Patient Outcome Following Two Different Stress Imaging Approaches: A Prospective Randomized Comparison.
J Am Coll Cardiol. 2013 May 2;
Authors: Porter TR, Smith LM, Wu J, Thomas D, Haas JT, Mathers DH, Williams E, Olson J, Nalty K, Hess R, Therrien S, Xie F
OBJECTIVES: The study sought to prospectively compare patient outcome after stress real-time myocardial contrast echocardiography (RTMCE) versus conventional stress echo (CSE), where contrast is used to optimize wall motion (WM) analysis. BACKGROUND: Myocardial perfusion imaging with RTMCE may improve the detection of coronary artery disease (CAD), and predict patient outcome. METHODS: Patients with intermediate to high pre-test probability referred for dobutamine or exercise stress echocardiography were prospectively randomized to either RTMCE or CSE. Definity contrast was used for CSE only when endocardial border delineation was inadequate (63% of studies). Studies were interpreted by either an experienced contrast reviewer (R1; n = 1257), or 4 Level 3 echocardiographers (R2) with basic contrast training (n = 806). Death, nonfatal myocardial infarction (MI), and revascularizations were recorded at follow-up. RESULTS: Follow-up was available in 2,014 patients (median 2.6 years). Mean age was 59 ± 13 years (53% women). An abnormal RTMCE was more frequently observed than an abnormal CSE (p http://clinicaltrials.gov/ct2/show/NCT00575549; NCT00575549.
PMID: 23643501 [PubMed - as supplied by publisher]