title: Efficacy and safety of the novel ultrasound contrast agent perflutren (definity) in patients with suboptimal baseline left ventricular echocardiographic images.
abstract: Suboptimal left ventricular (LV) cavity visualization and endocardial border delineation often compromise the clinical utility of echocardiography. This study examines the safety and efficacy of perflutren, a novel ultrasound contrast agent, for LV cavity opacification and endocardial border delineation in patients with suboptimal baseline echocardiograms. In a multicenter, randomized, placebo-controlled, double-blind trial, 211 patients with suspected cardiac disease and suboptimal baseline echocardiograms were enrolled at 17 sites. Two intravenous injections of either placebo (saline) or perflutren (5 or 10 microl/kg) were given approximately 30 minutes apart. Images of the apical 4- and 2-chamber views were acquired and scored. Perflutren opacified the LV cavity after both dosages (5 and 10 microl/kg dosages). Clinically useful contrast was observed in 89% of patients who received perflutren and in 0% of patients who received placebo (p < 0.01). Quantitative assessment of LV opacification with videodensitometry showed similar results. The mean duration of clinically useful contrast was 90 seconds. Improvement in endocardial border delineation was demonstrated in 91% of patients who received perflutren and in 12% of those who received placebo (p < 0.001). Following perflutren, an average of 4 more segments per patient were evaluable compared with baseline. Salvage of nondiagnostic baseline examinations by perflutren was demonstrated in 48% of eligible subjects. The safety profile of perflutren was similar to placebo. These data indicate that administration of perflutren to patients with suboptimal baseline images is well tolerated and provides substantial LV cavity opacification and improvement in endocardial border delineation.
authors.affiliation: Section of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1045, USA. dkitzman@wfubmc.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Kitzman
authors.forename: M E
authors.initials: ME
authors.lastname: Goldman
authors.forename: L D
authors.initials: LD
authors.lastname: Gillam
authors.forename: J L
authors.initials: JL
authors.lastname: Cohen
authors.forename: G P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: J S
authors.initials: JS
authors.lastname: Gottdiener
mesh_terms: D003287:Contrast Media; D003720:Densitometry; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005466:Fluorocarbons; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012449:Safety; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D014741:Video Recording
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren