Abstract 3570: Adenosine Myocardial Contrast Echocardiography in Comparison to Tl-201 SPECT for Coronary Artery Disease Detection in Hypertensive Patients
Objective: Our aim was to evaluate the diagnostic value of adenosine myocardial contrast echocardiography (MCE), in comparison to single-photon emission computed tomography (SPECT), with reference to angiography. Methods: Fifty hypertensive subjects (males: 34, mean age: 67 ± 5), were submitted to adenosine MCE, SPECT and coronary angiography within a one-month period, without any intervening events.
Results: Sensitivity, specificity and accuracy were 87.5%, 89%, 88% for MCE and 80%, 94.4%, 85.4% for SPECT, respectively (p=NS). We performed a stepwise discriminant analysis entering, in addition to MCE and SPECT, the assessment of wall-motion abnormalities in the model, which resulted in inclusion of MCE and SPECT in the final discriminant function (coefficients 0.675, 0.616 respectively; Wilks’ lambda=0.341, p<0.001) and exclusion of wall-motion analysis. In the analysis by coronary territory, it appears that MCE and SPECT were both more accurate in detecting lesions of the anterior than of the posterior coronary system (see figure⇓ for kappa statistic values for agreement with angiography per coronary territory). MCE was significantly more sensitive than SPECT in the left circumflex artery region (83% vs. 63%, p<0.01) and less - though not significantly - specific (84% vs. 97%, p=NS).
Conclusion: Adenosine MCE is diagnostically equivalent to SPECT for the detection of coronary artery disease in hypertensive patients. In the analysis per vascular territory, MCE shows superior sensitivity to SPECT in the left circumflex artery region.