Value of vasodilator stress myocardial contrast echocardiography and magnetic resonance imaging for the differential diagnosis of ischemic versus nonischemic cardiomyopathy

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Victor Mor-AviRoberto M Lang

Abstract

Noninvasive differentiation of ischemic versus nonischemic cardiomyopathy (CM) remains challenging because of the low specificity of imaging-based tests in these patients. We hypothesized that myocardial contrast echocardiography (MCE) and cardiac magnetic resonance (CMR), combined with vasodilator stress, could provide accurate alternatives for determining the cause of CM. To allow side-by-side comparisons between these techniques with coronary angiography as a reference, we studied 16 patients referred for coronary angiography after abnormal nuclear perfusion studies. Both MCE and CMR images were acquired within 48 hours with infusion of adenosine. MCE included flash-echo imaging during intravenous infusion of echocardiographic contrast solution. CMR included gadolinium injections for first-pass perfusion and delayed enhancement imaging. MCE and CMR images were reviewed by experienced investigators, blinded to the findings of the other modality and angiography. For each technique, each myocardial segment was classified as normal or abnormal. Sensitivity and specificity of each technique were calculated against the angiography reference. These calculations were also performed using a perfusion territory as a unit of analysis. ...Continue Reading

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Citations

Oct 7, 2009·Future Cardiology·Riccardo RambaldiCesare Fiorentini
Jul 6, 2010·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Rajesh K ChelliahRoxy Senior
Jun 26, 2009·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Dana DawsonKevin Wei
Feb 18, 2010·JACC. Cardiovascular Imaging·Thomas R Porter, Feng Xie
Jan 5, 2014·The Cochrane Database of Systematic Reviews·Elspeth AnwarLeonard Leibovici
Jul 29, 2009·Current Opinion in Pulmonary Medicine

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