Diagnostic Value of Three-Dimensional Contrast-Enhanced Echocardiography for Left Ventricular Volume and Ejection Fraction Measurement in Patients With Poor Acoustic Windows: A Comparison of Echocardiography and Magnetic Resonance Imaging

Saloux, Éric; Labombarda, Fabien; Pellissier, Arnaud; Anthune, Bruno; Dugué, Audrey Emmanuelle; Provost, Nicole; Allain, Philippe; Craene, Mathieu De; Milliez, Paul; Manrique, Alain

doi:10.1016/j.echo.2014.06.006

Cited by 29 publications

(22 citation statements)

References 28 publications

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“…The present study demonstrated good overall agreement in LV volumes and LVEF assessment between echocardiography and CMR with less underestimation in LV volumes by using LV contrast which is similar to the previous reports. Several recent studies have examined the potential for contrast‐enhanced 3D echocardiography . The first multicenter study comparing unenhanced and contrast‐enhanced 2D and 3D echocardiography with CMR demonstrated improved accuracy and reduced inter‐reader variability in the determination of LV volumes and LVEF by using contrast .…”

Section: Discussionmentioning

confidence: 99%

Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging

et al. 2018

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Aim Limited data exist on the impact of contrast‐enhanced echocardiography on treatment decisions in heart failure patients that require specific left ventricular ejection fraction (LVEF) criteria. This study assessed accuracy of contrast‐enhanced echocardiography in identifying patients with LVEF >35% vs ≤35% with cardiac magnetic resonance (CMR) used as reference method. Methods and results Fifty‐five patients from prospective Alberta HEART cohort with LVEF ≤50% on CMR were included. All patients had echocardiography performed within 2 weeks of CMR. Contrast agent was used when ≥2 contiguous LV endocardial segments were poorly visualized on echocardiography. LVEF was computed by Simpson's biplane method using non‐contrast echocardiography and contrast‐enhanced echocardiography and by outlining the endocardial contours in short‐axis cine CMR images. Strong agreement in LV volumes and LVEF was seen between CMR and echocardiography with and without contrast (intra‐class correlation coefficients >0.8) with less underestimation of LV volumes by contrast‐enhanced echocardiography. Good agreement in LVEF ≤35% vs >35% was seen between CMR and non‐contrast echocardiography with optimal images (κ 0.862) and contrast echocardiography (κ 0.769) while it was moderate for non‐contrast echocardiography with suboptimal images (κ 0.491). The use of LV contrast in patients with suboptimal images (n = 39) resulted in correctly upgrading LVEF from ≤35% to >35% in 5 (13%) patients and downgrading LVEF from >35% to ≤35% in 2 (5%) patients using CMR as reference. Conclusions Contrast‐enhanced echocardiography in heart failure patients with suboptimal images helps to more accurately assess eligibility for specific therapies and avoid need for further testing, therefore should be considered routine part of echocardiographic assessment.

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Section: Discussionmentioning

confidence: 99%

Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging

et al. 2018

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“…Moreover, several patients classified into Group LV-decreased had super-normal LVEF values before LT, which normalized after LT (from over 65% to around 55%). We realize that this observation may not be an actual LV functional deterioration, but instead a condition that reflects the “normalization of LV over-work,” a compensatory hyperkinetic LV under lung disease and the resolution of hyperkinetic state after LT. Further investigation with a larger cohort is required to find factors associated with “real” LV functional deterioration after LT. Further, cardiac magnetic resonance imaging or 3D echocardiography, which can provide more accurate volumetric measurements without geometric assumptions than 2D echocardiography, 30 was not utilized due to the retrospective nature of this study. Lastly, the prognosis and/or adverse outcome in patients with and without LVEF deterioration was not investigated.…”

Section: Discussionmentioning

confidence: 99%

Left and Right Ventricular Functional Dynamics Determined by Echocardiograms Before and After Lung Transplantation

Kato

Armstrong

Schulze

et al. 2015

The American Journal of Cardiology

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Impaired cardiac function is considered a contraindication for lung transplantation (LT). Since right ventricular (RV) function is expected to improve after LT, poor left ventricular (LV) function is often the determinant for LT eligibility. However, the changes in cardiac function before and after LT have not yet been elucidated. Therefore, we reviewed echocardiograms obtained from 67 recipients before and after LT. In a subset of 49 patients, both RV and LV longitudinal strains based on 2D speckle tracking echocardiography were analyzed. The cardiopulmonary exercise tests were also reviewed. All patients showed significant improvements in their exercise capacity after LT. RV-echo parameters improved in all patients following LT (RV fractional area change: 36.7±5.6 to 41.5±2.7%, RV strain: −15.5±2.9 to −18.0±2.1%, RV E/E’: 8.4±1.8 to 7.7±1.8; all p<0.05). Overall, the LV ejection fraction (LVEF) did not change (58.7±6.0 to 57.5±9.7%, p=0.385); however, 20 patients (30%) showed more than a 10% decrease in LVEF after LT (61.5±6.1 to 47.3±4.2%, p<0.001), and an increase in LV E/E’ (11.8±1.8 to 12.9±2.2, p=0.049). Multivariate logistic regression analysis revealed that pre-LT LV E/E’ was associated with decrease in LVEF after LT [odds ratio (OR) 1.381, 95%CI (confidential interval) 1.010–1.947, p=0.043]. Furthermore, patients with strain data showed lower pre-LT LV strain was independently associated with LVEF decrease after LT (OR 1.293, 95%CI 1.088–1.614, p=0.002). While RV function improves after LT, LV systolic and diastolic functions deteriorate in a sizable proportion of patients. Impaired LV diastolic function before transplant appears to increase the risk of LVEF deterioration after LT.

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“…Recent studies have shown that 3D contrast echocardiography provides the closest results to cardiac magnetic resonance in measuring left ventricular volumes. It further reduces variability and improves accuracy of left ventricle volume measurements when compared with 2D contrast echocardiography [12, 13]. …”

Section: Clinical Utility Of Contrast Echocardiographymentioning

confidence: 99%

Contrast echocardiography in daily clinical practice

Eskandari

Monaghan

2017

Herz

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Ultrasound contrast agents have unique acoustic properties that enable them to enhance the cardiac blood flow and thus are used broadly in modern echocardiography laboratories for salvage of nondiagnostic studies, improving accuracy and reducing variability even in the presence of adequate image quality. Contrast echocardiography is also used as an adjunctive technique when unenhanced echocardiography falls short in the differentiation of cardiac structural abnormalities such as cardiac masses. Ultrasound contrast agents are pure intravascular tracers. Development of innovative ultrasound imaging techniques has led to myocardial perfusion imaging with contrast echocardiography. Although currently an off-label indication, it has been shown that perfusion imaging with contrast echocardiography adds incremental value to stress echocardiography in the detection of coronary artery disease. Moreover, it can be used for assessment of myocardial viability. In this paper we briefly discuss the basics of contrast echocardiography and its use in daily clinical practice.

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Diagnostic Value of Three-Dimensional Contrast-Enhanced Echocardiography for Left Ventricular Volume and Ejection Fraction Measurement in Patients With Poor Acoustic Windows: A Comparison of Echocardiography and Magnetic Resonance Imaging

Cited by 29 publications

References 28 publications

Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging

Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging

Left and Right Ventricular Functional Dynamics Determined by Echocardiograms Before and After Lung Transplantation

Contrast echocardiography in daily clinical practice

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