Mariusz Kitlinski

Parametric quantification of myocardial ischaemia using real-time perfusion adenosine stress echocardiography images, with SPECT as reference method

Background:  Real‐time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique, provides images for off‐line parametric perfusion quantification using Qontrast® software. From replenishment curves, this generates parametric images of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ) at rest and stress. This may be a tool for objective myocardial ischaemia evaluation. We assessed myocardial ischaemia by RTP‐ASE Qontrast®‐generated images, using 99mTc‐tetrofosmin single‐photon emission computed tomography (SPECT) as reference.

Pattern recognition methods in evaluation of the structure of the laboratory data biominerals, antioxidant enzymes, selected biochemical parameters, and pulmonary function of welders

A wide set of biochemical and spirometrical parameters was applied to a group of 41 welders. The obtained parameters were analyzed by the pattern recognition method: principal-components analysis (PCA) and mutual contribution analysis (MCA). The aim of the investigation was to find out which of 23 parameters had an influence on the pulmonological indices of COPD. It was found that PCA gave a substantial reduction of dimensionality. The most relevant parameters were Fe, Zn, Cu (all elements in blood, not in hair), FEV1, MEF50, bilirubin, TAS, and SOD. Only the relationships of MEF50, Cu, and TAS were statistically valid.

Real-time perfusion adenosine stress echocardiography versus myocardial perfusion adenosine scintigraphy for the detection of myocardial ischaemia in patients with stable coronary artery disease.

Background:  Real‐time perfusion (RTP) contrast echocardiography using low mechanical index power modulation technique allows for simultaneous myocardial perfusion and wall motion analysis. RTP‐adenosine stress echocardiography (ASE) could be an alternative to dobutamine‐atropine stress echocardiography; more tolerable for the patients and possibly similarly accurate. We aimed to evaluate RTP‐ASE for the detection of myocardial ischaemia, compared to 99mTc‐sestamibi single‐photon emission computed tomography (SPECT).

Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT

AimsReal-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM), provides images for off-line perfusion quantification using Qontrast® software, generating values of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ). By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r) are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast® quantification, compared to visual perfusion evaluation with 99mTc-tetrofosmin single-photon emission computed tomography (SPECT).Methods and ResultsPatients admitted to SPECT underwent RTP-ASE (SONOS 5500) using AM during Sonovue® infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast® quantification, were blindly compared to one another and to SPECT, at different time points off-line.We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories) in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P < 0.001 and < 0.01, respectively. The closest agreements were seen in the LAD territory: kappa 0.442 for both β-r and Axβ-r; P < 0.01. Visual evaluation of ischaemia showed good agreement with SPECT: accuracy 93%; kappa 0.67; P < 0.001; without non-interpretable territories.ConclusionIn this agreement study with SPECT, RTP-ASE Qontrast® quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful.