Evaluation of coronary artery stenosis by adenosine stress myocardial contrast echocardiography

Abstract

Objective To investigate the value of adenosine stress myocardial contrast echocardiography(MCE) in evaluating the myocardial perfusion in patients with coronary artery stenosis in different degrees. Methods The 384 myocardial segments governed by the corresponding coronary arteries with different degrees of stenosis in 24 patients with coronary artery disease (CAD) were divided into group A (normal),B (50%～75%) ,C (76%～89%) and D (≥90%). Parametric quantification(PQ) was applied at rest and adenosine stress MCE to analyze myocardial perfusion by parameters (A,β and A×β). Then the receiver operating characteristic (ROC) curves were constructed according to the rangeability of the parameters and the cutoff points, sensibility and specificity were obtained. Results At rest, A,β and A ×β in group A,B,C and D decreased by degrees,while there were no significant differences between group A and B. At adenosine stress, the parameter rangeability increased in group A and B, while decreased in group C and D. The ROC curve analyses of parameter rangeability showed that the area under the curve of the rangeability of parameter A ×β was the largest when the rangeability was applied to diagnose stenosis of coronary artery,and the sensibility and specificity were 81.3% and 94. 9% for group B,82.6% and 84.5% for group C,71.9 % and 86. 3 % for group D. Conclusions Adenosine stress MCE can be applied to diagnose the various degrees of stenosis of coronary artery. Key words: Echocardiography,stress; Microbubbles; Coronary stenosis