Abstract
A new consensus statement on the clinical applications of ultrasound contrast agents was published in November 2008 in the Journal of the American Society of Echocardiography. These guidelines provide the rationale for contrast use, and specifically highlight a number of clinical scenarios in which contrast should always be considered. These include the 1) assessment of left ventricular (LV) systolic function—especially when quantitative LV volumes and ejection fraction, or serial assessments are required, and during stress echocardiography; 2) evaluation of the LV apex; 3) evaluation of mechanical complications of myocardial infarction; 4) evaluation of suspected intracardiac mass; and 5) to enhance Doppler signals in the systemic circulation. Furthermore, detailed outlines on contrast administration, logistics, personnel requirements, and responsibilities are provided. Recent data published in the past 2 years to support these recommendations, and contrast agent safety data, are reviewed in this article.
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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
•• Mulvagh SL, Rakowski H, Vannan MA, et al.: American Society of Echocardiography consensus statement on the clinical applications of ultrasonic contrast agents in echocardiography. J Am Soc Echocardiogr 2008, 21:1179–1201. This consensus statement provides the most current recommendations on contrast utilization during echocardiography.
Mulvagh SL, DeMaria AN, Feinstein SB, et al.: Contrast echocardiography: current and future applications. J Am Soc Echocardiogr 2000, 13:331–342.
Kurt M, Shaikh KA, Peterson L, et al.: Impact of contrast echocardiography on evaluation of ventricular function and clinical management in a large prospective cohort. J Am Coll Cardiol 2009, 53:802–810.
Cosyns B, Haberman D, Droogmans S, et al.: Comparison of contrast enhanced three dimensional echocardiography with MIBI gated SPECT for the evaluation of left ventricular function. Cardiovasc Ultrasound 2009, 7:27–36.
Mansencal N, Nasr IA, Pilliere R, et al.: Usefulness of contrast echocardiography for assessment of left ventricular thrombus after acute myocardial infarction. Am J Cardiol 2007, 99:1667–1670.
Nemes A, Geleijnse ML, Krenning BJ, et al.: Usefulness of ultrasound contrast agent to improve image quality during real-time three-dimensional stress echocardiography. Am J Cardiol 2007, 99:275–278.
Wyrick JJ, Kalvaitis S, McConnell J, et al.: Cost-efficiency of myocardial contrast echocardiography in patients presenting to the emergency department with chest pain of suspected cardiac origin and a nondiagnostic electrocardiogram. Am J Cardiol 2008, 102:649–652.
• Wei K, Mulvagh SL, Carson L, 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, 11:1202–1206. This study is one of the largest retrospective analyses evaluating the safety of ultrasound contrast agents.
Kusnetzky LL, Khalid A, Khumri TM, et al.: Acute mortality in hospitalized patients undergoing echocardiography with and without ultrasound contrast agent. Results in 18,671 consecutive studies. J Am Coll Cardiol 2008, 51:1704–1706.
Main ML, Ryan AC, Davis TE, et al.: Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent (multicenter registry results in 4,300,966 consecutive patients). Am J Cardiol 2008, 102:1742–1746.
European Medicines Agency: European public assessment report (EPAR) SonoVue. 2007. Available at http://www.emea.europa.eu/humandocs/PDFs/EPAR/sonovue/005301en1.pdf. Accessed February 2010.
US Food and Drug Administration: FDA Alert: Information for healthcare professionals. Micro-bubble contrast agents (marketed as Definity (perflutren lipid microsphere) injectable suspension and Optison (perflutren protein-type a microspheres for injection. 2008. Available at http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm125574.htm. Assessed February 2010.
Disclosure
Dr. Kevin Wei has received research funding from Lantheus Medical Imaging and GE Healthcare.
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Wei, K. Contrast Echocardiography: What Have We Learned From the New Guidelines?. Curr Cardiol Rep 12, 237–242 (2010). https://doi.org/10.1007/s11886-010-0105-x
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DOI: https://doi.org/10.1007/s11886-010-0105-x