Second harmonic imaging improves sensitivity of dobutamine stress echocardiography for the diagnosis of coronary artery disease

Objective Our purpose was to assess the valve of second harmonic imaging co mpared with fundamental imaging for the diagnosis of coronary artery diseas e during dobutamine stress echocardiography. Patients and Methods Sixty-four patients underwent dobutamine stress echoca rdiography with both fundamental imaging and second harmonic imaging. Coron ary angiography was performed within 3 months. Ischemia was defined as new or worsening wall motion abnormalities in greater than or equal to1 segment during dobutamine stress echocardiography. Coronary artery disease was def ined as a greater than or equal to 70% luminal diameter stenosis in 21 coro nary artery by coronary angiography. Results There was a higher prevalence of segments with invisible border wit h fundamental compared with second harmonic imaging both ai 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 dobutam ine stress echocardiography for detection of coronary artery disease by fun damental and second harmonic imaging was, respectively, 78% acid 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 d obutamine stress echocardiography for the diagnosis of coronary artery dise ase compared with fundamental imaging, particularly For 1-vessel coronary a rtery disease, whereas specificity remains unchanged.