Harmonic power Doppler imaging demonstrated 81% overall concordance with SPECT for detecting normal versus abnormal myocardial perfusion during pharmacological stress.
Observational (n=123)
Does Harmonic power Doppler imaging (HPDI) accurately assess myocardial perfusion compared to SPECT in patients with known or suspected coronary artery disease?
HPDI can reliably detect myocardial perfusion during pharmacological stress compared to SPECT, though it has a higher rate of false abnormalities in the circumflex territory.
BACKGROUND: Harmonic power Doppler imaging (HPDI) is a novel technique for assessing myocardial perfusion by contrast echocardiography in humans. The purpose of this study was to compare myocardial perfusion by HPDI with that obtained by (99m)Tc-sestamibi single photon emission computed tomography (SPECT) during rest and pharmacological stress. METHODS AND RESULTS: HPDI was performed on 123 patients who were referred for SPECT imaging for known or suspected coronary artery disease. Images were obtained at baseline and during adenosine infusion (0.14 mg. kg(-)(1). min(-)(1)x6 minutes) in 3 apical views. Myocardial perfusion by HPDI was graded for each coronary territory as absent, patchy, or full. The persistence of absent or patchy myocardial perfusion by HPDI between rest and adenosine was interpreted as a fixed defect, whereas any decrease in perfusion grade was interpreted as a reversible defect. Overall concordance between HPDI and SPECT was 83 (81%) of 103 for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 3 coronary territories was 81% (kappa=0.57) for the left anterior descending artery, 76% (kappa=0.52) for the right coronary artery, and 72% (kappa=0.40) for the left circumflex artery. Discrepancies between the 2 techniques were most notable in the circumflex territory, where fixed defects were observed in 33% by HPDI but in only 14% by SPECT (chi(2)=15.8, P=0.0001). CONCLUSIONS: This study demonstrates that HPDI can reliably detect myocardial perfusion during pharmacological stress, although there was a significantly higher number of falsely abnormal results in the circumflex territory.
Heinle et al. (2000) conducted an observational in known or suspected coronary artery disease (n=123). Harmonic power Doppler imaging (HPDI) vs. (99m)Tc-sestamibi single photon emission computed tomography (SPECT) was evaluated on Overall concordance between HPDI and SPECT for normal versus abnormal perfusion. Harmonic power Doppler imaging demonstrated 81% overall concordance with SPECT for detecting normal versus abnormal myocardial perfusion during pharmacological stress.