Comparison of real-time myocardial contrast echocardiography for the assessment of myocardial viability with fluorodeoxyglucose-18 positron emission tomography and dobutamine stress echocardiography

Grigorios Korosoglou, Alexander Hansen, Johannes Hoffend, Goran Gavrilovic, David Wolf, Joerg Zehelein, Uwe Haberkorn, Helmut Kuecherer

Research output: Contribution to journalArticle

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Abstract

Little is known about the diagnostic value of real-time myocardial contrast echocardiography (MCE) for the assessment of myocardial viability. We compared the diagnostic accuracy of MCE with that of low-dose dobutamine stress echocardiography (DSE) and of combined technetium-99 sestamibi single-photon emission computed tomography and fluorodeoxyglucose-18 positron emission tomography and investigated whether quantitative assessment of myocardial blood flow could increase its diagnostic value. Cardiac imaging was performed with these 3 methods in 41 patients who had ischemic heart disease (ejection fraction <40%) and were being considered for revascularization. Follow-up echocardiograms were obtained after 3 to 6 months in revascularized patients, and increased regional function served as a standard reference for assessment of myocardial viability. A control group of 25 patients who had no coronary artery disease underwent MCE to assess normal values of myocardial perfusion parameters. Recovery of myocardial function was predicted by MCE with a sensitivity of 86% and a specificity of 43%. Nuclear imaging was comparably sensitive (90%) and specific (44%), whereas low-dose DSE was similarly sensitive (83%) but more specific (76%). Normalization of myocardial signal intensity to that of the control group significantly increased the specificity of MCE from 43% to 64% and the accuracy from 73% to 81%. A combination of quantitative MCE and DSE provided the best diagnostic characteristics, with a sensitivity of 96%, a specificity of 63%, and an accuracy of 83%. Thus, MCE is useful for assessing myocardial viability. Normalization of contrast intensity to that of a reference control group is a valid approach for detection of myocardial viability and expands on information obtained from visual MCE and DSE.

Original languageEnglish (US)
Pages (from-to)570-576
Number of pages7
JournalAmerican Journal of Cardiology
Volume94
Issue number5
DOIs
StatePublished - Sep 1 2004

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Stress Echocardiography
Positron-Emission Tomography
Echocardiography
Control Groups
Technetium
Recovery of Function
Single-Photon Emission-Computed Tomography
Myocardial Ischemia
Coronary Artery Disease
Reference Values
Perfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Comparison of real-time myocardial contrast echocardiography for the assessment of myocardial viability with fluorodeoxyglucose-18 positron emission tomography and dobutamine stress echocardiography. / Korosoglou, Grigorios; Hansen, Alexander; Hoffend, Johannes; Gavrilovic, Goran; Wolf, David; Zehelein, Joerg; Haberkorn, Uwe; Kuecherer, Helmut.

In: American Journal of Cardiology, Vol. 94, No. 5, 01.09.2004, p. 570-576.

Research output: Contribution to journalArticle

Korosoglou, Grigorios ; Hansen, Alexander ; Hoffend, Johannes ; Gavrilovic, Goran ; Wolf, David ; Zehelein, Joerg ; Haberkorn, Uwe ; Kuecherer, Helmut. / Comparison of real-time myocardial contrast echocardiography for the assessment of myocardial viability with fluorodeoxyglucose-18 positron emission tomography and dobutamine stress echocardiography. In: American Journal of Cardiology. 2004 ; Vol. 94, No. 5. pp. 570-576.
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abstract = "Little is known about the diagnostic value of real-time myocardial contrast echocardiography (MCE) for the assessment of myocardial viability. We compared the diagnostic accuracy of MCE with that of low-dose dobutamine stress echocardiography (DSE) and of combined technetium-99 sestamibi single-photon emission computed tomography and fluorodeoxyglucose-18 positron emission tomography and investigated whether quantitative assessment of myocardial blood flow could increase its diagnostic value. Cardiac imaging was performed with these 3 methods in 41 patients who had ischemic heart disease (ejection fraction <40{\%}) and were being considered for revascularization. Follow-up echocardiograms were obtained after 3 to 6 months in revascularized patients, and increased regional function served as a standard reference for assessment of myocardial viability. A control group of 25 patients who had no coronary artery disease underwent MCE to assess normal values of myocardial perfusion parameters. Recovery of myocardial function was predicted by MCE with a sensitivity of 86{\%} and a specificity of 43{\%}. Nuclear imaging was comparably sensitive (90{\%}) and specific (44{\%}), whereas low-dose DSE was similarly sensitive (83{\%}) but more specific (76{\%}). Normalization of myocardial signal intensity to that of the control group significantly increased the specificity of MCE from 43{\%} to 64{\%} and the accuracy from 73{\%} to 81{\%}. A combination of quantitative MCE and DSE provided the best diagnostic characteristics, with a sensitivity of 96{\%}, a specificity of 63{\%}, and an accuracy of 83{\%}. Thus, MCE is useful for assessing myocardial viability. Normalization of contrast intensity to that of a reference control group is a valid approach for detection of myocardial viability and expands on information obtained from visual MCE and DSE.",
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