Contrast-Enhanced Stress Echocardiography and Myocardial Perfusion Imaging in Patients Hospitalized With Chest Pain: A Randomized Study

Critical Pathways in Cardiology
Gerald SalameMori J Krantz

Abstract

Ultrasound contrast-enhanced stress echocardiography improves endocardial visualization, but diagnostic test rates versus stress myocardial perfusion imaging (MPI) have not been studied. A prospective randomized trial was performed between April 2012 and October 2014 at a single-center, safety net hospital. Hospitalized patients referred for noninvasive stress imaging were randomized 1:1 to stress echocardiography or stress MPI. The primary outcome was diagnostic test rate defined as interpretable images and achievement of >85% of age-predicted maximal heart rate (for dobutamine and exercise). Rates were assessed among those completing testing and then based solely on image interpretability. Charges and length of stay were secondary outcomes. A total of 240 patients were randomized, and 229 completed testing. Diagnostic test rates were similar for stress echocardiography versus MPI {89.4% [95% confidence interval (CI), 82.2-94.4] vs. 94.8% [95% CI, 89.1-98.1], P = 0.13} and did not differ with multivariable adjustment. Modalities requiring a diagnostic heart rate criteria were more frequently ordered with stress echocardiography (100% vs. 26%; P < 0.001). Therefore, an imaging-based analysis without the 12 individuals who faile...Continue Reading

References

Sep 1, 1997·Journal of the American College of Cardiology·M L GeleijnseJ R Roelandt
Sep 18, 1998·JAMA : the Journal of the American Medical Association·K E FleischmannP S Douglas
Mar 18, 1999·The American Journal of Cardiology·Y KwokR Redberg
Jun 5, 1999·Annals of Internal Medicine·A M Garber, N A Solomon
Apr 11, 2000·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·S L MulvaghF S Villanueva
Mar 10, 2009·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Roxy SeniorPetros Nihoyannopoulos
Aug 28, 2009·The New England Journal of Medicine·Reza FazelBrahmajee K Nallamothu
Dec 17, 2009·Archives of Internal Medicine·Amy Berrington de GonzálezCharles Land
Jul 28, 2010·Circulation·Ezra A AmsterdamUNKNOWN American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology,
Jan 12, 2012·Circulation. Cardiovascular Quality and Outcomes·Bruce W Andrus, H Gilbert Welch
Jun 12, 2013·The Journal of Ambulatory Care Management·Mori J KrantzPhilip S Mehler
Aug 3, 2014·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Thomas R PorterKevin Wei
Jul 10, 2016·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Vasken DilsizianMark I Travin

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