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Heart. 2001 Dec;86(6):672-8.

Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echocardiography.

Author information

  • 1Thoraxcenter, Erasmus Medical Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands.

Abstract

OBJECTIVE:

To determine whether, compared with fundamental imaging, second harmonic imaging can improve the accuracy of dobutamine stress echocardiography for identifying viable myocardium, using nuclear imaging as a reference.

PATIENTS:

30 patients with chronic left ventricular dysfunction (mean (SD) age, 60 (8) years; 22 men).

METHODS:

Dobutamine stress echocardiography was carried out in all patients using both fundamental and second harmonic imaging. All patients underwent dual isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT) with (99m)technetium-tetrofosmin/(18)F-fluorodeoxyglucose on a separate day. Myocardial viability was considered present by dobutamine stress echocardiography when segments with severe dysfunction showed a biphasic sustained improvement or an ischaemic response. Viability criteria on DISA-SPECT were normal or mildly reduced perfusion and metabolism, or perfusion/metabolism mismatch.

RESULTS:

Using fundamental imaging, 330 segments showed severe dysfunction at baseline; 144 (44%) were considered viable. The agreement between dobutamine stress echocardiography by fundamental imaging and DISA-SPECT was 78%, kappa = 0.56. Using second harmonic imaging, 288 segments showed severe dysfunction; 138 (48%) were viable. The agreement between dobutamine stress echocardiography and DISA-SPECT was significantly better when second harmonic imaging was used (89%, kappa = 0.77, p = 0.001 v fundamental imaging).

CONCLUSIONS:

Second harmonic imaging applied during dobutamine stress echocardiography increases the agreement with DISA-SPECT for detecting myocardial viability.

PMID:
11711466
[PubMed - indexed for MEDLINE]
PMCID:
PMC1730030
Free PMC Article
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