Aim The aim of this study was to evaluate the feasibility of myocardial
wall-motion and perfusion assessment using contrast echocardiography
during real-time three-dimensional (RT3D) adenosine stress test, and
compare its diagnostic accuracy with the two-dimensional (2D) method
using coronary angiography as reference.
Methods and results Patients with known or suspected coronary artery
disease (CAD) have been submitted to adenosine stress contrast
echocardiography and coronary angiography, within a 1-month period.
Two-dimensional apical four, two, and three chamber, as well as
three-dimensional (3D) pyramidal full-volume data sets were acquired at
rest and at peak stress. The 17-segment division of the left ventricle
was used and each segment was evaluated based on wall motion and
perfusion. Sixty patients (age: 60.1+/-8.5 years, 38 men) were enrolled,
i.e. 1020 segments were evaluated at rest and at peak stress.
Wall-motion analysis per patient revealed that the sensitivity and
specificity of 2D to detect CAD were 80 and 82% and of RT3D
echocardiography were 82 and 64%, respectively, whereas in the per
patient perfusion analysis the respective percentages were 88, 64% for
2D and 90, 73% for RT3D. Regarding left anterior descending artery and
right coronary system, there seems to be no statistical significant
difference in terms of wall-motion and perfusion evaluation between the
two modalities.
Conclusions Real-time 3D adenosine stress echocardiography is a feasible
and valuable technique to evaluate myocardial wall motion and perfusion
in patients with suspected CAD, despite existing problems concerning
lower spatial and temporal resolution when compared with 2D
echocardiography
