Contrast agents provide a faster learning curve in dipyridamole stress echocardiography.
OBJECTIVE
Interobserver variability is an important limitation of the stress echocardiography and depends on the echocardiographer training. Our aim was to evaluate if the use of contrast agents during dipyridamole stress echocardiography would improve the agreement between an experienced and a non-experienced observer in stress echo and therefore if contrast would affect the learning period of dypyridamole stress echo.


RESULTS
Two independent observers without knowledge of any patient data interpreted all stress studies. One observer was an experienced one and the other had experience in echocardiography but not in stress echo. Two observers analysed 87 non-selected and consecutive studies. Out of the 87 studies, 46 were performed without contrast administration, whereas i.v. contrast (2.5 g Levovist by two bolus at rest and at peak stress) was administered in 41. In all cases, second harmonic imaging and stress digitalisation pack was used. The agreement between observers showed a kappa index of 0.58 and 0.83 without and with contrast administration, respectively.


CONCLUSIONS
The use of contrast agents provides a better agreement in the evaluation of stress echo between an experienced and a non-experienced observer in stress echo. Adding routinely contrast agents could probably reduce the number of exams required for the necessary learning curve in stress echocardiography.
Zamorano
Jose
J
Department of Cardiology, Clinico San Carlos Hospital, Hospital Doce de Octubre, Madrid, Spain. jlzamorano@jet.es
Sánchez
Violeta
V
Moreno
Raúl
R
Almería
Carlos
C
Rodrigo
Jose
J
Serra
Viviana
V
Azcona
Luis
L
Aubele
Adalia
A
Mataix
Luis
L
Sánchez-Harguindey
Luis
L
D002983:Clinical Competence; D003287:Contrast Media; D004176:Dipyridamole; D004452:Echocardiography; D005080:Exercise Test; D006801:Humans; D015588:Observer Variation; D011134:Polysaccharides; D014665:Vasodilator Agents
D003287:Contrast Media; D011134:Polysaccharides; D014665:Vasodilator Agents; C059891:SHU 508; D004176:Dipyridamole