title: Sonovue improves endocardial border detection and variability in assessing wall motion score and ejection fraction during stress echocardiography.
abstract: BACKGROUND
  Stress echocardiography is useful for assessing patients with coronary artery disease unable to undergo formal exercise testing. Considerable skill is required to avoid large intra- and inter-observer variability due to poor endocardial definition. Intravenous ultrasound contrast agents are now available which may improve this variability.
  
  
  OBJECTIVE
  To study intravenous Sonovue in assessing wall motion score and ejection fraction (EF) during stress echocardiography.
  
  
  METHODS
  Thirty-eight patients undergoing arbutamine stress echocardiography for known or suspected coronary artery disease were studied. Echocardiographic analysis of wall motion score index, endocardial border detection (EBD) and EF was performed at rest and at peak stress before and after intravenous injection of Sonovue, by experienced and inexperienced observers.
  
  
  RESULTS
  All three observers noted an improvement in endocardial border definition following Sonovue (p=<0.001). At baseline, there was a significant difference in wall motion score index between experienced and inexperienced observers at rest (p=0.01) and at peak stress (p=0.001). Following Sonovue administration this was no longer significant (p=0.07, p=0.114). Intra-observer variability of end diastolic, end systolic volumes (ESV) and EF improved following contrast (p<0.05) at rest and during stress.
  
  
  CONCLUSIONS
  Sonovue significantly improved EBD and reduced intra-observer variability of EF at rest and during peak arbutamine infusion.
authors.affiliation: Department of Cardiology, Beaumont Hospital, Dublin, Ireland. angiebrown29@hotmail.com
authors.forename: A S
authors.initials: AS
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Calachanis
authors.forename: C
authors.initials: C
authors.lastname: Evdoridis
authors.forename: J
authors.initials: J
authors.lastname: Hancock
authors.forename: S
authors.initials: S
authors.lastname: Wild
authors.forename: A
authors.initials: A
authors.lastname: Prasan
authors.forename: P
authors.initials: P
authors.lastname: Nihoyannopoulos
authors.forename: M J
authors.initials: MJ
authors.lastname: Monaghan
mesh_terms: D025401:Echocardiography, Stress / Q000379:methods*; D004699:Endocardium / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D009200:Myocardial Contraction; D010743:Phospholipids / Q000008:administration & dosage; D013318:Stroke Volume; D013459:Sulfur Hexafluoride / Q000008:administration & dosage
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
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