| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Circulation, Vol 85, 1026-1031, Copyright © 1992 by American Heart Association
MA Quinones, MS Verani, RM Haichin, JJ Mahmarian, J Suarez and WA Zoghbi
BACKGROUND. Exercise echocardiography (digital cine-loop technique) and
201Tl single-photon emission computed tomography (SPECT) were performed
simultaneously in 292 patients being evaluated for coronary artery disease.
METHODS AND RESULTS. Pretreadmill and posttreadmill echocardiographic
images of diagnostic quality were obtained in 289 patients, and the left
ventricle was divided into anterior, inferior, and lateral regions. Any
wall motion or perfusion abnormality observed within each region was
classified as totally reversible, fixed, or partially reversible. Exercise
echocardiography and SPECT were normal in 137 patients and abnormal in 118
(88% agreement). Equal numbers of regional abnormalities were detected by
one test when missed by the other. The two tests had an 82% agreement in
detecting the same type of finding within the regions analyzed. SPECT
detected more reversible abnormalities than echocardiography, whereas
echocardiography detected more fixed abnormalities than SPECT. Regions with
a fixed abnormality by echocardiography frequently showed partial
reversibility of a perfusion defect by SPECT. Nearly one third of regions
with fixed perfusion defects by SPECT demonstrated normal resting function
or reversible abnormalities by echocardiography. Sensitivity for coronary
artery disease by angiography (greater than or equal to 50% diameter
stenosis) in 112 patients was similar for the two tests, ranging from 58%
and 61% (echocardiography and SPECT, respectively) for one-vessel disease
to 94% for three-vessel disease. The specificities for echocardiography and
SPECT were 88% and 81%, respectively. CONCLUSIONS. Exercise
echocardiography had a diagnostic accuracy comparable to that of SPECT for
the detection of regional abnormalities produced by significant coronary
artery disease. A greater number of abnormal regions were detected with the
combined use of both tests.
ARTICLES
Exercise echocardiography versus 201Tl single-photon emission computed tomography in evaluation of coronary artery disease. Analysis of 292 patients
Department of Medicine, Baylor College of Medicine, Houston, TX 77030.
This article has been cited by other articles:
 |
|
 |
|
  T. Kurita, H. Sakuma, K. Onishi, M. Ishida, K. Kitagawa, T. Yamanaka, T. Tanigawa, T. Kitamura, K. Takeda, and M. Ito Regional myocardial perfusion reserve determined using myocardial perfusion magnetic resonance imaging showed a direct correlation with coronary flow velocity reserve by Doppler flow wire Eur. Heart J., February 2, 2009; 30(4): 444 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress Echocardiography Expert Consensus Statement--Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur. Heart J., February 1, 2009; 30(3): 278 - 289. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur J Echocardiogr, July 1, 2008; 9(4): 415 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Peteiro, I. Bendayan, J. Marinas, R. Campos, B. Bouzas, and A. Castro-Beiras Prognostic value of mitral regurgitation assessment during exercise echocardiography in patients with left ventricular dysfunction: A follow-up study of 1.7 {+/-} 1.5 years Eur J Echocardiogr, January 1, 2008; 9(1): 18 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.-H. Park, N. Tayan, K. Takeda, H.-K. Jeon, M. A. Quinones, and W. A. Zoghbi Supine Bicycle Echocardiography: Improved Diagnostic Accuracy and Physiologic Assessment of Coronary Artery Disease With the Incorporation of Intermediate Stages of Exercise J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1857 - 1863. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. N. Chandraratna, R. Maraj, G. Tabel, A. Vahdat, and L. Malaviya Left Ventricular Wall Motion Abnormalities Induced by Squatting: A New Echocardiographic Stress Test for the Diagnosis of Coronary Artery Disease J. Am. Coll. Cardiol., September 6, 2005; 46(5): 931 - 933. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Sakuma, N. Suzawa, Y. Ichikawa, K. Makino, T. Hirano, K. Kitagawa, and K. Takeda Diagnostic Accuracy of Stress First-Pass Contrast-Enhanced Myocardial Perfusion MRI Compared with Stress Myocardial Perfusion Scintigraphy Am. J. Roentgenol., July 1, 2005; 185(1): 95 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Armstrong and W. A. Zoghbi Stress Echocardiography: Current Methodology and Clinical Applications J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1739 - 1747. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Y Loong and C Anagnostopoulos Diagnosis of coronary artery disease by radionuclide myocardial perfusion imaging Heart, August 1, 2004; 90(suppl_5): v2 - v9. [Full Text] [PDF]
|
|
|
|
|
|
S. B. Labib, M. Goldstein, P. M. Kinnunen, and E. C. Schick Cardiac events in patients with negative maximal versus negative submaximal dobutamine echocardiograms undergoing noncardiac surgery: Importance of resting wall motion abnormalities J. Am. Coll. Cardiol., July 7, 2004; 44(1): 82 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Ishida, H. Sakuma, M. Motoyasu, T. Okinaka, N. Isaka, T. Nakano, and K. Takeda Noninfarcted Myocardium: Correlation between Dynamic First-Pass Contrast-enhanced Myocardial MR Imaging and Quantitative Coronary Angiography Radiology, October 1, 2003; 229(1): 209 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Cheitlin, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, J. L. Davis, P. S. Douglas, D. P. Faxon, L. D. Gillam, T. R. Kimball, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American college of cardiology/American heart association task force on practice guidelines (ACC/AHA/ASE committee to update the 1997 guidelines for the clinical application of echocardiography) J. Am. Coll. Cardiol., September 3, 2003; 42(5): 954 - 970. [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Cheitlin, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, J. L. Davis, P. S. Douglas, D. P. Faxon, L. D. Gillam, T. R. Kimball, et al. ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography) Circulation, September 2, 2003; 108(9): 1146 - 1162. [Full Text] [PDF]
|
|
|
|
|
|
J Peteiro, L Monserrat, R Perez, E Vazquez, J.M Vazquez, and A Castro-Beiras Accuracy of peak treadmill exercise echocardiography to detect multivessel coronary artery disease: comparison with post-exercise echocardiography Eur J Echocardiogr, September 1, 2003; 4(3): 182 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.F.L Schinkel, J.J Bax, M.L Geleijnse, E Boersma, A Elhendy, J.R.T.C Roelandt, and D Poldermans Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echocardiography? Eur. Heart J., May 1, 2003; 24(9): 789 - 800. [Full Text] [PDF]
|
|
|
|
|
|
J.-W. Ha, E. M. Juracan, D. W. Mahoney, J. K. Oh, C. Shub, J. B. Seward, and P. A. Pellikka Hypertensive response to exercise: a potential cause for new wall motion abnormality in the absence of coronary artery disease J. Am. Coll. Cardiol., January 16, 2002; 39(2): 323 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Inzucchi Noninvasive Assessment of the Diabetic Patient for Coronary Artery Disease Diabetes Care, September 1, 2001; 24(9): 1519 - 1521. [Full Text] [PDF]
|
|
|
|
|
|
S. Shimoni, W. A. Zoghbi, F. Xie, D. Kricsfeld, S. Iskander, L. Gobar, I. A. Mikati, J. Abukhalil, M. S. Verani, E. L. O'Leary, et al. Real-time assessment of myocardial perfusion and wall motion during bicycle and treadmill exercise echocardiography: comparison with single photon emission computed tomography J. Am. Coll. Cardiol., March 1, 2001; 37(3): 741 - 747. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. von Bibra, A. Tuchnitz, A. Klein, J. Schneider-Eicke, A. Schomig, and M. Schwaiger Regional diastolic function by pulsed doppler myocardial mapping for the detection of left ventricular ischemia during pharmacologic stress testing: A comparison with stress echocardiography and perfusion scintigraphy J. Am. Coll. Cardiol., August 1, 2000; 36(2): 444 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Samady, J. A. Elefteriades, B. G. Abbott, J. A. Mattera, C. A. McPherson, and F. J. Th. Wackers Failure to Improve Left Ventricular Function After Coronary Revascularization for Ischemic Cardiomyopathy Is Not Associated With Worse Outcome Circulation, September 21, 1999; 100(12): 1298 - 1304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Koch, R. M. Lang, M.-J. Garcia, L. Weinert, J. Bednarz, C. Korcarz, B. Coughlan, A. Spiegel, E. Kaji, K. T. Spencer, et al. Objective evaluation of regional left ventricular wall motion during dobutamine stress echocardiographic studies using segmental analysis of color kinesis images J. Am. Coll. Cardiol., August 1, 1999; 34(2): 409 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Gibbons, K. Chatterjee, J. Daley, J. S. Douglas, S. D. Fihn, J. M. Gardin, M. A. Grunwald, D. Levy, B. W. Lytle, R. A. O'Rourke, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina) J. Am. Coll. Cardiol., June 1, 1999; 33(7): 2092 - 2197. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Badruddin, A. Ahmad, J. Mickelson, J. Abukhalil, W. L. Winters, S. F. Nagueh, and W. A. Zoghbi Supine bicycle versus post-treadmill exercise echocardiography in the detection of myocardial ischemia: a randomized single-blind crossover trial J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1485 - 1490. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P. Michaelides, Z. D. Psomadaki, P. E. Dilaveris, D. J. Richter, G. K. Andrikopoulos, K. D. Aggeli, C. I. Stefanadis, and P. K. Toutouzas Improved Detection of Coronary Artery Disease by Exercise Electrocardiography with the Use of Right Precordial Leads N. Engl. J. Med., February 4, 1999; 340(5): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. I. Olmos, H. Dakik, R. Gordon, J. K. Dunn, M. S. Verani, M. A. Quinones, and W. A. Zoghbi Long-Term Prognostic Value of Exercise Echocardiography Compared With Exercise 201Tl, ECG, and Clinical Variables in Patients Evaluated for Coronary Artery Disease Circulation, December 15, 1998; 98(24): 2679 - 2686. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Fleischmann, M. G. M. Hunink, K. M. Kuntz, and P. S. Douglas Exercise Echocardiography or Exercise SPECT Imaging?: A Meta-analysis of Diagnostic Test Performance JAMA, September 9, 1998; 280(10): 913 - 920. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R S Khattar, R Senior, and A Lahiri Assessment of myocardial perfusion and contractile function by inotropic stress Tc-99m sestamibi SPECT imaging and echocardiography for optimal detection of multivessel coronary artery disease Heart, March 1, 1998; 79(3): 274 - 280. [Abstract] [Full Text]
|
|
|
|
|
|
M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]
|
|
|
|
|
|
R. E. Dinsmore Noninvasive Coronary Arteriography— Here at Last? Circulation, March 1, 1995; 91(5): 1607 - 1608. [Full Text]
|
|
|
|
|
|
E. Pahl, R. Sehgal, D. Chrystof, W. H. Neches, C. L. Webb, C. E. Duffy, S. T. Shulman, and F. A. Chaudhry Feasibility of Exercise Stress Echocardiography for the Follow-up of Children With Coronary Involvement Secondary to Kawasaki Disease Circulation, January 1, 1995; 91(1): 122 - 128. [Abstract] [Full Text]
|
|