Efficacy and adverse effects of transpulmonary contrast echocardiography using sonicated albumin

We studied the feasibility and adverse effects of transpulmonary contrast echocardiography using sonicated albumin in 6 dogs. Left heart contrast was observed by two-dimensional echocardiography, monitoring left ventricular pressure, its first derivative (dP/dt) and arterial oxygen saturation. The left heart was adequately opacified in 48 of 55 injections of various intravenous doses of sonicated albumin. Left ventricular myocardial opacification was faintly observed in only 1 injection. After injections of a large dose (0.5 ml/kg), left ventricular systolic pressure decreased, maximal positive dP/dt decreased and negative dP/dt increased, slightly. Hemodynamic parameters showed no significant changes with the other doses. Arterial oxygen saturation tended to decrease after injection, which was most remarkable with a large dose injection. In conclusion, although a large dose of intravenous sonicated albumin may opacify not only the left heart cavity but the ventricular myocardium, it deteriorates hemodynamic parameters and oxygen exchange in the lung.