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Parametric quantification of myocardial ischaemia using real-time perfusion adenosine stress echocardiography images, with SPECT as reference method.

Gudmundsson, P; Shahgaldi, K; Winter, Reidar LU ; Dencker, Magnus LU ; Kitlinski, M; Thorsson, Ola LU ; Ljunggren, L and Willenheimer, Ronnie LU (2010) In Clinical Physiology and Functional Imaging2002-01-01+01:00 30(1). p.30-42
Abstract
Summary Background: Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique, provides images for off-line parametric perfusion quantification using Qontrast((R)) software. From replenishment curves, this generates parametric images of peak signal intensity (A), myocardial blood flow velocity (beta) and myocardial blood flow (Axbeta) at rest and stress. This may be a tool for objective myocardial ischaemia evaluation. We assessed myocardial ischaemia by RTP-ASE Qontrast((R))-generated images, using 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) as reference. Methods: Sixty-seven patients admitted to SPECT underwent... (More)
Summary Background: Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique, provides images for off-line parametric perfusion quantification using Qontrast((R)) software. From replenishment curves, this generates parametric images of peak signal intensity (A), myocardial blood flow velocity (beta) and myocardial blood flow (Axbeta) at rest and stress. This may be a tool for objective myocardial ischaemia evaluation. We assessed myocardial ischaemia by RTP-ASE Qontrast((R))-generated images, using 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) as reference. Methods: Sixty-seven patients admitted to SPECT underwent RTP-ASE (SONOS 5500) during Sonovue((R)) infusion, before and throughout adenosine stress, also used for SPECT. Quantitative off-line analyses of myocardial perfusion by RTP-ASE Qontrast((R))-generated A, beta and Axbeta images, at different time points during rest and stress, were blindly compared to SPECT. Results: We analysed 201 coronary territories [corresponding to the left anterior descendent (LAD), left circumflex (LCx) and right coronary (RCA) arteries] from 67 patients. SPECT showed ischaemia in 18 patients. Receiver operator characteristics and kappa values showed that A, beta and Axbeta image interpretation significantly identified ischaemia in all territories (area under the curve 0.66-0.80, P = 0.001-0.05). Combined A, beta and Axbeta image interpretation gave the best results and the closest agreement was seen in the LAD territory: 89% accuracy; kappa 0.63; P<0.001. Conclusion: Myocardial isachemia can be evaluated in the LAD territory using RTP-ASE Qontrast((R))-generated images, especially by combined A, beta and Axbeta image interpretation. However, the technique needs improvements regarding the LCx and RCA territories. (Less)
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Contribution to journal
publication status
published
subject
in
Clinical Physiology and Functional Imaging2002-01-01+01:00
volume
30
issue
1
pages
30 - 42
publisher
Wiley Online Library
external identifiers
  • wos:000272884400006
  • pmid:20089074
  • scopus:72549107087
ISSN
1475-0961
DOI
10.1111/j.1475-0961.2009.00901.x
language
English
LU publication?
yes
id
900ac0d7-59b4-44a5-a3c5-faaa540d2673 (old id 1500875)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19793114?dopt=Abstract
date added to LUP
2009-11-03 13:30:25
date last changed
2018-05-29 10:53:48
@article{900ac0d7-59b4-44a5-a3c5-faaa540d2673,
  abstract     = {Summary Background: Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique, provides images for off-line parametric perfusion quantification using Qontrast((R)) software. From replenishment curves, this generates parametric images of peak signal intensity (A), myocardial blood flow velocity (beta) and myocardial blood flow (Axbeta) at rest and stress. This may be a tool for objective myocardial ischaemia evaluation. We assessed myocardial ischaemia by RTP-ASE Qontrast((R))-generated images, using 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) as reference. Methods: Sixty-seven patients admitted to SPECT underwent RTP-ASE (SONOS 5500) during Sonovue((R)) infusion, before and throughout adenosine stress, also used for SPECT. Quantitative off-line analyses of myocardial perfusion by RTP-ASE Qontrast((R))-generated A, beta and Axbeta images, at different time points during rest and stress, were blindly compared to SPECT. Results: We analysed 201 coronary territories [corresponding to the left anterior descendent (LAD), left circumflex (LCx) and right coronary (RCA) arteries] from 67 patients. SPECT showed ischaemia in 18 patients. Receiver operator characteristics and kappa values showed that A, beta and Axbeta image interpretation significantly identified ischaemia in all territories (area under the curve 0.66-0.80, P = 0.001-0.05). Combined A, beta and Axbeta image interpretation gave the best results and the closest agreement was seen in the LAD territory: 89% accuracy; kappa 0.63; P&lt;0.001. Conclusion: Myocardial isachemia can be evaluated in the LAD territory using RTP-ASE Qontrast((R))-generated images, especially by combined A, beta and Axbeta image interpretation. However, the technique needs improvements regarding the LCx and RCA territories.},
  author       = {Gudmundsson, P and Shahgaldi, K and Winter, Reidar and Dencker, Magnus and Kitlinski, M and Thorsson, Ola and Ljunggren, L and Willenheimer, Ronnie},
  issn         = {1475-0961},
  language     = {eng},
  number       = {1},
  pages        = {30--42},
  publisher    = {Wiley Online Library},
  series       = {Clinical Physiology and Functional Imaging2002-01-01+01:00},
  title        = {Parametric quantification of myocardial ischaemia using real-time perfusion adenosine stress echocardiography images, with SPECT as reference method.},
  url          = {http://dx.doi.org/10.1111/j.1475-0961.2009.00901.x},
  volume       = {30},
  year         = {2010},
}