Author/Authors :
Senior ، نويسنده , , Roxy and Moreo، نويسنده , , Antonella and Gaibazzi، نويسنده , , Nicola and Agati، نويسنده , , Luciano and Tiemann، نويسنده , , Klaus and Shivalkar، نويسنده , , Bharati and von Bardeleben، نويسنده , , Stephan and Galiuto، نويسنده , , Leonarda and Lardoux، نويسنده , , Hervé and Trocino، نويسنده , , Giuseppe and Carriَ، نويسنده , , Ignasi and Le Guludec، نويسنده , , Dominique and Sambuceti، نويسنده , , Gianmario and Becher، نويسنده , , Harald and Colonna، نويسنده , , Paolo and ten Cate، نويسنده , , Folkert and Bramucci، نويسنده , , Ezio and Cohen، نويسنده , , Ariel and Bezante، نويسنده , , Gianpaolo and Aggeli، نويسنده , , Costantina and Kasprzak، نويسنده , , Jaroslaw D.، نويسنده ,
Abstract :
Objectives
rpose of this study was to compare sulfur hexafluoride microbubble (SonoVue)-enhanced myocardial contrast echocardiography (MCE) with single-photon emission computed tomography (SPECT) relative to coronary angiography (CA) for assessment of coronary artery disease (CAD).
ound
scale studies have shown that myocardial perfusion assessed by SonoVue-enhanced MCE is a viable alternative to SPECT for CAD assessment. However, large multicenter studies are lacking.
s
ts referred for myocardial ischemia testing at 34 centers underwent rest/vasodilator SonoVue-enhanced flash-replenishment MCE, standard 99mTc-labeled electrocardiography-gated SPECT, and quantitative CA within 1 month. Myocardial ischemia assessments by 3 independent, blinded readers for MCE and 3 readers for SPECT were collapsed into 1 diagnosis per patient per technique and were compared to CA (reference standard) read by 1 independent blinded reader.
s
enrolled patients who received SonoVue (71% males; mean age: 64 years; >1 cardiovascular [CV] risk factor in 99% of patients) 516 patients underwent all 3 examinations, of whom 161 (31.2%) had ≥70% stenosis (131 had single-vessel disease [SVD]; 30 had multivessel disease), and 310 (60.1%) had ≥50% stenosis. Higher sensitivity was obtained with MCE than with SPECT (75.2% vs. 49.1%, respectively; p < 0.0001), although specificity was lower (52.4% vs. 80.6%, respectively; p < 0.0001) for ≥70% stenosis. Similar findings were obtained for patients with ≥50% stenosis. Sensitivity levels for detection of SVD and proximal disease for ≥70% stenosis were higher for MCE (72.5% vs. 42.7%, respectively; p < 0.0001; 80% vs. 58%, respectively; p = 0.005, respectively).
sions
e-enhanced MCE demonstrated superior sensitivity but lower specificity for detection of CAD compared to SPECT in a population with a high incidence of CV risk factors and intermediate-high prevalence of CAD.
se III study to compare SonoVue® enhanced myocardial echocardiography [MCE] to single photon emission computerized tomography [ECG-GATED SPECT], at rest and at peak of low-dose Dipyridamole stress test, in the assessment of significant coronary artery disease [CAD] in patients with suspect or known CAD using Coronary Angiography as Gold Standard–SonoVue MCE vs SPECT; EUCTR2007-003492-39-GR)
