorcontrib><creatorcontrib>LETSOU, George V</creatorcontrib><creatorcontrib>LAWRIE, Gerald M</creatorcontrib><creatorcontrib>WINTERS, William L</creatorcontrib><title>Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: Comparison with dobutamine echocardiography and thallium-201 scintigraphy</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>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<0.001). The best MCE parameter for predicting functional recovery was Peak MCIxbeta, an index of myocardial blood flow (area under the curve, 0.83). MCE parameters were higher in segments with contractile reserve and Tl(201) uptake > or =60% (P<0.05) and identified viable segments without contractile reserve by DE. The sensitivity of Peak MCIxbeta >1.5 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<0.05).
MCE with intravenous contrast identifies myocardial hibernation in humans. Prediction of viable myocardium with MCE is best using quantification of myocardial blood flow and provides improved accuracy compared with DE and Tl(201) scintigraphy.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Cardiology. Vascular system</subject><subject>Contrast Media - administration & dosage</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary Circulation</subject><subject>Coronary heart disease</subject><subject>Dobutamine</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>Myocardial Stunning - diagnosis</subject><subject>Myocardial Stunning - diagnostic imaging</subject><subject>Observer Variation</subject><subject>Predictive Value of Tests</subject><subject>Radionuclide Imaging</subject><subject>Recovery of Function</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Thallium Radioisotopes</subject><subject>Ventricular Dysfunction - diagnosis</subject><subject>Ventricular Dysfunction - etiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNplkdtq3DAQhkVpabZpX6GIQHNnV6ODD7krS9IuBAohvRayLMcKtrSR5JR9sT5ftNmlC61uxMx8Mz8zP0IXQEqACr4SKNebu5LsH68pQCkY500J9A1agaC84IK1b9Eq19uiZpSeoQ8xPuawYrV4j86AiqpiFVuhP5veuGQHq1Wy3mE_4NF2Jrgcugc877xWobfLjH_bNOKnRWU65eKzwdaloJ6N80v8C6oJa7_Px4SNHg9J_xDUdtxd4bWftyrYmIVex_W-W5KarTP_wVi5HqdRTVMWLygBHHUWtIfqR_RuUFM0n47_Ofp1c32__lHc_vy-WX-7LTQTVSqA8oZxZgYjamAdaUirWtYPRAiteV0LA8powlrRdaQzrAeVzykaBrxrBkLYObo8zN0G_7SYmORsozbTpJzJa8uati3wtsrgxT_go1_yFacoKdCa16ThGbo6QDr4GIMZ5DbYWYWdBCL31koCMlsrT9bKV2sl0Nz8-aiwdLPpT61HLzPw5QioqNU0BOW0jSeOC07zauwFtIexvA</recordid><startdate>20030204</startdate><enddate>20030204</enddate><creator>SHIMONI, Sarah</creator><creator>FRANGOGIANNIS, Nikolaos G</creator><creator>REARDON, Michael J</creator><creator>ZOGHBI, William A</creator><creator>AGGELI, Constadina J</creator><creator>SHAN, Kesavan</creator><creator>VERANI, Mario S</creator><creator>QUINONES, Miguel A</creator><creator>ESPADA, Rafael</creator><creator>LETSOU, George V</creator><creator>LAWRIE, Gerald M</creator><creator>WINTERS, William L</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20030204</creationdate><title>Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: Comparison with dobutamine echocardiography and thallium-201 scintigraphy</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-1248343efe5713b0809a93df055cc4775e1aec0395bb0be3d1a21158314b8f003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Cardiology. Vascular system</topic><topic>Contrast Media - administration & dosage</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary Circulation</topic><topic>Coronary heart disease</topic><topic>Dobutamine</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>Myocardial Stunning - diagnosis</topic><topic>Myocardial Stunning - diagnostic imaging</topic><topic>Observer Variation</topic><topic>Predictive Value of Tests</topic><topic>Radionuclide Imaging</topic><topic>Recovery of Function</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Thallium Radioisotopes</topic><topic>Ventricular Dysfunction - diagnosis</topic><topic>Ventricular Dysfunction - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SHIMONI, Sarah</creatorcontrib><creatorcontrib>FRANGOGIANNIS, Nikolaos G</creatorcontrib><creatorcontrib>REARDON, Michael J</creatorcontrib><creatorcontrib>ZOGHBI, William A</creatorcontrib><creatorcontrib>AGGELI, Constadina J</creatorcontrib><creatorcontrib>SHAN, Kesavan</creatorcontrib><creatorcontrib>VERANI, Mario S</creatorcontrib><creatorcontrib>QUINONES, Miguel A</creatorcontrib><creatorcontrib>ESPADA, Rafael</creatorcontrib><creatorcontrib>LETSOU, George V</creatorcontrib><creatorcontrib>LAWRIE, Gerald M</creatorcontrib><creatorcontrib>WINTERS, William L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SHIMONI, Sarah</au><au>FRANGOGIANNIS, Nikolaos G</au><au>REARDON, Michael J</au><au>ZOGHBI, William A</au><au>AGGELI, Constadina J</au><au>SHAN, Kesavan</au><au>VERANI, Mario S</au><au>QUINONES, Miguel A</au><au>ESPADA, Rafael</au><au>LETSOU, George V</au><au>LAWRIE, Gerald M</au><au>WINTERS, William L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: Comparison with dobutamine echocardiography and thallium-201 scintigraphy</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2003-02-04</date><risdate>2003</risdate><volume>107</volume><issue>4</issue><spage>538</spage><epage>544</epage><pages>538-544</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><abstract>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<0.001). The best MCE parameter for predicting functional recovery was Peak MCIxbeta, an index of myocardial blood flow (area under the curve, 0.83). MCE parameters were higher in segments with contractile reserve and Tl(201) uptake > or =60% (P<0.05) and identified viable segments without contractile reserve by DE. The sensitivity of Peak MCIxbeta >1.5 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<0.05).
MCE with intravenous contrast identifies myocardial hibernation in humans. Prediction of viable myocardium with MCE is best using quantification of myocardial blood flow and provides improved accuracy compared with DE and Tl(201) scintigraphy.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12566363</pmid><doi>10.1161/01.CIR.0000047211.53448.12</doi><tpages>7</tpages></addata></record> |
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| source | EZB Electronic Journals Library |
| 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 |
| title | Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: Comparison with dobutamine echocardiography and thallium-201 scintigraphy |
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