Release of cardiac bio-markers during high mechanical index contrast-enhanced echocardiography in humans.
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.
Vancraeynest
David
D
Division of Cardiology, Université Catholique de Louvain, School of Medicine, Brussels, Belgium.
Kefer
Joelle
J
Hanet
Claude
C
Fillee
Catherine
C
Beauloye
Christophe
C
Pasquet
Agnes
A
Gerber
Bernhard L
BL
Philippe
Marianne
M
Vanoverschelde
Jean-Louis J
JL
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
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