Left ventricular opacification for the diagnosis of coronary artery disease with stress echocardiography: An angiographic study of incremental benefit and cost-effectiveness

Abstract

Background: Left ventricular opacification (LVO) improves image quality at stress echocardiography (SE). We examined whether routine use of LVO adds incremental benefit and is cost-effective for diagnosis of coronary artery disease (CAD). Methods: Contrast pharmacologic and/or exercise SE was performed in 135 patients (81 men; 56 ± 10 years) undergoing coronary angiography. Observers sequentially interpreted first standard, then LVO images; a positive SE was defined by resting or inducible wall motion abnormality in ≥2 segments. Coronary artery disease (75 patients, 119 territories) was defined as >50% stenosis. Three cost-effectiveness models were studied, and a sensitivity analysis was per..