Copyright © 2007, The European Society of Cardiology
The clinical applications of contrast echocardiography
aOxford University, John Radcliffe Hospital, Oxford, OX3 9DU, UK
bKing's College Hospital, London, UK
cNational Heart and Lung Institute, Hammersmith Hospital, London, W12 0HS, UK
dDepartment of Cardiology, Northwick Park Hospital, Harrow, HA1 3UJ, UK
* Corresponding author. Cardiac Investigation Annexe, John Radcliffe Hospital, Oxford, OX3 9DU, UK. Tel.: +44 1865 220 325; fax: +44 1865 740 409. harald.becher@orh.nhs.uk
Keywords: Contrast echocardiography; LV opacification; Stress echocardiography; LV ejection fraction; LV systolic function
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| 1 Available contrast agents and imaging techniques |
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At present three contrast agents are licensed for left ventricular (LV) opacification and endocardial definition: SonoVue (Bracco, Italy), Luminity (BMS, USA) and Optison (GE, USA). The latter is currently not available. All these agents provide intensive opacification of the left heart chambers when administered intravenously. All agents are suspensions of microspheres filled with a perfluorocarbon gas and have a similar size as red blood cells. The dosages of contrast needed for LV opacification are minimal (0.1–0.3ml) compared to those in other imaging modalities, such as X-ray for instance. These small dosages are possible because of very sensitive contrast specific imaging technologies, which have been implemented in all state of the art ultrasound systems.1
Harmonic imaging has been developed primarily as a contrast specific imaging modality that can be used with a lower transmit power (mechanical index <0.6) than used for non-contrast imaging (mechanical index >1.0). Harmonic imaging has become the standard
| 2 Is there enough evidence for using contrast agents? |
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| 3 Contrast echo only in patients with suboptimal windows? |
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| 4 Clinical practice of contrast echocardiography |
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4.1 Assessment of LV function to guide further treatment in heart failure: implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT)
4.2 Follow up of patients with moderate valvular disease and decision for surgical treatment
4.3 Selection and monitoring of patients undergoing chemotherapy with cardiotoxic drugs
4.4 Assessment of LV function in patients in intensive care and coronary care units
4.5 Left ventricular masses and thrombi
4.6 Left ventricular non-compaction/apical hypertrophy
4.7 Right ventricular dysplasia, right ventricular thrombus
4.8 Stress echocardiography and regional wall motion assessment
| 5 Future echocardiography will still need cavity opacification |
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| Uncited reference |
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Related articles in Eur J Echocardiogr:
- Corrigendum to "The clinical applications of contrast echocardiography" [Eur J Echocardiogr 2007;8:S13–S23]
- Robert Olszewski, Jonathan Timperley, Cezary Szmigielski, Mark Monaghan, Petros Nihoyannopoulos, Roxy Senior, and Harald Becher
Eur J Echocardiogr 2007 8: 308.[Extract] [FREE Full Text]