Effect of intravenous contrast for left ventricular opacification and border definition on sensitivity and specificity of dobutamine stress echocardiography compared with coronary angiography in technically difficult patients

The value of contrast dobutamine stress echocardiography in detecting coronary artery disease in overweight and obese patients

“…The present (16) reported that in 274 patients with known or suspected CAD who had undergone both contrast-enhanced DSE and coronary angiography, the sensitivity, specificity and accuracy of detecting left anterior descending coronary artery disease were 78%, 89% and 86%, respectively. Dolan et al (17) studied 229 patients prospectively, 112 of whom had good at-rest echocardiography results with no contrast, and 117 had poor at-rest echocardiography results with Optison injection during DSE. The percentages of endocardial border visualization, wall thickening, sensitivity and specificity were compared between both groups.…”

Clinical usefulness of SonoVue contrast echocardiography: the Thoraxcentre experience

“…As seen in figure 3, echo contrast improves endocardial border detection and therefore makes LV wall motion analysis 8 and LV ejection fraction assessment 9,10 more reliable. This improvement is reflected by an increase in intra-and inter-observer agreement of LV ejection fraction and volumes.…”

“…8,20,21 The limited use of contrast in stress echocardiography in our centre is mainly due to the confidence of the observer during the described time period in its interpretation quality and to a lesser extent SonoVue costs. Because 3D real-time stress echocardiography suffers from a significant decrease in image quality compared with conventional 2D imaging we are convinced that contrast may play an even more important role in this new stress modality.…”

Contrast echocardiography in Canada: Canadian Cardiovascular Society/Canadian Society of Echocardiography position paper

“…Some investigators have provided indirect evidence suggesting superior stress echocardiography performance in the detection of CAD with contrast. For example, LVO, during dobutamine stress echocardiography in patients with suboptimal acoustic windows, has shown sensitivity and specificity similar to noncontrast examinations in subjects with adequate images (34). In the largest trial of stress echocardiography with contrast (6), 300 consecutive outpatients underwent dobutamine testing using both noncontrast harmonic imaging and LVO.…”

“…Stress echocardiography in conjunction with LVO has been studied mostly with dobutamine testing (6,26,(34)(35)(36)(37). In several trials, contrast use consistently improved endocardial depiction and confidence of interpretation during stress echocardiography.…”