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Infusion versus bolus contrast echocardiography: a multicenter, open-label, crossover trial
N J Weissman1, M C Cohen, T C Hack
1Georgetown Medical Center, Washington DC, USA.
American Heart Journal
|February 26, 2000
Summary
Controlled contrast infusion in echocardiography significantly improves left ventricular opacification (LVO) duration and reduces attenuation compared to bolus injections. This method offers a more uniform and prolonged contrast effect for enhanced cardiac imaging.
Area of Science:
- Cardiovascular Imaging
- Medical Ultrasound
- Diagnostic Echocardiography
Background:
- Current contrast echocardiography uses bolus injections, leading to uncontrolled attenuation and transient left ventricular opacification (LVO).
- A slower contrast delivery method may improve uniformity, reduce attenuation, and prolong LVO duration.
Purpose of the Study:
- To test the hypothesis that controlled contrast infusion optimizes contrast echocardiography.
- To compare the effects of contrast infusion versus bolus injection on LVO and endocardial border visualization.
Main Methods:
- A randomized, multicenter, controlled, crossover trial involving 64 patients with poor baseline echocardiograms.
- Patients received either slow bolus injections or a continuous infusion of contrast (DEFINITY) and then crossed over to the alternative method.
- Independent echocardiographers assessed LVO duration, attenuation, and endocardial border evaluability.
Main Results:
- Both bolus and infusion methods significantly improved LVO and endocardial border visualization compared to baseline.
- Contrast infusion resulted in a significantly longer duration of adequate LVO (158–174 seconds longer) and a shorter duration of attenuation (18–54 seconds shorter) than bolus injections.
- No severe adverse events were reported with contrast infusion.
Conclusions:
- Contrast echocardiography delivered as an infusion optimizes the contrast effect.
- Infusion decreases attenuation and extends LVO duration, providing a uniform contrast effect.
- This optimized contrast delivery may enhance various echocardiographic applications, including stress testing and myocardial perfusion imaging.