1096 High-resolution grey scale or angio mode power modulation? Head to head comparisons of two modalities of real-time perfusion adenosine stress echocardiography with simultaneous SPECT

Eur J Echocardiography Abstracts Supplement, December 2006 purpose of this study was to evaluate the association between RADEC and cardiovascular risk in subjects with normal systolic wall motion during CSE. Methods: 68 patients (mean age 48+15 years; 34 females), with negative CSE [no systolic wall motion abnormality at rest or during/after peak stress; exercise in 31 (46%), dobutamine in 37 (54%)] were identified during the period October 2004 through August 2005. Analysis of presence, location, and number of RADEC was done for both rest and stress contrast images. Framingham cardiovascular risk was scored in 67/68 patients and patients were stratified into low ( 20%) groups. 22/68 (32%) patients underwent coronary angiography (significant stenosis was defined as >70% luminal diameter) within 3 months of the CSE). Framingham risks score and angiographic findings were evaluated (using Pearson Chi-square test) to determine potential association with RADEC. Results: RADEC were seen in 17/68 (25%) patients and occurred during stress in 6, during rest in 4, and in both rest and stress in 7. A statistically significant difference was detected between different Framingham score risk groups and the presence of RADEC [low risk 9/50 (18%), intermediate risk 4/10 (40%), and high risk 4/7 (57%), p=0.042]. 8 patients had coronary artery disease (CAD) on angiography, and of these 3 had RADEC. There was a trend to presence of RADEC and angiographic CAD (p=0.082). Conclusion: In-patients with negative CSE studies, the presence of RADEC was associated with increased risk for CAD. Careful observations during the diastolic portion of echocardiographic stress testing, when performed with contrast, may permit detection of myocardial ischemia earlier in the cascade, and improve sensitivity. Further evaluation in a large prospective trial design is needed for additional insight into this unique observation.