Author + information
- Thomas Richard Porter,
- Juefei Wu,
- Feng Xie,
- Stacey Therrien,
- Valentina Lorenzoni,
- Sabrina Molinaro,
- Claudio Reverberi and
- Nicola Gaibazzi
Real time myocardial contrast echocardiography (RT MCE) has been utilized to detect myocardial perfusion (MP) and wall motion (WM) abnormalities during both dobutamine (DSE) and dipyridamole (DiSE) stress echocardiography. The comparative prognostic value of MP when using these two stressors is unknown. The purpose of this study was to compare the incremental prognostic value of MP imaging during DSE versus DiSE.
We analyzed the outcome (death/non fatal infarction) of 2869 patients referred to two experienced institutions for either DiSE (n=1355) or DSE (n=1514). Abnormal studies were stratified by inducible MP defects only, or both inducible MP and WM abnormalities. MP and WM were assessed during myocardial replenishment after high mechanical index impulses following either intravenous Definity of Sonovue infusions.
Median follow up was 1113 days. Abnormal MP (fixed or inducible) was seen in 496 (33%) of DSE and 632 (47%) of DiSE studies, while abnormal WM was seen in 385 (25%) of DSE and 532 (39%) DiSE studies (both p<0.005 comparing MP to WM). Inducible MP (despite normal WM) defects with either DSE or DiSE had a significantly lower event-free survival (EFS) than normal MP(graph), while abnormal MP and WM had the lowest EFS.
RT MCE assessments of MP during either DiSE or DSE add equivalent, significant predictive value over WM analysis. MP imaging should be strongly considered during either test to improve its predictive value.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: Echo – Contrast Echocardiography/Vascular Imaging
Abstract Category: 18. Imaging: Echo
Presentation Number: 1225-328
- 2013 American College of Cardiology Foundation