Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress

M. Ishii, W. Himeno, M. Sawa, M. Iemura, J. Furui, H. Muta, Y. Sugahara, K. Egami, Teiji Akagi, M. Ishibashi, H. Kato

Research output: Contribution to journalArticle

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Abstract

The aim of our study was to assess the ability of myocardial contrast echocardiography (MCE) with harmonic power Doppler imaging (HPDI) to identify perfusion abnormalities in patients with Kawasaki disease at rest and during pharmacological stress imaging with dipyridamole. Results were compared with those of 99mTc-tetro-fosmin single-photon emission computed tomography (SPECT) imaging as the clinical reference standard. MCE with HPDI was performed on 20 patients with a history of Kawasaki disease. Images were obtained at baseline and during dipyridamole infusion (0.56 mg kg-1) in the apical two- and four-chamber views. Myocardial opacification suitable for the analysis was obtained in all patients. Nine patients with stenotic lesions had a reversible defect after dipyridamole infusion detected by both MCE with HPDI and SPECT, and 3 patients with a history of myocardial infarction had a partially or completely irreversible defect detected by both methods. Three patients with coronary aneurysm without stenotic lesion, 4 patients with regressed coronary aneurysm, and 2 patients with normal coronary artery in acute phase also had normal perfusion at rest and after pharmacological stress by both methods. A 96% concordance (κ = 0.87) was obtained when comparing the respective segmental perfusion scores using the two methods at baseline, and an 86% concordance (κ = 0.81) was obtained at postdipyridamole infusion. After combining baseline and postdipyridamole images, each segment was labeled as having normal perfusion, irreversible defects, or reversible defects. Using these classifications, concordance for the two methods was 92% (κ = 0.87). MCE with HPDI is a safe and feasible method by which to detect asymptomatic ischemia due to severe stenotic lesion, and it may be an important addition to the modalities used to identify patients at risk for myocardial infarction as a complication of Kawasaki disease.

Original languageEnglish
Pages (from-to)192-199
Number of pages8
JournalPediatric Cardiology
Volume23
Issue number2
DOIs
Publication statusPublished - Mar 2002
Externally publishedYes

Fingerprint

Mucocutaneous Lymph Node Syndrome
Dipyridamole
Echocardiography
Perfusion
Coronary Aneurysm
Single-Photon Emission-Computed Tomography
Myocardial Infarction
Pharmacology
Coronary Vessels
Ischemia

Keywords

  • Harmonic power Doppler imaging
  • Ischemic heart disease
  • Kawasaki disease
  • Myocardial contrast echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress. / Ishii, M.; Himeno, W.; Sawa, M.; Iemura, M.; Furui, J.; Muta, H.; Sugahara, Y.; Egami, K.; Akagi, Teiji; Ishibashi, M.; Kato, H.

In: Pediatric Cardiology, Vol. 23, No. 2, 03.2002, p. 192-199.

Research output: Contribution to journalArticle

Ishii, M. ; Himeno, W. ; Sawa, M. ; Iemura, M. ; Furui, J. ; Muta, H. ; Sugahara, Y. ; Egami, K. ; Akagi, Teiji ; Ishibashi, M. ; Kato, H. / Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress. In: Pediatric Cardiology. 2002 ; Vol. 23, No. 2. pp. 192-199.
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abstract = "The aim of our study was to assess the ability of myocardial contrast echocardiography (MCE) with harmonic power Doppler imaging (HPDI) to identify perfusion abnormalities in patients with Kawasaki disease at rest and during pharmacological stress imaging with dipyridamole. Results were compared with those of 99mTc-tetro-fosmin single-photon emission computed tomography (SPECT) imaging as the clinical reference standard. MCE with HPDI was performed on 20 patients with a history of Kawasaki disease. Images were obtained at baseline and during dipyridamole infusion (0.56 mg kg-1) in the apical two- and four-chamber views. Myocardial opacification suitable for the analysis was obtained in all patients. Nine patients with stenotic lesions had a reversible defect after dipyridamole infusion detected by both MCE with HPDI and SPECT, and 3 patients with a history of myocardial infarction had a partially or completely irreversible defect detected by both methods. Three patients with coronary aneurysm without stenotic lesion, 4 patients with regressed coronary aneurysm, and 2 patients with normal coronary artery in acute phase also had normal perfusion at rest and after pharmacological stress by both methods. A 96{\%} concordance (κ = 0.87) was obtained when comparing the respective segmental perfusion scores using the two methods at baseline, and an 86{\%} concordance (κ = 0.81) was obtained at postdipyridamole infusion. After combining baseline and postdipyridamole images, each segment was labeled as having normal perfusion, irreversible defects, or reversible defects. Using these classifications, concordance for the two methods was 92{\%} (κ = 0.87). MCE with HPDI is a safe and feasible method by which to detect asymptomatic ischemia due to severe stenotic lesion, and it may be an important addition to the modalities used to identify patients at risk for myocardial infarction as a complication of Kawasaki disease.",
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AU - Furui, J.

AU - Muta, H.

AU - Sugahara, Y.

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