title: Release of cardiac bio-markers during high mechanical index contrast-enhanced echocardiography in humans.
abstract: BACKGROUND
  Recent experimental data have shown that the combined exposure of rodent hearts to high acoustic pressure and ultrasound contrast agents can induce vascular injury and cell damage. The aim of the present work was to test whether similar effects can be observed in humans.
  
  
  RESULTS
  Twenty patients underwent simultaneous arterial and coronary sinus blood sampling during contrast-enhanced echocardiography using Perfluorocarbon-enhanced Sonicated Dextrose Albumin. Control subjects were compared to groups of patients exposed to either high mechanical index (MI = 1.5) triggered second harmonic (1.3-2.6 MHz) imaging or low mechanical index (MI = 0.2) real-time power modulation imaging for 15 min. No significant changes arterio-venous differences in lactate, total creatine kinase (CK) and myoglobin occurred over time in the three groups. Similarly, the arterio-venous difference in CK-MB and troponin I remained stable over time in control and low-MI patients. By contrast, these two parameters progressively increased over time in the high-MI group (P < 0.05 vs. baseline and vs. controls).
  
  
  CONCLUSIONS
  Our data suggest that high-MI contrast-enhanced echocardiography can cause subclinical release of cardiac bio-markers in humans, while low-MI real-time imaging appears to be safer.
authors.affiliation: Division of Cardiology, Université Catholique de Louvain, School of Medicine, Brussels, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Vancraeynest
authors.forename: Joelle
authors.initials: J
authors.lastname: Kefer
authors.forename: Claude
authors.initials: C
authors.lastname: Hanet
authors.forename: Catherine
authors.initials: C
authors.lastname: Fillee
authors.forename: Christophe
authors.initials: C
authors.lastname: Beauloye
authors.forename: Agnes
authors.initials: A
authors.lastname: Pasquet
authors.forename: Bernhard L
authors.initials: BL
authors.lastname: Gerber
authors.forename: Marianne
authors.initials: M
authors.lastname: Philippe
authors.forename: Jean-Louis J
authors.initials: JL
authors.lastname: Vanoverschelde
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins; D000818:Animals; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D004452:Echocardiography / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005466:Fluorocarbons / Q000009:adverse effects*; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D010100:Oxygen / Q000097:blood; D019210:Troponin I / Q000097:blood
chemical_list: D000418:Albumins; D015415:Biomarkers; D003287:Contrast Media; D005466:Fluorocarbons; D009211:Myoglobin; D019210:Troponin I; D019344:Lactic Acid; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D010100:Oxygen; C108042:perfluorobutane