title: Safety and feasibility of real time adenosine myocardial contrast echocardiography with emphasis on induction of arrhythmias: a study in healthy volunteers and patients with stable coronary artery disease.
abstract: BACKGROUND
  Some studies reported an increased incidence of premature ventricular complexes (PVCs) during triggered myocardial contrast echocardiography (MCE) using high-intensity ultrasound destruction. Whether PVCs are also induced by real time MCE using low emission power, is unknown. The aim of the study was to assess the occurrence of arrhythmias during real time adenosine MCE in healthy volunteers and patients with stable coronary artery disease (CAD).
  
  
  METHODS
  Fifty healthy volunteers and 26 patients with stable CAD underwent real time MCE using Sonovue and power pulse inversion (ATL 5000) at rest and during adenosine stress. The occurrence of premature atrial complexes (PAC) and PVCs was analyzed before and during MCE using ECG-tracings from videotapes.
  
  
  RESULTS
  In healthy subjects, the occurrence of PVCs at baseline (0.04 +/- 0.23 PVCs/min) was similar at rest (0.04 +/- 0.23 PVCs/min, P = NS), and adenosine stress (0.03 +/- 0.14, P = NS). In CAD patients, the occurrence of PVCs at baseline was 0.30 +/- 0.76 PVC/min, compared to 0.29 +/- 0.74 at rest (P = NS), and 0.34 +/- 0.74 during adenosine stress (P = NS). The number of subjects demonstrating PVCs did not increase during MCE. The occurrence of PACs during MCE was not increased compared to baseline.
  
  
  CONCLUSIONS
  Real time MCE using low emission power does not increase the occurrence of premature complexes in healthy volunteers or CAD patients.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. pa.dijkmans@vumc.nl
authors.forename: P A
authors.initials: PA
authors.lastname: Dijkmans
authors.forename: L J M
authors.initials: LJ
authors.lastname: Juffermans
authors.forename: J
authors.initials: J
authors.lastname: van Dijk
authors.forename: R J P
authors.initials: RJ
authors.lastname: Musters
authors.lastname: Spreeuwenberg
authors.forename: O
authors.initials: O
authors.lastname: Kamp
mesh_terms: D000241:Adenosine; D000328:Adult; D003199:Computer Systems; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000009:adverse effects*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014665:Vasodilator Agents; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; D014665:Vasodilator Agents; C420843:contrast agent BR1; D000241:Adenosine; D013459:Sulfur Hexafluoride