Improvement of endocardial border delineation in suboptimal stress-echocardiograms using the new left heart contrast agent SH U 508 A.
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 > or = 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.
Klinikum Steglitz, University Berlin, Dept. of Cardiology, Germany.
K
K
Schröder
R
R
Agrawal
H
H
Völler
R
R
Schlief
R
R
Schröder
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004176:Dipyridamole; D004280:Dobutamine; D004452:Echocardiography; D004699:Endocardium / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011134:Polysaccharides
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D004280:Dobutamine; D004176:Dipyridamole