Abstract
Recent studies have shown that the saccharide based echocardiographic contrast agent SH U 508 A opacifies the left ventricle after i.v. injection, thus possibly improving endocardial border definition. This study was performed to determine whether SH U 508 A can enhance the wall motion analysis in suboptimal echocardiographic images at rest and following pharmacological stress. Ten male patients (mean 58 years) exhibiting ≥30% endocardial border dropout were examined prior to a diagnostic left heart catheterization. Five patients were stressed with Dobutamine, 5 with Dipyridamole. The wall motion was assessed visually (qualitatively) as well as computer-aided (quantitatively). The concordance between left ventricular angiography as ‘gold standard’ and resting echocardiography regarding the wall motion analysis was significantly improved from 64.5% to 90.3% following the injection of SH U 508 A (p < 0.05). A delineation score (0 = not delineated, 1 = delineated) of 12 individual wall segments was used. The mean delineation score at baseline was 6.1 ±1.4 at rest and 6.6 ±1.9 during stress. SH U 508 A significantly (p < 0.01) increased the score to 9.6 ±1.9 and 10.3 ±1.7, respectively. The intraobserver variability for assessing the delineation score was significantly (p < 0.04) improved by SH U 508 A. SH U 508 A, however, did not improve the quantitative assessment of the left ventricular function. Only 40% of the patients could be analyzed following SH U 508 A injection. No severe adverse reactions were seen. SH U 508 A led to a significant, clinically important, improvement in the interpretation of stress echocardiograms in patients with inconclusive routine echocardiograms.
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The data was presented in part at the 41st Annual Scientific Sessions of the American College of Cardiology, Dallas, April 1992 as well as during the 58. Jahrestagung der Deutschen Gesellschaft für Herz- und Kreislaufforschung, Mannheim, April 1992, and the 1st International Symposium on Stress Echo, Pisa, January 1993. Klaus Schröder was supported by a grant from the Deutsche Forschungsgemeinschaft (Bonn, Germany).
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Schröder, K., Agrawal, R., Völler, H. et al. Improvement of endocardial border delineation in suboptimal stressechocardiograms using the new left heart contrast agent SH U 508 A. Int J Cardiac Imag 10, 45–51 (1994). https://doi.org/10.1007/BF01151580
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DOI: https://doi.org/10.1007/BF01151580