[Usefulness of left ventricular opacification with intravenous contrast echocardiography in patients with asymptomatic negative T waves on electrocardiography].
OBJECTIVE
Patients with electrocardiography (ECG) abnormalities sometimes present without obvious symptoms or abnormal physical findings. In some cases, echocardiography fails to reveal abnormalities compatible with the ECG findings because of poor echocardiographic image quality. New intravenous contrast agents now enable opacification of the left ventricular cavity in the clinical setting. The usefulness of left ventricular opacification (LVO) by ultrasonic contrast agent was examined in asymptomatic patients with negative T waves on ECG.


METHODS
Thirty-four consecutive patients (23 males, 11 females, mean age 68 +/- 10 years) with negative T waves without symptoms or abnormal physical findings underwent routine transthoracic echocardiography and LVO by intravenous injection of Levovist using harmonic imaging.


RESULTS
Without LVO, abnormal echocardiographic findings compatible with the negative T waves were identified in 22 (65%) of the 34 patients. With LVO, the endocardial border of the left ventricle was observed in all patients and findings compatible with negative T waves were detected in 32 (94%) of the 34 patients, which was significantly higher than that without LVO (chi 2 = 9.79, p = 0.0055). Furthermore, LVO revealed additional findings in nine patients such as mural thrombus or apical thinning. In total, LVO revealed abnormal apical findings in 22 patients (65%), which was significantly higher than that without LVO (chi 2 = 10.0, p = 0.0013).


CONCLUSIONS
LVO is useful for identifying abnormal findings, especially in the apex in asymptomatic patients with negative T waves on ECG.
Zhu
Hong
H
Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka.
Muro
Takashi
T
Hozumi
Takeshi
T
Watanabe
Hiroyuki
H
Abo
Koji
K
Nakao
Mitsuru
M
Yoshikawa
Junichi
J
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011134:Polysaccharides
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508