OBJECTIVE: To determine whether, compared with fundamental imaging, second harmonic imaging can improve the accuracy of dobutamine stress echocardiography for identifying viable myocardium, using nuclear imaging as a reference. PATIENTS: 30 patients with chronic left ventricular dysfunction (mean (SD) age, 60 (8) years; 22 men). METHODS: Dobutamine stress echocardiography was carried out in all patients using both fundamental and second harmonic imaging. All patients underwent dual isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT) with (99m)technetium-tetrofosmin/(18)F-fluorodeoxyglucose on a separate day. Myocardial viability was considered present by dobutamine stress echocardiography when segments with severe dysfunction showed a biphasic sustained improvement or an ischaemic response. Viability criteria on DISA-SPECT were normal or mildly reduced perfusion and metabolism, or perfusion/metabolism mismatch. RESULTS: Using fundamental imaging, 330 segments showed severe dysfunction at baseline; 144 (44%) were considered viable. The agreement between dobutamine stress echocardiography by fundamental imaging and DISA-SPECT was 78%, kappa = 0.56. Using second harmonic imaging, 288 segments showed severe dysfunction; 138 (48%) were viable. The agreement between dobutamine stress echocardiography and DISA-SPECT was significantly better when second harmonic imaging was used (89%, kappa = 0.77, p = 0.001 v fundamental imaging). CONCLUSIONS: Second harmonic imaging applied during dobutamine stress echocardiography increases the agreement with DISA-SPECT for detecting myocardial viability.
OBJECTIVE: To determine whether, compared with fundamental imaging, second harmonic imaging can improve the accuracy of dobutamine stress echocardiography for identifying viable myocardium, using nuclear imaging as a reference. PATIENTS: 30 patients with chronic left ventricular dysfunction (mean (SD) age, 60 (8) years; 22 men). METHODS:Dobutamine stress echocardiography was carried out in all patients using both fundamental and second harmonic imaging. All patients underwent dual isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT) with (99m)technetium-tetrofosmin/(18)F-fluorodeoxyglucose on a separate day. Myocardial viability was considered present by dobutamine stress echocardiography when segments with severe dysfunction showed a biphasic sustained improvement or an ischaemic response. Viability criteria on DISA-SPECT were normal or mildly reduced perfusion and metabolism, or perfusion/metabolism mismatch. RESULTS: Using fundamental imaging, 330 segments showed severe dysfunction at baseline; 144 (44%) were considered viable. The agreement between dobutamine stress echocardiography by fundamental imaging and DISA-SPECT was 78%, kappa = 0.56. Using second harmonic imaging, 288 segments showed severe dysfunction; 138 (48%) were viable. The agreement between dobutamine stress echocardiography and DISA-SPECT was significantly better when second harmonic imaging was used (89%, kappa = 0.77, p = 0.001 v fundamental imaging). CONCLUSIONS: Second harmonic imaging applied during dobutamine stress echocardiography increases the agreement with DISA-SPECT for detecting myocardial viability.
Authors: J D Kasprzak; B Paelinck; F J Ten Cate; W B Vletter; N de Jong; D Poldermans; A Elhendy; A Bouakaz; J R Roelandt Journal: Am J Cardiol Date: 1999-01-15 Impact factor: 2.778
Authors: K Caidahl; E Kazzam; J Lidberg; G Neumann Andersen; J Nordanstig; S Rantapää Dahlqvist; A Waldenström; R Wikh Journal: Lancet Date: 1998-10-17 Impact factor: 79.321
Authors: J H Cornel; J J Bax; A Elhendy; A P Maat; G J Kimman; M L Geleijnse; R Rambaldi; E Boersma; P M Fioretti Journal: J Am Coll Cardiol Date: 1998-04 Impact factor: 24.094
Authors: J J Bax; D Poldermans; A Elhendy; J H Cornel; E Boersma; R Rambaldi; J R Roelandt; P M Fioretti Journal: J Am Coll Cardiol Date: 1999-07 Impact factor: 24.094
Authors: U Qureshi; S F Nagueh; I Afridi; P Vaduganathan; A Blaustein; M S Verani; W L Winters; W A Zoghbi Journal: Circulation Date: 1997-02-04 Impact factor: 29.690
Authors: A Elhendy; R T van Domburg; J J Bax; D Poldermans; P R Nierop; J D Kasprzak; J R Roelandt Journal: Am J Cardiol Date: 1998-12-01 Impact factor: 2.778
Authors: I Matsunari; G Böning; S I Ziegler; S G Nekolla; J C Stollfuss; I Kosa; E P Ficaro; M Schwaiger Journal: J Am Coll Cardiol Date: 1998-10 Impact factor: 24.094
Authors: J J Bax; J H Cornel; F C Visser; P M Fioretti; A van Lingen; J M Huitink; O Kamp; F Nijland; J R Roelandt; C A Visser Journal: J Am Coll Cardiol Date: 1997-08 Impact factor: 24.094