title: Can contrast dobutamine stress echocardiography be performed with standardized imaging settings for everybody?
abstract: OBJECTIVE
  The objective was to assess a standardized imaging and contrast injection protocol for contrast-enhanced dobutamine stress echocardiography (DSE).
  
  
  METHODS
  A total of 102 patients underwent DSE with tissue harmonic imaging and a standardized protocol with contrast power modulation. Contrast intensities in the left ventricular cavity and the myocardium were evaluated by a visual score and quantitative analysis.
  
  
  RESULTS
  Of the contrast studies, 98% were diagnostic without modification of the settings. Excellent endocardial border definition was found in 93% of the segments with contrast versus 53% with tissue harmonic imaging (P < .05). The interobserver agreement in assessing segmental wall motion improved from 71.5% to 85.9%. There were no differences between the myocardial segments' video intensity in the four- and three-chamber views. In the two-chamber view video intensity was lower in the basal segments compared with the other segments.
  
  
  CONCLUSIONS
  Power modulation contrast imaging can be applied with a completely standardized protocol for DSE in the majority of patients with excellent endocardial border definition.
authors.affiliation: Department of Cardiology, The John Radcliffe Hospital, Headington, Oxford, United Kingdom.
authors.forename: Hélène
authors.initials: H
authors.lastname: Thibault
authors.forename: Jonathan
authors.initials: J
authors.lastname: Timperley
authors.forename: Alexander
authors.initials: A
authors.lastname: Ehlgen
authors.forename: Antoine
authors.initials: A
authors.lastname: Pariente
authors.forename: Dana
authors.initials: D
authors.lastname: Dawson
authors.forename: Harald
authors.initials: H
authors.lastname: Becher
mesh_terms: D000418:Albumins / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods / Q000592:standards*; D005080:Exercise Test / Q000379:methods / Q000592:standards*; D005466:Fluorocarbons / Q000008:administration & dosage; D005602:France; D006801:Humans; D007089:Image Enhancement / Q000379:methods / Q000592:standards*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods / Q000592:standards*; D010743:Phospholipids / Q000008:administration & dosage; D010818:Practice Patterns, Physicians' / Q000592:standards; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D006113:United Kingdom; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons; D010743:Phospholipids; C420843:contrast agent BR1; D004280:Dobutamine; D013459:Sulfur Hexafluoride