Can contrast dobutamine stress echocardiography be performed with standardized imaging settings for everybody?

The objective was to assess a standardized imaging and contrast injection protocol for contrast-enhanced dobutamine stress echocardiography (DSE).

A total of 102 patients underwent DSE with tissue harmonic imaging and a standardized protocol with contrast power modulation. Contrast intensities in the left ventricular cavity and the myocardium were evaluated by a visual score and quantitative analysis.

Of the contrast studies, 98% were diagnostic without modification of the settings. Excellent endocardial border definition was found in 93% of the segments with contrast versus 53% with tissue harmonic imaging (P < .05). The interobserver agreement in assessing segmental wall motion improved from 71.5% to 85.9%. There were no differences between the myocardial segments' video intensity in the four- and three-chamber views. In the two-chamber view video intensity was lower in the basal segments compared with the other segments.

Power modulation contrast imaging can be applied with a completely standardized protocol for DSE in the majority of patients with excellent endocardial border definition.