Safety of contrast flash-replenishment stress echocardiography in 500 patients with a chest pain episode of undetermined origin within the last 5 days.
OBJECTIVE
Safety concerns regarding the use of echo-contrast agents during baseline and SE in patients with recent chest pain have been raised. The purpose of the present study was to provide evidence regarding the safety of flash-replenishment contrast dipyridamole-atropine echocardiography (DASE) in such patients.


RESULTS
Five hundred consecutive individuals who presented to the Emergency Department with chest pain, normal electrocardiograms (ECG) and troponin I were selected based on a less than 5 days interval between chest pain episode and performance of contrast flash-replenishment DASE. Analysis of myocardial perfusion with SonoVue infusion after dipyridamole was routinely added on top of standard wall motion assessment during DASE. Adverse events (AEs) were reported according to standardized terminology and then compared with a historical control group in which contrast was not used. No deaths, myocardial infarctions, sustained arrhythmias, or any other life-threatening events were observed. Adverse events were not significantly different between the study group and the control group. In the selected subgroup of patients (n = 149) who underwent coronary angiography, accuracy of DASE with additional perfusion assessment was higher (88%, 95% C.I. 83-93%) than without (72%, 95% C.I. 65-79%).


CONCLUSIONS
DASE with SonoVue infusion for myocardial perfusion assessment was exceptionally safe even when routinely performed within the first 5 days following a chest pain episode of undetermined origin in subjects without ECG and troponin abnormalities.
Gaibazzi
Nicola
N
Heart Centre, Parma University Hospital, Parma, Italy. nicola.gaibazzi@inwind.it
Squeri
Angelo
A
Ardissino
Diego
D
Reverberi
Claudio
C
D000368:Aged; D002637:Chest Pain / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage / Q000009:adverse effects*; D012449:Safety; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000008:administration & dosage / Q000009:adverse effects*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride