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Titolo:
Non-contrast second harmonic imaging improves interobserver agreement and accuracy of dobutamine stress echocardiography in patients with impaired image quality
Autore:
Franke, A; Hoffmann, R; Kuhl, HP; Lepper, W; Breithardt, OA; Schormann, M; Hanrath, P;
Indirizzi:
Univ Hosp, Med Clin 1, D-52057 Aachen, Germany Univ Hosp Aachen Germany D-52057 sp, Med Clin 1, D-52057 Aachen, Germany
Titolo Testata:
HEART
fascicolo: 2, volume: 83, anno: 2000,
pagine: 133 - 140
SICI:
1355-6037(200002)83:2<133:NSHIII>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; 2-DIMENSIONAL ECHOCARDIOGRAPHY; DIPYRIDAMOLE-ECHOCARDIOGRAPHY; PERFUSION SCINTIGRAPHY; ENHANCED SENSITIVITY; TISSUE; DIAGNOSIS; ATROPINE; AGENTS;
Keywords:
coronary artery disease; dobutamine stress echocardiography; second harmonic imaging; interobserver agreement;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Franke, A Univ Hosp, Med Clin 1, Pauwelsstr 30, D-52057 Aachen, Germany Univ Hosp Pauwelsstr 30 Aachen Germany D-52057 Aachen, Germany
Citazione:
A. Franke et al., "Non-contrast second harmonic imaging improves interobserver agreement and accuracy of dobutamine stress echocardiography in patients with impaired image quality", HEART, 83(2), 2000, pp. 133-140

Abstract

Objective-To examine the influence of second harmonic imaging during dobutamine echocardiography on regional endocardial visibility, interobserver agreement in the interpretation of wall motion abnormalities, and diagnostic accuracy in patients with reduced image quality. Design-Blinded comparison. Setting-Tertiary care centre. Patients-103 consecutive patients with suspected coronary artery disease and impaired transthoracic image quality (greater than or equal to 2 segments with poor endocardial delineation). Methods-Fundamental and second harmonic imaging were performed at each stage of a dobutamine stress echocardiography. Coronary angiography was undertaken within three weeks of dobutamine echocardiography in 75 patients. Main outcome measures-Evaluation of regional endocardial visibility (scoring from 0 = poor to 2 = good) and of segmental wall motion abnormalities for both modalities separately. A second blinded examiner analysed 70 studiesto determine interobserver agreement. Results-Mean (SD) visibility score for all segments was 1.2 (0.4) using fundamental imaging and 1.7 (0.2) using second harmonic imaging at rest (p < 0.001), and 1.1 (0.4) v 1.6 (0.3), respectively, at peak dobutamine dose (p< 0.001). The average number of segments with poor endocardial visibility was lower for second harmonic than for fundamental imaging (0.6 (1.1) v 3.8(2.6) at rest, p < 0.001; 0.9 (1.3) v 4.3 (2.9) at peak dose, p < 0.001). Improvement was most pronounced in all lateral and anterior segments. The kappa value for identical study interpretation increased from 0.40 to 0.69 (p < 0.05). Sensitivity for the diagnosis of coronary artery disease was 64%using fundamental imaging versus 92% using harmonic imaging (p < 0.001), while specificity remained unchanged at 75% for both imaging modalities. Conclusions-Second harmonic imaging enhances endocardial visibility duringdobutamine echocardiography. Consequently, interobserver agreement on stress echocardiography interpretation and diagnostic accuracy are significantly improved compared to fundamental imaging. Thus, in difficult to image patients, dobutamine echocardiography should be performed using second harmonic imaging.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 01:03:34