CORRESPONDENCE: LETTERS TO THE EDITOR
Reply
Jeane M. Tsutsui, MD,
Abdou Elhendy, MD, FACC,
Feng Xie, MD,
Edward O’Leary, MD, FACC,
Anna C. McGrain, RN, BSN and
Thomas R. Porter, MD, FACC*
* University of Nebraska Medical Center, Internal Medicine, 981165 Nebraska Medical Center, Omaha, NE 68198-1165 (Email: trporter{at}unmc.edu).
We thank Mr. Timperley and Dr. Becher for their comments regarding the safety of contrast echocardiography (1). Their findings reinforce our results demonstrating no increase in the incidence of adverse effects when using intravenous (IV) second-generation contrast agents and low mechanical index real-time imaging during dobutamine stress echocardiography. Nevertheless, we would like to emphasize that in our study (1), IV contrast agents were also used for the assessment of myocardial perfusion. We tested two contrast agents already approved by the Food and Drug Administration using the same doses as recommended for the enhancement of left ventricular opacification during stress testing (2). The high sensitivity of the low mechanical index pulse scheme techniques for detecting small amounts of microbubbles in the myocardium allowed for simultaneous evaluation of both contrast-enhanced wall motion and myocardial perfusion with high feasibility and good safety profile. Consistent with previous studies (3,4), we demonstrated that the analysis of myocardial perfusion increased the sensitivity and diagnostic accuracy of dobutamine stress echocardiography for detecting angiographically significant coronary artery disease. Thus, our findings demonstrate the potential use of real-time myocardial contrast echocardiography as an alternative and safe method of perfusion imaging during stress testing.
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References
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- Tsutsui JM, Elhendy A, Xie F, O’Leary EL, McGrain AC, Porter TR. Safety of dobutamine stress real-time myocardial contrast echocardiography J Am Coll Cardiol 2005;45:1235-1242.[Abstract/Free Full Text]
- Mulvagh SL, DeMaria AN, Feinstein SB, et al. Contrast echocardiographycurrent and future applications. J Am Soc Echocardiogr 2000;13:331-342.[CrossRef][ISI][Medline]
- Elhendy A, O’Leary EL, Xie F, McGrain AC, Anderson JR, Porter TR. Comparative accuracy of real-time myocardial contrast perfusion imaging and wall motion analysis during dobutamine stress echocardiography for the diagnosis of coronary artery disease J Am Coll Cardiol 2004;44:2185-2191.[Abstract/Free Full Text]
- Porter TR, Xie F, Silver M, Kricsfeld D, Oleary E. Real-time perfusion imaging with low mechanical index pulse inversion Doppler imaging J Am Coll Cardiol 2001;37:748-753.[Abstract/Free Full Text]
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