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

FB Sozzi, D Poldermans, JJ Bax, A Elhendy, EC Vourvouri, R Valkema, Johan De Sutter UGent, AFL Schinkel, A Borghetti and JRTC Roelandt (2001) HEART. 86(6). p.672-678
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
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
journal title
HEART
Heart
volume
86
issue
6
pages
672 - 678
Web of Science type
Article
Web of Science id
000172341100027
JCR category
CARDIAC & CARDIOVASCULAR SYSTEMS
JCR impact factor
2.636 (2001)
JCR rank
13/65 (2001)
JCR quartile
1 (2001)
ISSN
1355-6037
DOI
10.1136/heart.86.6.672
language
English
UGent publication?
yes
classification
A1
id
140731
handle
http://hdl.handle.net/1854/LU-140731
date created
2004-01-14 13:37:00
date last changed
2016-12-19 15:38:04
@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},
}

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.