Objective: Our purpose was to assess the value of second harmonic imaging compared with fundamental imaging for the diagnosis of coronary artery disease during dobutamine stress echocardiography. Patients and Methods: Sixty-four patients underwent dobutamine stress echocardiography with both fundamental imaging and second harmonic imaging. Coronary angiography was performed within 3 months. Ischemia was defined as new or worsening wall motion abnormalities in ≤1 segment during dobutamine stress echocardiography. Coronary artery disease was defined as a ≤70% luminal diameter stenosis in ≤1 coronary artery by coronary angiography. Results: There was a higher prevalence of segments with invisible border with fundamental compared with second harmonic imaging both at rest (11% vs 8%, P <.05) and at peak stress (17% vs 10%, P <.001). Significant coronary artery disease was present in 49 (77%) patients. The sensitivity of dobutamine stress echocardiography for detection of coronary artery disease by fundamental and second harmonic imaging was, respectively, 78% and 94% (P <.05), whereas specificity was similar (73% vs 73%). Second harmonic imaging had a particularly higher sensitivity for the diagnosis of 1-vessel disease (93% vs 50%, P <.05). Conclusion: The use of second harmonic imaging improves the sensitivity of dobutamine stress echocardiography for the diagnosis of coronary artery disease compared with fundamental imaging, particularly for 1-vessel coronary artery disease, whereas specificity remains unchanged.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine