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.

Additional Metadata
Persistent URL dx.doi.org/10.1067/mhj.2001.116075, hdl.handle.net/1765/54906
Journal American Heart Journal
Citation
Sozzi, F.B, Poldermans, D, Bax, J.J, Boersma, H, Vletter, W.B, Elhendy, A, … Roelandt, J.R.T.C. (2001). Second harmonic imaging improves sensitivity of dobutamine stress echocardiography for the diagnosis of coronary artery disease. American Heart Journal, 142(1), 153–159. doi:10.1067/mhj.2001.116075