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Side effects and potential toxicity of myocardial contrast echocardiography

  • Chapter
Myocardial Contrast Two-dimensional Echocardiography

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 99))

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Abstract

The use of contrast agents during echocardiography was first reported in 1968 by Gramiak & Shah at the University of Rochester [1]. Numerous studies since have shown the efficacy and safety of contrast echocardiography. Roelandt & Meltzer [2–4] have reported hundreds of peripheral and intracardiac contrast injections without serious adverse effects. The committee on contrast echocardiography for the American Society of Echocardiography found only 32 cases of possible (always transient) toxicity out of 13,946 examinations surveyed [5]. There has been one case report of a stroke caused by intravenous contrast [6]. This very low risk gives intravenous contrast echocardiography a very favorable risk-benefit ratio.

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References

  1. Gramiak R, Shah PM (1968): Echocardiography of the aortic root. Invest Radiol 3: 356–366.

    Article  PubMed  CAS  Google Scholar 

  2. Roelandt J, Meltzer RS (1982): Contrast echocardiography review paper. Ultrasound in Med & Biol 8: 471–491.

    Article  CAS  Google Scholar 

  3. Roelandt J, Meltzer RS (1983): Contrast echocardiography in clinical practice (pp 183–216) in Kurjak A (ed): Progress in Medical Ultrasound, Vol 3. Amsterdam-Oxford-Princeton: Excerpta Medica.

    Google Scholar 

  4. Meltzer RS, Roelandt J (1983): Contrast echocardiography (pp 111–127) in Roelandt J (ed): The Practice of M-Mode and Two-Dimensional Echocardiography. The Hague-Boston-Lancaster: Martinus Nijhoff Publishers (DICM 23).

    Google Scholar 

  5. Bommer WJ, Shah PM, Allen H, Meltzer RS, Kisslo J (1984): The safety of contrast echocardiography: Report of the committee on contrast echocardiography for the American Society of Echocardiography. J Am Coll Cardiol 3: 6–13.

    Article  PubMed  CAS  Google Scholar 

  6. Lee F, Ginzton L (1983): A central nervous system complication of contrast echocardiography. J Clin Ultrasound 11: 292–294.

    Article  PubMed  CAS  Google Scholar 

  7. Klicpera M, Glogar D, Mayr H, Mohl W, Losent U, Kaimde F (1982): Myocardial perfusion evaluated by contrast echocardiography: A preliminary report. Chest 82: 751 [–756.

    Article  CAS  Google Scholar 

  8. Kemper AJ, O’Boyle JE, Sharma S, Cohen CA, Kloner RA, Khuri SF, Parisi AF (1983): Hydrogen peroxide contrast-enhanced two-dimensional echocardiography: Real-time in vivo delineation of regional myocardial perfusion. Circulation 68: 603–611.

    Article  PubMed  CAS  Google Scholar 

  9. Kemper AJ, O’Boyle BS, Cohen CA, Taylor A, Parisi AF (1984): Hydrogen peroxide contrast echocardiography: Quantification in vivo of myocardial risk area during coronary occlusion and of the necrotic area remaining after myocardial reperfusion. Circulation 70: 309–317.

    Article  PubMed  CAS  Google Scholar 

  10. Wang X, Wang J, Chen H, Lu C (1979): Contrast echocardiography with hydrogen peroxide, II: Clinical application. Chin Med J 92:693.

    PubMed  CAS  Google Scholar 

  11. Meltzer RS, Vermeulen HW, Valk N, Verdouw P, Lancee CT, Roelandt J (1982): New echocardiographic contrast agents: Transmission through the lungs and myocardial perfusion imaging. J Cardiovasc Ultrasonography 1: 277–282.

    Google Scholar 

  12. Armstrong WF, Mueller TM, Kinney EL, Tickner EG, Dillon JC, Feigenbaum H (1982): Assessment of myocardial perfusion abnormalities with contrast-enhanced two-dimensional echocardiography. Circulation 66:166–173.

    Article  PubMed  CAS  Google Scholar 

  13. Feinstein SB, Ten Cate KJ, Zwehl W, Ong K, Maurer G, Tei C, Shah PM, Meerbaum S, Corday E (1984): Two-dimensional contrast echocardiography, I: In vitro development and quantitative analysis of echo contrast agents. J Am Coll Cardiol 3:14–20.

    Article  PubMed  CAS  Google Scholar 

  14. Koenig K, Meltzer RS (1986): Effect of viscosity on the size of microbubbles generated for use as echocardiographic agents. J Cardiovasc Ultrasonograph 5: 3–6.

    Google Scholar 

  15. Hajduczki I, Rajogopalan RE, Meerbaum S, Drury JK, Corday E (1987): Effects of intra-coronary administered echo-contrast agents on epicardial coronary flow, ECG, and global and regional hemodynamics. J Cardiovasc Ultrasonograph 6:85–93.

    Google Scholar 

  16. Lang RM, Borow KM, Neumann A, Feinstein SB (1987): Echocardiographic contrast agents: Effect of microbubbles and carrier solutions on left ventricular contractility. J Am Coll Cardiol 9:910–919.

    Article  PubMed  CAS  Google Scholar 

  17. Kondo S, Tei C, Meerbaum S, Corday E, Shah P (1984): Hyperemic response of intracoro-nary contrast agents during two-dimensional echographic delineation of regional myocardium. J Am Coll Cardiol 4: 149–156.

    Article  PubMed  CAS  Google Scholar 

  18. Oppenheimer MJ, Ascanio G, Henny GC, Caldwell E, Vinciguerra T (1973): Metabolic and cardiovascular effects of selective intracoronary injections of contrast media. Invest Radiol 8: 13–21.

    Article  PubMed  CAS  Google Scholar 

  19. Wisenski JA, Gentz EW, Neese R, Soo WJ, Bristow JD, Adams JR, Beaudry JP (1982): Myocardial metabolic alterations after contrast angiography. Am J Cardiol 50:239–245.

    Article  Google Scholar 

  20. Gerber KH, Higgins CB, Yuh YS, Koziol JA (1982): Regional myocardial hemodynamic and metabolic effects of ionic and nonionic contrast media in normal and ischemic states. Circulation 65:1307–1314.

    Article  PubMed  CAS  Google Scholar 

  21. Feinstein SB (1986): Myocardial perfusion imaging: Contrast echocardiography today and tomorrow. J Am Coll Cardiol 8: 251–253.

    Article  PubMed  CAS  Google Scholar 

  22. Keller MW, Feinstein SB, Watson DD (1987): Successful left ventricular opacification following peripheral venous injection of sonicated contrast agent: An experimental evaluation. Am Heart J 114: 570.

    Article  PubMed  CAS  Google Scholar 

  23. Santoso T, Roelandt J, Mansyoer H, Abdurahman N, Meltzer R, Hugenholtz PG (1985): Myocardial perfusion imaging in humans by contrast echocardiography using polygelin colloid solution. Am J Cardiol 6:612–620.

    Article  CAS  Google Scholar 

  24. Ernst A, Cikes I (1984): Polygelin colloid solution as a new echocardiographic agent. J Cardiovasc Ultrasonograph 1984; 2: 143–145.

    Google Scholar 

  25. Feinstein SB, Shah PM, Bing RJ, Meerbaum S, Corday E, Chang BL, Santillan G, Fuji-bayashi Y (1984): Microbubble dynamics visualized in the intact capillary circulation. J Am Coll Cardiol 4: 595–600.

    Article  PubMed  CAS  Google Scholar 

  26. Kort A, Kronzon I (1982): Microbubble formation: in vitro and in vivo observation. J Clin Ultrasound 10: 117–120.

    Article  PubMed  CAS  Google Scholar 

  27. Miller DL (1985): Microstreaming as a mechanism of all death in Elodea leaves exposed to ultrasound. Ultrasound in Med & Biol 11: 285–292.

    Article  CAS  Google Scholar 

  28. Child SZ, Carstensen EL (1982): Effects of ultrasound on Drosophilia, IV: Pulsed exposure of eggs. Ultrasound in Med & Biol 8:311–312.

    Article  CAS  Google Scholar 

  29. Flynn HG (1982): Generation of transient cavities in liquids by microsound pulses of ultrasound. J Acoust Soc Am 72:1926–1932.

    Article  Google Scholar 

  30. Carstensen EL, Flynn HG (1982): The potential for transient cavitation with microsecond pulses of ultrasound. Ultrasound in Med &Biol 8: 720–740.

    Article  Google Scholar 

  31. Carstensen EL (1985?): Acoustic cavitation and the safety of diagnostic ultrasound. Ultrasound in Med & Biol.

    Google Scholar 

  32. Gross DR, Miller DL, Williams AR (1985): A search for ultrasound cavitation within the canine cardiovascular system. Ultrasound in Med &Biol 11: 85–97.

    Article  CAS  Google Scholar 

  33. Meltzer RS, Gramiak R (1986): Safety issues related to ultrasonic energy exposure during echocardiographic examinations (editorial). Am J Cardiol 58:128–129.

    Google Scholar 

  34. Porder JB, Porder KN, Meltzer RS (1987): Ultrasound bioeffects. Echocardiography 4: 89–99.

    Article  Google Scholar 

  35. Ten Cate FJ, Drury JK, Meerbaum S, Noordsy J, Feinstein S, Shah PM, Corday E (1984): Myocardial contrast echocardiography: Experimental examination at different coronary flow levels. J Am Coll Cardiol 3:1219–1226.

    Article  PubMed  Google Scholar 

  36. Maurer G, Ong K, Haendchen R, Torres M, Tei C, Wood F, Meerbaum S, Shah PM, Corday E (1984): Myocardial contrast two-dimensional echocardiography: Comparison of contrast disappearance rates in normal and underperfused myocardium. Circulation 69: 418–429.

    Article  PubMed  CAS  Google Scholar 

  37. Gillam LD, Kaul S, Fallon JT, Levine RA, Hedley-Whyte ET, Guerrero JC, Weyman AE (1985): Functional and pathologic effects of multiple echocardiographic contrast injections on the myocardium, brain and kidney. J Am Coll Cardiol 6:687–694.

    Article  PubMed  CAS  Google Scholar 

  38. Levine RA, Gillam LD, Guerrero JC, Weyman AE (1985): Wall motion abnormalities after myocardial echo contrast injection are caused by microbubbles (abstract). J Am Coll Cardiol 5:474.

    Google Scholar 

  39. Holt G, Reeves W, Rieder M, Daley L, Murthy V, Christensen C (1985): Negative inotropic effects of intracoronary contrast agents (abstract). J Am Coll Cardiol 5:474.

    Google Scholar 

  40. Christensen CW, Reeves WC, Daley LC, Rieder MA, Holt GW (1986): Intracoronary echo-contrast agents: comparison of effects on myocardial function under conditions of normal and reduced coronary flow (abstract). Circulation 70 (suppl II): 11–474.

    Google Scholar 

  41. Tei C, Sakamaki T, Shah PM, Meerbaum S, Shimoura K, Kondo S, Corday E (1983): Myocardial contrast echocardiography: A reproducible technique of myocardial opacification for identifying regional perfusion deficits. Circulation 67: 585–593.

    Article  PubMed  CAS  Google Scholar 

  42. Xie F, Shapiro J, Meltzer R (1987): Toxicity of intracoronary microbubbles in contrast echo (abstract). Circulation 76 (suppl IV): IV–505.

    Google Scholar 

  43. Moore CA, Smucher MC, Kaul S (1986): Myocardial contrast echocardiography in humans, I: Safety-comparison with routine coronary anteriography J Am Coll Cardiol 8: 1066–1072.

    Article  PubMed  CAS  Google Scholar 

  44. Lang R, Rorow KM, Neuman A, Al-Sadir J, Feinstein S (1986): Effect of intracoronary injections of sonicated microbubbles on left ventricular contractility in humans (abstract). J Am Coll Cardiol 7: 189A.

    Google Scholar 

  45. Yasui K, Matsumoto M, Maeda T, Fukushima M, Hori M, Shimazu T, Inoue M, Abe H, Sato H, Maniamino T (1983): Estimation of intramyocardial blood flow distribution with contrast echocardiography (abstract). Circulation 66 (suppl II): 11–28.

    Google Scholar 

  46. Goldman ME, Mindich BP (1984): Intraoperative cardioplegic contrast echocardiography for assessing myocardial perfusion during open heart surgery. Am Coll Cardiol 6: 1029–1034.

    Article  Google Scholar 

  47. Lang RM, Feinstein SB, Feldman T, Neuman A, Chua KG, Borrow KM (1986): Contrast echocardiography for evaluation of myocardial perfusion: Effects of coronary angioplasty. J Am Coll Cardiol 8: 232–235.

    Article  PubMed  CAS  Google Scholar 

  48. Griffin B, Timmis AD, Sowton E (1987): Contrast perfusion echocardiography: Distribution and reproducibility of myocardial contrast enhancement in coronary artery disease. Am J Cardiol 60: 538–543.

    Article  PubMed  CAS  Google Scholar 

  49. Meerbaum S (1986): Promise and status of myocardial contrast-enhanced two-dimensional echocardiography: Delineation of ischemic risk zone and quantitation of myocardial perfusion defects. J Am Coll Cardiol 7: 395–396.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Shimon Reisner
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  2. Janine R. Shapiro
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  3. Richard S. Meltzer
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Editor information

Editors and Affiliations

  1. Woodland Hills, California, USA

    Samuel Meerbaum

  2. University of Rochester Medical Center, Rochester, New York, USA

    Richard S. Meltzer

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© 1989 Kluwer Academic Publishers, Dordrecht

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Reisner, S., Shapiro, J.R., Meltzer, R.S. (1989). Side effects and potential toxicity of myocardial contrast echocardiography. In: Meerbaum, S., Meltzer, R.S. (eds) Myocardial Contrast Two-dimensional Echocardiography. Developments in Cardiovascular Medicine, vol 99. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2346-1_5

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  • DOI: https://doi.org/10.1007/978-94-009-2346-1_5

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-7556-5

  • Online ISBN: 978-94-009-2346-1

  • eBook Packages: Springer Book Archive

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