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Hydrogen peroxide contrast echocardiography.

F A Gaffney, J C Lin, R M Peshock

    The American Journal of Cardiology
    |September 1, 1983
    PubMed
    Summary

    Dilute hydrogen peroxide (H2O2) offers a safe, reliable, and inexpensive method for echocardiographic contrast. This simple technique reliably produces dense opacification in cardiac patients, with no observed complications.

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    Area of Science:

    • Cardiology
    • Medical Imaging
    • Biochemistry

    Background:

    • Current echocardiographic contrast agents often lack reliability, limiting routine clinical application.
    • Historical studies from the 1960s indicate that dilute hydrogen peroxide (H2O2) is a safe intravascular agent.

    Purpose of the Study:

    • To evaluate the efficacy and safety of hydrogen peroxide (H2O2) as an echocardiographic contrast agent.
    • To determine if H2O2 can reliably produce dense opacification for contrast echocardiography.

    Main Methods:

    • A sterile 0.2 micron Millipore filtered 3% H2O2 solution was diluted with heparinized saline to achieve 0.1-0.2% concentration.
    • Blood was withdrawn, mixed with 0.5-2.0 ml of dilute H2O2 in a syringe, and injected intravenously.
    • Evaluations were conducted in dogs, healthy adults, and 36 patients with cardiac disorders.

    Main Results:

    • Intravenous injection of 0.1-0.2% H2O2 reliably produced dense and sustained opacification during echocardiography.
    • No complications were observed in any of the study subjects (dogs, adults, patients).
    • In vitro studies suggested leukocyte peroxidase plays a role in H2O2-induced microbubble formation.

    Conclusions:

    • Hydrogen peroxide contrast echocardiography is a simple, inexpensive, and effective method for achieving dense opacification.
    • Intravenous administration of 0.2% H2O2 appears safe for contrast echocardiography.
    • Caution is advised in patients with severe pulmonary hypertension or large right-to-left shunts due to limited clinical data.

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