© 2004 by European Society of Cardiology
Copyright © 2004, The European Society of Cardiology
Inter- and intra-study reproducibility of contrast echocardiography for assessment of interventricular septal wall perfusion rate in humans*
Department of Clinical and Experimental Medicine, Federico II University Hospital, School of Medicine, Naples, Italy
Received 24 November 2003; received in revised form 26 January 2004; accepted after revision 29 January 2004.
* Corresponding author. Universita' degli Studi di Napoli "Federico II", Medicina Interna, Via Pansini 5, Edificio 1/A, stanza 421, 80131 Napoli, Italy. Tel.: +39-081-746-4323; fax: +39-081-546-6152. vpalmier{at}med.cornell.edu
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Abstract |
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Aims: To assess inter- and intra-study reproducibility of myocardial contrast echocardiography (MCE) imaging for quantitative measurement of myocardial perfusion rate in humans in ambulatory setting.
Methods and results: In 20 subjects, we performed 2 MCE tests 20–40 min apart on the same day under the same standardized protocol, and evaluated single-reader between-study and between-reading reproducibility of assessment of indicators of myocardial perfusion rate, such as the slope of video-intensity change k, and the factors A (peak video-intensity) and B (background video-intensity after bubble destruction) and the product kxA. The region of interest was placed at the mid-posterior interventricular septal wall visualized in apical 4-chamber view. In a sub-analysis, we evaluated indicators of myocardial perfusion rate comparing subjects with normal vs. those with subnormal ejection fraction (EF). Inter-study reproducibility of assessment of k was relatively low (intraclass correlation coefficient = 0.36), whereas intra-study reproducibility was fair (intraclass correlation coefficient = 0.61). The parameters kxA and B showed higher reproducibility than the k (inter- and intra-study intraclass correlation coefficients 0.64 and 0.75, 0.74 and 0.91, respectively). For reference, reproducibility data of the depth of the region of interest, of EF and CO were excellent. k and kxA were lower in subjects with low vs. those with normal EF. Only k and kxA were lower in subjects with subnormal than in those with normal EF.
Conclusions: The MCE-derived indicator of myocardial perfusion rate kxA showed fairly good between-study and between-reading reproducibility.
Keywords: Echocardiography; Reproducibility; Contrast
Supported in part: Ph.D. program "XVI ciclo", educational grant 2002 and General Electric Educational Grant, recipient Dr. Aldo Celentano.
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