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  • Title: Physiologic assessment of left anterior descending coronary artery stenosis by quantitative intravenous myocardial contrast echocardiography in humans: comparison with exercise single-photon emission computed tomography.
    Author: Fukuda S, Muro T, Hozumi T, Watanabe H, Yamagishi H, Yoshiyama M, Takeuchi K, Yoshikawa J.
    Journal: Echocardiography; 2003 Aug; 20(6):519-26. PubMed ID: 12859364.
    Abstract:
    OBJECTIVE: To clarify the potential of quantitative intravenous myocardial contrast echocardiography (MCE) for physiologic assessment of the left anterior descending artery (LAD) stenosis. METHODS: We studied 38 patients with suspected coronary artery disease. MCE was performed by continuous infusion of Levovist and intermittent ultrasonic exposure. Images were obtained from the apical four-chamber view at rest and after dipyridamole infusion. The background-subtracted intensity versus pulsing interval plots were fitted to an exponential function,Y=A(1 e-ss), to obtain the plateau level (A) and rate of rise (ss) of background-subtracted intensity both at rest and after dipyridamole infusion. We compared the results with those of exercise thallium-201 single-photon emission computed tomography (SPECT). RESULTS: Of the 38 patients, 18 patients exhibited redistribution in the LAD territories with SPECT (group A), although 20 did not (group B). The ss reserve (DIP/rest) in group A was significantly lower than those in group B (0.8 +/- 0.5 versus 2.0 +/- 1.1, P < 0.001), while the A reserve did not differ between the two groups (1.2 +/- 0.6 versus 1.0 +/- 0.5, P = NS). The ss reserve <1.1, which was the optimal cutoff value, provided sensitivity of 79% and specificity of 84% for the presence of redistribution in SPECT. CONCLUSIONS: Quantitative intravenous MCE allows us to estimate physiologic severity of the LAD stenosis in the clinical setting.
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