Does Cardiac Function Modify Left Heart Opacification with Transpulmonary Echo Contrast Agents?

Abstract

Dependence of left heart opacification on ventricular function was evaluated for the new transpulmonary echo enhancing agent (SH U 508-A). The contrast agent was injected intravenously in 5 patients with normal cardiac function (ejection fraction [EF] greater than 60% and echocardiographic left ventricular end-diastolic diameter [LVED] less than 56 mm) and in five patients with pathological ventricular function (EF less than 40%, LVED greater than 65 mm). A concentration of 400 mg/mL with dosages of 5, 9, and 16 mL was used in all patients. The visually assessed signal enhancement as well as the videodensitometrically determined peak intensity and duration of signal enhancement did not differ significantly between the two patient groups, while the transit times were markedly prolonged in patients with impaired ventricular function. No significant alteration was found for systemic blood pressure and heart rate. Side effects were transitory and dose related. The noninvasive nature of the procedure and the absence of hemodynamic effects make repeated studies of left ventricular performance with SH U 508-A in patients with varied hemodynamic status possible.

Clinical utility of the transpulmonary echo enhancing agent Levovist to improve diagnostic confidence in echocardiography

“…This was first demonstrated in humans in 1990, 12 and it has been established that echo enhancement produced by Levovist is not dependent on ventricular function. 14 There are natural limitations on the potential for improvement in the signal-to-noise ratio that is possible in B-mode imaging. Excessive noise in a B-mode scan is related mainly to problems such as obesity or emphysema, which ''muffle'' the entire image by returning echoes over a large area.…”

“…16 Adverse effects like these are not encountered following echo enhancement with Levovist, with the result that repeated bedside investigations of heart function become practicable. 14…”