Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: Comparison with 99mTc-sestamibi SPECT imaging

Sheila K. Heinle, Jennifer Noblin, Pam Goree-Best, Ana Mello, Guy Ravad, Stephanie Mull, Pradeep Mammen, Paul A. Grayburn

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Background: Harmonic power Doppler imaging (HPDI) is a novel technique for assessing myocardial perfusion by contrast echocardiography in humans. The purpose of this study was to compare myocardial perfusion by HPDI with that obtained by 99mTc-sestamibi single photon emission computed tomography (SPECT) during rest and pharmacological stress. Methods and Results - HPDI was performed on 123 patients who were referred for SPECT imaging for known or suspected coronary artery disease. Images were obtained at baseline and during adenosine infusion (0.14 mg · kg-1 · min-1 x 6 minutes) in 3 apical views. Myocardial perfusion by HPDI was graded for each coronary territory as absent, patchy, or full. The persistence of absent or patchy myocardial perfusion by HPDI between rest and adenosine was interpreted as a fixed defect, whereas any decrease in perfusion grade was interpreted as a reversible defect. Overall concordance between HPDI and SPECT was 83 (81%) of 103 for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 3 coronary territories was 81% (κ=0.57) for the left anterior descending artery, 76% (κ=0.52) for the right coronary artery, and 72% (κ=0.40) for the left circumflex artery. Discrepancies between the 2 techniques were most notable in the circumflex territory, where fixed defects were observed in 33% by HPDI but in only 14% by SPECT (χ2=15.8, P=0.0001). Conclusions - This study demonstrates that HPDI can reliably detect myocardial perfusion during pharmacological stress, although there was a significantly higher number of falsely abnormal results in the circumflex territory.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalCirculation
Volume102
Issue number1
StatePublished - Jul 4 2000

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Technetium Tc 99m Sestamibi
Single-Photon Emission-Computed Tomography
Adenosine
Perfusion
Arteries
Pharmacology
Echocardiography
Coronary Artery Disease
Coronary Vessels

Keywords

  • Adenosine
  • Contrast media
  • Echocardiography
  • Perfusion
  • Stress
  • Tomography

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Heinle, S. K., Noblin, J., Goree-Best, P., Mello, A., Ravad, G., Mull, S., ... Grayburn, P. A. (2000). Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: Comparison with 99mTc-sestamibi SPECT imaging. Circulation, 102(1), 55-60.

Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress : Comparison with 99mTc-sestamibi SPECT imaging. / Heinle, Sheila K.; Noblin, Jennifer; Goree-Best, Pam; Mello, Ana; Ravad, Guy; Mull, Stephanie; Mammen, Pradeep; Grayburn, Paul A.

In: Circulation, Vol. 102, No. 1, 04.07.2000, p. 55-60.

Research output: Contribution to journalArticle

Heinle, SK, Noblin, J, Goree-Best, P, Mello, A, Ravad, G, Mull, S, Mammen, P & Grayburn, PA 2000, 'Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: Comparison with 99mTc-sestamibi SPECT imaging', Circulation, vol. 102, no. 1, pp. 55-60.
Heinle, Sheila K. ; Noblin, Jennifer ; Goree-Best, Pam ; Mello, Ana ; Ravad, Guy ; Mull, Stephanie ; Mammen, Pradeep ; Grayburn, Paul A. / Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress : Comparison with 99mTc-sestamibi SPECT imaging. In: Circulation. 2000 ; Vol. 102, No. 1. pp. 55-60.
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AB - Background: Harmonic power Doppler imaging (HPDI) is a novel technique for assessing myocardial perfusion by contrast echocardiography in humans. The purpose of this study was to compare myocardial perfusion by HPDI with that obtained by 99mTc-sestamibi single photon emission computed tomography (SPECT) during rest and pharmacological stress. Methods and Results - HPDI was performed on 123 patients who were referred for SPECT imaging for known or suspected coronary artery disease. Images were obtained at baseline and during adenosine infusion (0.14 mg · kg-1 · min-1 x 6 minutes) in 3 apical views. Myocardial perfusion by HPDI was graded for each coronary territory as absent, patchy, or full. The persistence of absent or patchy myocardial perfusion by HPDI between rest and adenosine was interpreted as a fixed defect, whereas any decrease in perfusion grade was interpreted as a reversible defect. Overall concordance between HPDI and SPECT was 83 (81%) of 103 for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 3 coronary territories was 81% (κ=0.57) for the left anterior descending artery, 76% (κ=0.52) for the right coronary artery, and 72% (κ=0.40) for the left circumflex artery. Discrepancies between the 2 techniques were most notable in the circumflex territory, where fixed defects were observed in 33% by HPDI but in only 14% by SPECT (χ2=15.8, P=0.0001). Conclusions - This study demonstrates that HPDI can reliably detect myocardial perfusion during pharmacological stress, although there was a significantly higher number of falsely abnormal results in the circumflex territory.

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