Enhanced Left Ventricular Endocardial Border Delineation with an Intravenous Injection of SonoVue, a New Echocardiography Contrast Agent:

Abstract

The safety and efficacy of SonoVue (also referred to as BR1), a new contrast agent for delineating endocardial border of the left ventricle after intravenous administration, was assessed. Two hundred and eighteen patients with suspected coronary artery disease undergoing fundamental echocardiography for the assessment of left ventricle were enrolled in a prospective multicenter, single blind, cross-over study with random sequence allocation of four different doses of SonoVue. Endocardial border definition in the apical and parasternal views was scored as 0 = not visible, 1 = barely visible, and 2 = well visualized before and after contrast enhancement. Analysis was performed by two pairs of off-site observers. Safety of SonoVue was also assessed. Results of our study indicated that the mean improvements in the endocardial border visualization score were as follows: 3.1 +/- 7.8 (95% CI, 2.5 and 3.7) for 0.5 ml, 3.4 +/- 8.0 (95% CI, 2.8 and 4.0) for 1 ml, 3.4 +/- 7.9 (95% CI, 2.8 and 4.0) for 2 ml, and 3.7 +/- 8.0 (95% CI, 3.1 and 4.3) for 4 ml (P < 0.05 for all doses from baseline). Changes from baseline in endocardial visualization scores were also seen in the apical views (P < 0.05) and they were dose-dependent (P < 0.001). Similar enhancements of endocardial visualization scores were observed in the apical views in patients with suboptimal baseline echocardiographic images. Diagnostic confidence for assigning a score and image quality also were significantly better following contrast enhancement. No significant changes in the laboratory parameters and vital signs were noted following contrast enhancement, and the side effects were minimal. It was concluded that SonoVue is safe and effective in delineating endocardial border, including in patients with suboptimal baseline images.

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

“…Secondary generation transpulmonary contrast agents increase backscatter in an ultrasound field and opacify the left ventricular cavity. Some studies demonstrated an improvement of endocardial border delineation at rest and during stress testing after the administration of a transpulmonary contrast agent (11)(12)(13)(14). In the present study, at-rest echochardiography graded 536 of 992 (54%) myocardial segments as a score of 2 and peak DSE graded only 434 of 992 (44%) segments as a score of 2 before the intravenous bolus of SonoVue or Optison because of an invisible or barely visible left ventricular endocardial border.…”

“…The value of contrast dobutamine stress echocardiography in detecting coronary artery disease in overweight and obese patients. Can J Cardiol 2007;23 (11):885-889.…”

Assessment of left ventricular ejection fraction after myocardial infarction using contrast echocardiography

“…However, echocardiographic images are sometimes of poor quality and in a recent review article high intra-and inter-observer variabilities were reported for echocardiographic LVEF assessment. 5 Left ventricular opacification (LVO) with echo contrast has been shown to improve image quality and in particular endocardial border delineation 8,9 and this may improve intraand inter-observer variability. Therefore, we conducted a post-AMI trial in which LV-EF was assessed with secondharmonic imaging (SHI) and LVO.…”

Microbubbles: Basic Principles

“…Sono Vue® can provide ventricular opacification and improve endocardial border definition [ 45] and Doppler signal. Moreover its utility was shown in myocardial perfusion studies [ 46,47].…”