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Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echo cardiography

(2001) HEART. 86(6). p.672-678
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Organization
Abstract
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 tetrofosmin/F-18-fluorodeoxyglucose on a separate day. Myocardial viability was considered present by dobutamine stress echo cardiography 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%, K = 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 echo cardiography increases the agreement with DISA-SPECT for detecting myocardial viability.
Keywords
HIBERNATING MYOCARDIUM, F-18 FLUORODEOXYGLUCOSE, SURGICAL REVASCULARIZATION, CONTRACTILE RESERVE, ENDOCARDIAL BORDER, EJECTION FRACTION, dobutamine stress echocardiography, second harmonic imaging, F-18-fluorodeoxyglucose imaging, myocardial viability, EMISSION COMPUTED-TOMOGRAPHY, LEFT-VENTRICULAR FUNCTION, CORONARY-ARTERY DISEASE, REDISTRIBUTION TL-201 TOMOGRAPHY

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Chicago
Sozzi, FB, D Poldermans, JJ Bax, A Elhendy, EC Vourvouri, R Valkema, Johan De Sutter, AFL Schinkel, A Borghetti, and JRTC Roelandt. 2001. “Improved Identification of Viable Myocardium Using Second Harmonic Imaging During Dobutamine Stress Echo Cardiography.” Heart 86 (6): 672–678.
APA
Sozzi, F., Poldermans, D., Bax, J., Elhendy, A., Vourvouri, E., Valkema, R., De Sutter, J., et al. (2001). Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echo cardiography. HEART, 86(6), 672–678.
Vancouver
1.
Sozzi F, Poldermans D, Bax J, Elhendy A, Vourvouri E, Valkema R, et al. Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echo cardiography. HEART. 2001;86(6):672–8.
MLA
Sozzi, FB, D Poldermans, JJ Bax, et al. “Improved Identification of Viable Myocardium Using Second Harmonic Imaging During Dobutamine Stress Echo Cardiography.” HEART 86.6 (2001): 672–678. Print.
@article{140731,
  abstract     = {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 tetrofosmin/F-18-fluorodeoxyglucose on a separate day. Myocardial viability was considered present by dobutamine stress echo cardiography 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\%, K = 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 echo cardiography increases the agreement with DISA-SPECT for detecting myocardial viability.},
  author       = {Sozzi, FB and Poldermans, D and Bax, JJ and Elhendy, A and Vourvouri, EC and Valkema, R and De Sutter, Johan and Schinkel, AFL and Borghetti, A and Roelandt, JRTC},
  issn         = {1355-6037},
  journal      = {HEART},
  keyword      = {HIBERNATING MYOCARDIUM,F-18 FLUORODEOXYGLUCOSE,SURGICAL REVASCULARIZATION,CONTRACTILE RESERVE,ENDOCARDIAL BORDER,EJECTION FRACTION,dobutamine stress echocardiography,second harmonic imaging,F-18-fluorodeoxyglucose imaging,myocardial viability,EMISSION COMPUTED-TOMOGRAPHY,LEFT-VENTRICULAR FUNCTION,CORONARY-ARTERY DISEASE,REDISTRIBUTION TL-201 TOMOGRAPHY},
  language     = {eng},
  number       = {6},
  pages        = {672--678},
  title        = {Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echo cardiography},
  url          = {http://dx.doi.org/10.1136/heart.86.6.672},
  volume       = {86},
  year         = {2001},
}

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