Key result
Contrast-enhanced low-dose dobutamine stress echocardiography demonstrated a 78.6% agreement (kappa = 0.63) with 99mTc-Sestamibi SPECT for detecting myocardial viability in dysfunctional segments.
Why the study?
DSE is cheaper and widely available for detecting viable myocardium but has lower sensitivity than myocardial perfusion scans.
Does contrast-enhanced low-dose dobutamine echocardiography agree with 99mTc-sestamibi SPECT in detecting myocardial viability in patients with CAD and LV systolic dysfunction?
Population
50 patients with coronary artery disease and left ventricular systolic dysfunction (EF < 40%)
Comparison
Contrast-enhanced LDDE vs gated 99mTc-sestamibi SPECT
Design
Head-to-head comparative diagnostic study
Authors
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Supports contrast-enhanced dobutamine echo for viability assessment in CAD; leaves open outcome validation before wider adoption.
Cross-Sectional (n=50)
Double-blind
No
Does contrast-enhanced low-dose dobutamine echocardiography agree with 99mTc-sestamibi SPECT in detecting myocardial viability in patients with CAD and LV systolic dysfunction?
Effect estimate: 78.6% agreement (kappa = 0.63)
Absolute Event Rate: 46.2% vs 52%
p-value: p=0.31
Contrast-enhanced low-dose dobutamine echocardiography shows substantial agreement with 99mTc-sestamibi SPECT for assessing myocardial viability and improves endocardial border visualization.
Verma et al. (2019) conducted a cross-sectional in Coronary artery disease with left ventricular systolic dysfunction (n=50). Contrast-enhanced low-dose dobutamine stress echocardiography vs. 99mTc-Sestamibi gated SPECT was evaluated on Agreement in detection of myocardial viability in dysfunctional segments (78.6% agreement (kappa = 0.63), p=0.31). Contrast-enhanced low-dose dobutamine stress echocardiography demonstrated a 78.6% agreement (kappa = 0.63) with 99mTc-Sestamibi SPECT for detecting myocardial viability in dysfunctional segments.
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