title: Multicenter evaluation of SonoVue for improved endocardial border delineation.
abstract: OBJECTIVE
  Two multicenter studies were conducted to evaluate the safety and efficacy of SonoVue as a contrast agent for enhanced left ventricular endocardial border delineation (LVEBD), and to compare the efficacy of SonoVue and Albunex in adult patients with a suboptimal, nonenhanced echocardiogram.
  
  
  BACKGROUND
  The use of contrast to enhance echocardiographic assessment of LVEBD is well-established. SonoVue is a new microbubble contrast agent that contains sulfur hexafluoride.
  
  
  METHODS
  Patients were randomized to receive four injections of SonoVue (0.5, 1, 2, and 4 ml), or two injections of Albunex and two injections of hand-agitated saline (0.08 and 0.22 ml/kg). Echocardiographic images were evaluated at the study centers and by four blinded, offsite reviewers for degree of left ventricle opacification (LVO), duration of contrast enhancement, and LVEBD.
  
  
  RESULTS
  LVO scores were significantly higher for all doses of SonoVue. Patients with complete LVO ranged from 34%-87% for SonoVue and from 0%-16% for Albunex. The mean duration of useful contrast effect ranged from 0.8-4.1 minutes for SonoVue and < 15 seconds for Albunex. Mean increases in LVEBD scores ranged from 3.8-18.2 for SonoVue and 0.1-4.3 for Albunex. SonoVue (cumulative 7.5 ml dose) was well-tolerated, with a safety profile similar to that observed in the control group.
  
  
  CONCLUSIONS
  SonoVue is superior to Albunex for improving visualization of endocardial borders in patients with suboptimal noncontrast echocardiograms. Optimal increases in LVEBD, LVO, and duration of useful contrast effect were observed at the 2.0 ml dose of SonoVue.
authors.affiliation: University of Alabama at Birmingham, Heart Station SW-S102, 619 South 19th Street, Birmingham, AL 35249. nanda@uab.edu
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Wistran
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Karlsberg
authors.forename: Terrence C
authors.initials: TC
authors.lastname: Hack
authors.forename: William B
authors.initials: WB
authors.lastname: Smith
authors.forename: David A
authors.initials: DA
authors.lastname: Foley
authors.forename: Michael H
authors.initials: MH
authors.lastname: Picard
authors.forename: Bruno
authors.initials: B
authors.lastname: Cotter
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins; D000704:Analysis of Variance; D015150:Echocardiography, Doppler / Q000379:methods*; D004699:Endocardium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011336:Probability; D011856:Radiographic Image Enhancement / Q000379:methods*; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013459:Sulfur Hexafluoride; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
chemical_list: D000418:Albumins; C060687:Albunex; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride