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 - 26/08/11
, Wolfgang Lepper, MD b, Agnes Pasquet, MD c, George Chung, MBBS a, Rainer Hoffman, MD b, Jean-Louis Vanoverschelde, MD c, Manuel Cerqueira, MD d, Sanjiv Kaul, MD eAbstract |
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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 | Supported by a grant from Amersham Health, Amersham, UK, and in part by grants (RO1-HL48890 and RO1-HL66034) from the National Institutes of Health, Bethesda, Md. |
Vol 147 - N° 6
P. 1100-1105 - Giugno 2004 Ritorno al numero
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