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Contrast Echocardiography

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Abstract

Contrast echocardiography is an enhanced ultrasound imaging technique utilizing a contrast agent to increase blood echogenicity in cardiac chambers or myocardial microvessels. This technique can improve image quality and provide interpretable recordings in cases with suboptimal acoustic window like ventilated or obese patients. Contrast enhancement can be used during transthoracic, transesophageal and stress echocardiography.

Clinical applications for contrast echocardiography are classified into four main categories: Left ventricular opacification, Detection of intracardiac shunt, Doppler signal enhancement and assessment of myocardial perfusion.

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Abbreviations

CAD:

Coronary artery disease

EBD:

Endocardial border delineation

EF:

Ejection fraction

IV:

Intravenous

LV:

Left ventricle

LVO:

Left ventricular opacification

MBF:

Myocardial blood flow

MCE:

Myocardial contrast echocardiography

PFO:

Patent foramen ovale

TEE:

Transesophageal echocardiography

UCA:

Ultrasound contrast agent

References

  1. Porter TR, Abdelmoneim S, Belcik JT, McCulloch ML, Mulvagh SL, Olson JJ, et al. Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American society of echocardiography. J Am Soc Echocardiogr. 2014;:797–810.

    Article  Google Scholar 

  2. Mulvagh SL, Rakowski H, Vannan MA, Abdelmoneim SS, Becher H, Bierig M, et al. ASE consensus statement on the clinical applications of ultrasonic contrast agents in echocardiography. J Am Soc Echocardiogr. 2008;21:1179–201.

    Article  Google Scholar 

  3. Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P. Contrast echocardiography: evidence-based recommendations by European Association of Echocardiography. Eur J Echocardiogr. 2009;10:194–212.

    Article  Google Scholar 

  4. Olszewski R, Timperley J, Szmigielski C, Monaghan M, Nihoyannopoulos P, Senior R, et al. The clinical applications of contrast echocardiography. Eur J Echocardiogr. 2007;8:S13–23.

    Article  Google Scholar 

  5. Thanigaraj S, Schechtman KB, Perez JE. Improved echocardiographic delineation of left ventricular thrombus with the use of intravenous second-generation contrast image enhancement. J Am Soc Echocardiogr. 1999;12(12):1022–6.

    Article  CAS  Google Scholar 

  6. Soman P, Swinburn J, Callister M, Stephens NG, Senior R. Apical hypertrophic cardiomyopathy: bedside diagnosis by intravenous contrast echocardiography. J Am Soc Echocardiogr. 2001;14(4):311–3.

    Article  CAS  Google Scholar 

  7. Koo BK, Choi D, Ha JW, Kang SM, Chung N, Cho SY. Isolated noncompaction of the ventricular myocardium: contrast echocardiographic findings and review of the literature. Echocardiography. 2002;19(2):153–6.

    Article  Google Scholar 

  8. Moreno R, Zamorano JL, Almeria C, Rodrigo JL, Villate A, Serra V, et al. Usefulness of contrast agents in the diagnosis of left ventricular pseudoaneurysm after acute myocardial infarction. Eur J Echocardiogr. 2002;3(2):111–6.

    Article  CAS  Google Scholar 

  9. Soliman OII, Geleijnse ML, Meijboom FJ, Nemes A, Kamp O, Nihoyannopoulos P, et al. The use of contrast echocardiography for the detection of cardiac shunts. Eur J Echocardiogr. 2007;8:S2–12.

    Article  Google Scholar 

  10. Kaul S. Myocardial contrast echocardiography: a 25-year retrospective. Circulation. 2008;118(3):291–308.

    Article  Google Scholar 

  11. McCulloch M, Gresser C, Moos S, Odabashian J, Jasper S, Bednarz J, et al. Ultrasound contrast physics: a series on contrast echocardiography. J Am Soc Echocardiogr. 2000;13:959–67.

    Article  CAS  Google Scholar 

  12. Stewart MJ. Contrast echocardiography. Heart. 2003;89(3):342–8.

    Article  Google Scholar 

  13. GE Healthcare. OPTISON prescribing information. 2012.

    Google Scholar 

  14. Luminity Summary of Product Characteristics. 2011.

    Google Scholar 

  15. EMEA. Scientific discussion. SonoVue: European Public Assessment Report; 2016.

    Google Scholar 

  16. Main ML, Ryan AC, Davis TE, Albano MP, Kusnetzky LL, Hibberd M. Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent. Am J Cardiol. 2008;102(12):1742–6.

    Article  Google Scholar 

  17. Shaikh K, Chang SM, Peterson L, Rosendahl-Garcia K, Quinones MA, Nagueh SF, et al. Safety of contrast administration for endocardial enhancement during stress echocardiography compared with noncontrast stress. Am J Cardiol. 2008;102:1444–50.

    Article  Google Scholar 

  18. Wei K, Mulvagh SL, Carson L, Davidoff R, Gabriel R, Grimm RA, et al. The safety of Definity and Optison for ultrasound image enhancement: a retrospective analysis of 78,383 administered contrast doses. J Am Soc Echocardiogr. 2008;21(11):1202–6.

    Article  Google Scholar 

  19. Parker JM, Weller MW, Feinstein LM, Adams RJ, Main ML, et al. Safety of ultrasound contrast agents in patients with known or suspected cardiac shunts. Am J Cardiol. 2013;112:1039–45.

    Article  CAS  Google Scholar 

  20. Abdelmoneim SS, Bernier M, Scott CG, Dhoble A, Ness SAC, Hagen ME, et al. Safety of contrast agent use during stress echocardiography in patients with elevated right ventricular systolic pressure: a cohort study. Circ Cardiovasc Imaging. 2010;3(3):240–8.

    Article  Google Scholar 

  21. Wever-Pinzon O, Suma V, Ahuja A, Romero J, Sareen N, Henry SA, et al. Safety of echocardiographic contrast in hospitalized patients with pulmonary hypertension: a multi-center study. Eur Heart J Cardiovasc Imag. 2012;13:857–62.

    Article  Google Scholar 

  22. Dolan MS, Gala SS, Dodla S, Abdelmoneim SS, Xie F, Cloutier D, et al. Safety and efficacy of commercially available ultrasound contrast agents for rest and stress echocardiography a multicenter experience. J Am Coll Cardiol. 2009;53(1):32–8.

    Article  CAS  Google Scholar 

  23. Becher H, Burns PN. Assessment of left ventricular function by contrast echo. Handbook of contrast echocardiography. Berlin: Springer; 2000. p. 47–79.

    Google Scholar 

  24. Nakatani S, Imanishi T, Terasawa A, Beppu S, Nagata S, Miyatake K. Clinical application of transpulmonary contrast-enhanced Doppler technique in the assessment of severity of aortic stenosis. J Am Coll Cardiol. 1992;20(4):973–8.

    Article  CAS  Google Scholar 

  25. Nakatani S, Satoshi T. Contrast-enhanced Doppler in the assessment of aortic stenosis. In: Nanda NC, Schleif R, Goldberg BB, editors. Advances in echo imaging using contrast enhancement. Dordrecht: Springer; 1997. p. 253–61.

    Chapter  Google Scholar 

  26. Dubourg O, Delorme G, Jondeau G, Chikli F, Clavier H, Valtier B, et al. Simultaneous measurement of systolic pulmonary artery pressure by catheterization and contrast enhancement doppler echocardiography. Arch Mal Coeur Vaiss. 1993 Dec;86(12):1721–7.

    CAS  PubMed  Google Scholar 

  27. Kurt M, Shaikh KA, Peterson L, Kurrelmeyer KM, Shah G, Nagueh SF, et al. Impact of contrast echocardiography on evaluation of ventricular function and clinical management in a large prospective cohort. J Am Coll Cardiol. 2009;53(9):802–10.

    Article  Google Scholar 

  28. Thavendiranathan P, Grant AD, Negishi T, Plana JC, Popovic ZB, Marwick TH. Reproducibility of echocardiographic techniques for sequential assessment of left ventricular ejection fraction and volumes: application to patients undergoing cancer chemotherapy. J Am Coll Cardiol. 2013;61:77–84.

    Article  Google Scholar 

  29. Jung PH, Mueller M, Schuhmann C, Eickhoff M, Schneider P, Seemueller G, et al. Contrast enhanced transesophageal echocardiography in patients with atrial fibrillation referred to electrical cardioversion improves atrial thrombus detection and may reduce associated thromboembolic events. Cardiovasc Ultrasound. 2013;11:1–5.

    Article  Google Scholar 

  30. Plana JC, Mikati IA, Dokainish H, Lakkis N, Abukhalil J, Davis R, et al. A randomized cross-over study for evaluation of the effect of image optimization with contrast on the diagnostic accuracy of dobutamine echocardiography in coronary artery disease The OPTIMIZE Trial. JACC Cardiovasc Imaging. 2008;1(2):145–52.

    Article  Google Scholar 

  31. Gaibazzi N, Reverberi C, Lorenzoni V, Molinaro S, Porter TR. Prognostic value of high-dose dipyridamole stress myocardial contrast perfusion echocardiography. Circulation. 2012;126(10):1217–24.

    Article  CAS  Google Scholar 

  32. Lepper W, Shivalkar B, Rinkevich D, Belcik T, Wei K. Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2002;15(11):1419–22.

    Article  Google Scholar 

  33. Janardhanan R, Senior R. Accuracy of dipyridamole myocardial contrast echocardiography for the detection of residual stenosis of the infarct-related artery and multivessel disease early after acute myocardial infarction. J Am Coll Cardiol. 2004;43(12):2247–52.

    Article  Google Scholar 

  34. Arnold JR, Karamitsos TD, Pegg TJ, Francis JM, Olszewski R, Searle N, et al. Adenosine stress myocardial contrast echocardiography for the detection of coronary artery disease: a comparison with coronary angiography and cardiac magnetic resonance. JACC Cardiovasc Imaging. 2010;3(9):934–43.

    Article  Google Scholar 

  35. Zamorano JL, García-Fernández MA. Contrast echocardiography in clinical practice, vol 1. Mailand: Springer; 2004. p. 241.

    Book  Google Scholar 

  36. Shimoni S, Frangogiannis NG, Aggeli CJ, Shan K, Quinones MA, Espada R, et al. Microvascular structural correlates of myocardial contrast echocardiography in patients with coronary artery disease and left ventricular dysfunction: implications for the assessment of myocardial hibernation. Circulation. 2002;106(8):950–6.

    Article  Google Scholar 

  37. Janardhanan R, Moon JC, Pennell DJ, Senior R. Myocardial contrast echocardiography accurately reflects transmurality of myocardial necrosis and predicts contractile reserve after acute myocardial infarction. Am Heart J. 2005;149:355–62.

    Article  Google Scholar 

  38. Shimoni S, Frangogiannis NG, Aggeli CJ, Shan K, Verani MS, Quinones MA, et al. Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: comparison with dobutamine echocardiography and thallium-201 scintigraphy. Circulation. 2003;107:538–44.

    Article  Google Scholar 

  39. Wei K, Jayaweera AR, Firoozan S, Linka A, Skyba DM, Kaul S. Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. Circulation. 1998;97:473–83.

    Article  CAS  Google Scholar 

  40. Abdelmoneim SS, Basu A, Bernier M, Dhoble A, Abdel-Kader SS, Pellikka PA, et al. Detection of myocardial microvascular disease using contrast echocardiography during adenosine stress in type 2 diabetes mellitus: prospective comparison with single-photon emission computed tomography. Diab Vasc Dis Res. 2011;8(4):254–61.

    Article  Google Scholar 

  41. Madua EC, Potua C, Baugh D, Tulloch-Reid E. Myocardial contrast echocardiography in the evaluation of hypertensive heart disease. Cardiol Res. 2011;2(6):259–68.

    Google Scholar 

  42. Main ML, Goldman JH, Grayburn PA. Thinking outside the “Box”—the ultrasound contrast controversy. J Am Coll Cardiol. 2007;50(25):2434–7.

    Article  Google Scholar 

  43. Lindner JR. Microbubbles in medical imaging: current applications and future directions. Nat Rev Drug Discov. 2004;3(6):5–32.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Echocardiography Department, Razavi Hospital, Mashhad, Iran

    Farimah Aminian MD & Harald Becher

Authors
  1. Farimah Aminian MD
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  2. Harald Becher
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Editor information

Editors and Affiliations

  1. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Anita Sadeghpour

  2. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Azin Alizadehasl

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Aminian, F., Becher, H. (2018). Contrast Echocardiography. In: Sadeghpour, A., Alizadehasl, A. (eds) Case-Based Textbook of Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-67691-3_9

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  • DOI: https://doi.org/10.1007/978-3-319-67691-3_9

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