Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents

Sahar S. Abdelmoneim; Sharon L. Mulvagh; Feng Xie; Edward O'Leary; Mary Adolphson; Mohamed A. Omer; Lara F. Nhola; Runqing Huang; Sara J. Warta; Brenda Kirby; Thomas R. Porter

doi:10.1016/j.echo.2015.08.011

Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents

Sahar S. Abdelmoneim, Sharon L. Mulvagh, Feng Xie, Edward O'Leary, Mary Adolphson, Mohamed A. Omer, Lara F. Nhola, Runqing Huang, Sara J. Warta, Brenda Kirby, Thomas R. Porter

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Background The aim of this study was to compare the efficacy of myocardial perfusion (MP) and wall motion (WM) analysis obtained with real-time myocardial contrast echocardiography (RTMCE) and two widely used contrast agents in detecting coronary artery disease after injection of the vasodilator regadenoson. Methods One hundred fifty patients were studied at two academic centers using regadenoson (400-μg intravenous bolus) vasodilator stress RTMCE (7.5% Optison infusion [n = 50] or 1.5% Definity infusion [n = 100]). Both MP and WM with RTMCE were analyzed at rest and after regadenoson bolus. Comparisons of WM and MP sensitivity, specificity, and accuracy were made. Quantitative angiography was performed in all patients within 1 month of the regadenoson stress study (>50% and >70% diameter stenosis was considered significant). Reviewers were blinded to all clinical and quantitative angiographic data. Results Rate-pressure product after regadenoson was higher in Optison than Definity patients (P =.004). Using a 50% diameter stenosis on quantitative angiography as a reference standard, overall sensitivity, specificity, and accuracy for combined WM and MP analysis were not different for both agents (Optison, 77%, 64%, and 73%; Definity, 80%, 74%, and 78%; P = NS). The sensitivity, specificity, and accuracy of WM analysis alone for Optison were 68%, 71%, and 69% compared with 60%, 72%, and 66% for Definity (P = NS). Adding MP analysis improved the sensitivity and accuracy of Definity for detecting both >50% and >70% stenoses (P <.001 vs WM), while MP analysis did not improve the sensitivity of Optison for detecting either >50 or >70% stenoses. Conclusions RTMCE during regadenoson stress using either Optison or Definity is a rapid and effective method for the detection of coronary artery disease. The ability of MP imaging to improve WM accuracy may depend on the rate-pressure product achieved.

Original language	English
Pages (from-to)	1393-1400
Number of pages	8
Journal	Journal of the American Society of Echocardiography
Volume	28
Issue number	12
DOIs	https://doi.org/10.1016/j.echo.2015.08.011
Publication status	Published - Dec 1 2015
Externally published	Yes

Bibliographical note

Funding Information:
This study was supported by the Theodore F. Hubbard Foundation. Grant support was also provided by Astellas Pharma . This included partial salary support for the principal investigators to perform the study, partial salary support for a study coordinator, and partial salary support for the blinded reviewer. GE Healthcare and Lantheus Medical Imaging supplied Optison and Definity, respectively, for the study. Thomas R. Porter does speaking engagements for Bracco Lantheus.

Publisher Copyright:
© 2015 American Society of Echocardiography.

ASJC Scopus Subject Areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

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10.1016/j.echo.2015.08.011

Cite this

Abdelmoneim, S. S., Mulvagh, S. L., Xie, F., O'Leary, E., Adolphson, M., Omer, M. A., Nhola, L. F., Huang, R., Warta, S. J., Kirby, B., & Porter, T. R. (2015). Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents. Journal of the American Society of Echocardiography, 28(12), 1393-1400. https://doi.org/10.1016/j.echo.2015.08.011

Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents. / Abdelmoneim, Sahar S.; Mulvagh, Sharon L.; Xie, Feng et al.
In: Journal of the American Society of Echocardiography, Vol. 28, No. 12, 01.12.2015, p. 1393-1400.

Research output: Contribution to journal › Article › peer-review

Abdelmoneim, SS, Mulvagh, SL, Xie, F, O'Leary, E, Adolphson, M, Omer, MA, Nhola, LF, Huang, R, Warta, SJ, Kirby, B & Porter, TR 2015, 'Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents', Journal of the American Society of Echocardiography, vol. 28, no. 12, pp. 1393-1400. https://doi.org/10.1016/j.echo.2015.08.011

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title = "Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents",

abstract = "Background The aim of this study was to compare the efficacy of myocardial perfusion (MP) and wall motion (WM) analysis obtained with real-time myocardial contrast echocardiography (RTMCE) and two widely used contrast agents in detecting coronary artery disease after injection of the vasodilator regadenoson. Methods One hundred fifty patients were studied at two academic centers using regadenoson (400-μg intravenous bolus) vasodilator stress RTMCE (7.5% Optison infusion [n = 50] or 1.5% Definity infusion [n = 100]). Both MP and WM with RTMCE were analyzed at rest and after regadenoson bolus. Comparisons of WM and MP sensitivity, specificity, and accuracy were made. Quantitative angiography was performed in all patients within 1 month of the regadenoson stress study (>50% and >70% diameter stenosis was considered significant). Reviewers were blinded to all clinical and quantitative angiographic data. Results Rate-pressure product after regadenoson was higher in Optison than Definity patients (P =.004). Using a 50% diameter stenosis on quantitative angiography as a reference standard, overall sensitivity, specificity, and accuracy for combined WM and MP analysis were not different for both agents (Optison, 77%, 64%, and 73%; Definity, 80%, 74%, and 78%; P = NS). The sensitivity, specificity, and accuracy of WM analysis alone for Optison were 68%, 71%, and 69% compared with 60%, 72%, and 66% for Definity (P = NS). Adding MP analysis improved the sensitivity and accuracy of Definity for detecting both >50% and >70% stenoses (P <.001 vs WM), while MP analysis did not improve the sensitivity of Optison for detecting either >50 or >70% stenoses. Conclusions RTMCE during regadenoson stress using either Optison or Definity is a rapid and effective method for the detection of coronary artery disease. The ability of MP imaging to improve WM accuracy may depend on the rate-pressure product achieved.",

author = "Abdelmoneim, {Sahar S.} and Mulvagh, {Sharon L.} and Feng Xie and Edward O'Leary and Mary Adolphson and Omer, {Mohamed A.} and Nhola, {Lara F.} and Runqing Huang and Warta, {Sara J.} and Brenda Kirby and Porter, {Thomas R.}",

note = "Funding Information: This study was supported by the Theodore F. Hubbard Foundation. Grant support was also provided by Astellas Pharma . This included partial salary support for the principal investigators to perform the study, partial salary support for a study coordinator, and partial salary support for the blinded reviewer. GE Healthcare and Lantheus Medical Imaging supplied Optison and Definity, respectively, for the study. Thomas R. Porter does speaking engagements for Bracco Lantheus. Publisher Copyright: {\textcopyright} 2015 American Society of Echocardiography.",

year = "2015",

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doi = "10.1016/j.echo.2015.08.011",

language = "English",

volume = "28",

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TY - JOUR

T1 - Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease

T2 - Feasibility and Accuracy of Two Different Ultrasound Contrast Agents

AU - Abdelmoneim, Sahar S.

AU - Mulvagh, Sharon L.

AU - Xie, Feng

AU - O'Leary, Edward

AU - Adolphson, Mary

AU - Omer, Mohamed A.

AU - Nhola, Lara F.

AU - Huang, Runqing

AU - Warta, Sara J.

AU - Kirby, Brenda

AU - Porter, Thomas R.

N1 - Funding Information: This study was supported by the Theodore F. Hubbard Foundation. Grant support was also provided by Astellas Pharma . This included partial salary support for the principal investigators to perform the study, partial salary support for a study coordinator, and partial salary support for the blinded reviewer. GE Healthcare and Lantheus Medical Imaging supplied Optison and Definity, respectively, for the study. Thomas R. Porter does speaking engagements for Bracco Lantheus. Publisher Copyright: © 2015 American Society of Echocardiography.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background The aim of this study was to compare the efficacy of myocardial perfusion (MP) and wall motion (WM) analysis obtained with real-time myocardial contrast echocardiography (RTMCE) and two widely used contrast agents in detecting coronary artery disease after injection of the vasodilator regadenoson. Methods One hundred fifty patients were studied at two academic centers using regadenoson (400-μg intravenous bolus) vasodilator stress RTMCE (7.5% Optison infusion [n = 50] or 1.5% Definity infusion [n = 100]). Both MP and WM with RTMCE were analyzed at rest and after regadenoson bolus. Comparisons of WM and MP sensitivity, specificity, and accuracy were made. Quantitative angiography was performed in all patients within 1 month of the regadenoson stress study (>50% and >70% diameter stenosis was considered significant). Reviewers were blinded to all clinical and quantitative angiographic data. Results Rate-pressure product after regadenoson was higher in Optison than Definity patients (P =.004). Using a 50% diameter stenosis on quantitative angiography as a reference standard, overall sensitivity, specificity, and accuracy for combined WM and MP analysis were not different for both agents (Optison, 77%, 64%, and 73%; Definity, 80%, 74%, and 78%; P = NS). The sensitivity, specificity, and accuracy of WM analysis alone for Optison were 68%, 71%, and 69% compared with 60%, 72%, and 66% for Definity (P = NS). Adding MP analysis improved the sensitivity and accuracy of Definity for detecting both >50% and >70% stenoses (P <.001 vs WM), while MP analysis did not improve the sensitivity of Optison for detecting either >50 or >70% stenoses. Conclusions RTMCE during regadenoson stress using either Optison or Definity is a rapid and effective method for the detection of coronary artery disease. The ability of MP imaging to improve WM accuracy may depend on the rate-pressure product achieved.

AB - Background The aim of this study was to compare the efficacy of myocardial perfusion (MP) and wall motion (WM) analysis obtained with real-time myocardial contrast echocardiography (RTMCE) and two widely used contrast agents in detecting coronary artery disease after injection of the vasodilator regadenoson. Methods One hundred fifty patients were studied at two academic centers using regadenoson (400-μg intravenous bolus) vasodilator stress RTMCE (7.5% Optison infusion [n = 50] or 1.5% Definity infusion [n = 100]). Both MP and WM with RTMCE were analyzed at rest and after regadenoson bolus. Comparisons of WM and MP sensitivity, specificity, and accuracy were made. Quantitative angiography was performed in all patients within 1 month of the regadenoson stress study (>50% and >70% diameter stenosis was considered significant). Reviewers were blinded to all clinical and quantitative angiographic data. Results Rate-pressure product after regadenoson was higher in Optison than Definity patients (P =.004). Using a 50% diameter stenosis on quantitative angiography as a reference standard, overall sensitivity, specificity, and accuracy for combined WM and MP analysis were not different for both agents (Optison, 77%, 64%, and 73%; Definity, 80%, 74%, and 78%; P = NS). The sensitivity, specificity, and accuracy of WM analysis alone for Optison were 68%, 71%, and 69% compared with 60%, 72%, and 66% for Definity (P = NS). Adding MP analysis improved the sensitivity and accuracy of Definity for detecting both >50% and >70% stenoses (P <.001 vs WM), while MP analysis did not improve the sensitivity of Optison for detecting either >50 or >70% stenoses. Conclusions RTMCE during regadenoson stress using either Optison or Definity is a rapid and effective method for the detection of coronary artery disease. The ability of MP imaging to improve WM accuracy may depend on the rate-pressure product achieved.

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Regadenoson Stress Real-Time Myocardial Perfusion Echocardiography for Detection of Coronary Artery Disease: Feasibility and Accuracy of Two Different Ultrasound Contrast Agents

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

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