TY - JOUR T1 - Quantitative stress echocardiography in coronary artery disease using contrast-based myocardial blood flow measurements: prospective comparison with coronary angiography JF - Heart JO - Heart SP - 377 LP - 384 DO - 10.1136/hrt.2007.134577 VL - 95 IS - 5 AU - R Vogel AU - A Indermühle AU - P Meier AU - C Seiler Y1 - 2009/03/01 UR - http://heart.bmj.com/content/95/5/377.abstract N2 - Aim: To test whether quantitative stress echocardiography using contrast-based myocardial blood flow (MBF, ml.min−1.g−1) measurements can detect coronary artery disease in humans. Methods: 48 patients eligible for pharmacological stress testing by myocardial contrast echocardiography (MCE) and willing to undergo subsequent coronary angiography were prospectively enrolled in the study. Baseline and adenosine-induced (140 μg.kg−1.min−1) hyperaemic MBF was analysed according to a three-coronary-artery-territory model. Vascular territories were categorised into three groups with increasing stenosis severity defined as percentage diameter reduction by quantitative coronary angiography. Results: Myocardial blood flow reserve (MBFR)—that is, the ratio of hyperaemic to baseline MBF, was obtained in 128 (89%) territories. Mean (SD) baseline MBF was 1.073 (0.395) ml.min−1.g−1 and did not differ between territories supplied by coronary arteries with mild (<50% stenosis), moderate (50%–74% stenosis) or severe (⩾75% stenosis) disease. Mean (SD) hyperaemic MBF and MBFR were 2.509 (1.078) ml.min−1.g−1 and 2.54 (1.03), respectively, and decreased linearly (r2 = 0.21 and r2 = 0.39) with stenosis severity. ROC analysis revealed that a territorial MBFR <1.94 detected ⩾50% stenosis with 89% sensitivity and 92% specificity. Conclusion: Quantitative stress testing based on MBF measurements derived from contrast echocardiography is a new method for the non-invasive and reliable assessment of coronary artery disease in humans. ER -