Adenosine-echocardiography for the detection of coronary artery disease.

: The use of adenosine-echocardiography to detect coronary artery disease was evaluated in 39 patients. Adenosine was infused intravenously at 0.14 mg/kg/min for 6 minutes with continuous recordings of two-dimensional echocardiography. Three minutes after the start of adenosine infusion, thallium (201Tl) was administered into a separate vein. Myocardial single photon emission computed tomography (SPECT) images were obtained 10 minutes and 3 hours after the 201Tl injection. Transient reduction of systolic wall motion after adenosine infusion was considered an abnormal ischemic response. Echocardiography detected a wall motion abnormality after adenosine infusion in 17 of 39 patients. 201Tl redistribution was observed in 28 patients. Agreements for the presence of myocardial ischemia or infarction between 201Tl SPECT and echocardiography were 62% (24/39). The sensitivity of echocardiography in patients with single-vessel disease was 21%, but 76% with multi-vessel disease (p < 0.01 vs single-vessel disease). All side effects were tolerated well and disappeared within 1 or 2 minutes after stopping adenosine infusion. Adenosine-echocardiography was particularly useful for the detection of multiple-vessel coronary disease. Simultaneous evaluation of wall motion and myocardial perfusion during adenosine-induced maximal coronary vasodilation may improve the functional description of diseased myocardial segments.