title: The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging: results from an Australian multicentre cohort.
abstract: BACKGROUND
  Contrast enhanced echocardiography (CEE) is utilised when sub-optimal image quality results in non-diagnostic echocardiograms. However, there have been numerous safety notices issued by regulatory authorities regarding rare but potentially serious adverse reactions (AR). This multi-centre, retrospective analysis was performed to assess the short-term safety of CEE in a broad range of indications.
  
  
  METHODS
  All CEE performed over 58 months at three institutions were assessed for AR within 30 min.
  
  
  RESULTS
  A total of 5956 CEE were performed in 5576 patients. A total of 4903 were stress CEE and 1053 resting CCE. Bolus administration in 5719, infusion in 237 cases; 89.9% of CCE were outpatients. Commonest CEE indication was functional stress testing (82.3%). There were 16 AR related to CEE (0.27%). All AR were mild, transient and all patients made a full recovery. No cases of serious anaphylaxis or death within 30 min of contrast administration. Comparing those with and without an AR, there were no significant differences in age, gender, BMI, LVEF, patient location, exam type or RVSP. There was a slightly increased likelihood of an AR during infusion versus bolus dosing (p = 0.02).
  
  
  CONCLUSIONS
  CEE is a safe investigation in a broad range of indications and clinical scenarios. AR are very rare, mild and transient.
authors.affiliation: Echocardiography Department, The Prince Charles Hospital, Australia; School of Medicine, University of Queensland, Australia. Electronic address: david_platts@health.qld.gov.au.
authors.forename: David G
authors.initials: DG
authors.lastname: Platts
authors.forename: Sushil A
authors.initials: SA
authors.lastname: Luis
authors.forename: Damian
authors.initials: D
authors.lastname: Roper
authors.forename: Darryl
authors.initials: D
authors.lastname: Burstow
authors.forename: Tony
authors.initials: T
authors.lastname: Call
authors.forename: Anthony
authors.initials: A
authors.lastname: Forshaw
authors.forename: Roess
authors.initials: R
authors.lastname: Pascoe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D025401:Echocardiography, Stress / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren
keywords: Contrast echocardiography; Dobutamine stress echocardiography; Exercise stress echocardiography; Left ventricular opacification; Safety