Release of cardiac bio-markers during high mechanical index contrast-enhanced echocardiography in humans

Vancraeynest, David; Kefer, Joëlle; C, Hanet; Fillée, Catherine; Beauloye, Christophe; Pasquet, Agnès; Gerber, Bernhard; Philippe, Marianne; Vanoverschelde, Jean-Louis

doi:10.1093/eurheartj/ehm051

Cited by 41 publications

(29 citation statements)

References 27 publications

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“…These values are comparable to those found in other studies (Chen et al 2002;Vancraeynest et al 2007). cTnI is a highly specific and sensitive marker for myocardial damage, because it is not expressed in skeletal muscle and is not present in the blood circulation of healthy animals (O'Brien et al 2006;O'Brien 2008).…”

Section: Discussionsupporting

confidence: 92%

“…However, it has been shown that the destruction of microbubbles with high-intensity ultrasound can cause bio-effects in small animals (Miller 2007) and induce mild troponin release and premature ventricular contractions in humans (van der Wouw et al 2000;Vancraeynest et al 2007). To some extent, these bio-effects may open opportunities for therapeutic applications (Hernot and Klibanov 2008).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of High-Intensity Ultrasound–Targeted Microbubble Destruction on Perfusion and Function of the Rat Heart Assessed by Pinhole-Gated SPECT

Hernot

Cosyns

Droogmans

et al. 2010

Ultrasound in Medicine & Biology

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Effect of High-Intensity Ultrasound–Targeted Microbubble Destruction on Perfusion and Function of the Rat Heart Assessed by Pinhole-Gated SPECT

Hernot

Cosyns

Droogmans

et al. 2010

Ultrasound in Medicine & Biology

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“…51, No. 12, 2008 Weyman March 25, 2008March 25, :1221 Year in Echocardiography stable patients with largely normal LV function but could not exclude the possibility that microscale myocyte damage might contribute to serious complications in hemodynamically unstable patients or those with ongoing myocardial infarction or ischemia (20). In interpreting these data it is important to note that the use of a 15-min continuous infusion, prolonged high MI imaging, and a single constant examining plane represent significantly more exposure than would occur in normal clinical practice.…”

Section: Mcementioning

confidence: 99%

The Year in Echocardiography

Weyman

2008

Journal of the American College of Cardiology

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During the past year, progress in echocardiographic research has again been incremental with reports describing both expanded and refined applications of tissue Doppler imaging (TDI), myocardial contrast echocardiography (MCE), stress echocardiography, and real-time 3-dimensional (RT3D) imaging. The primary focus this year has been on the use of TDI and speckle tracking (ST) to identify left ventricular (LV) systolic and/or diastolic dyssynchrony (DYS) and determine its prevalence and functional significance in specific patient subgroups (systolic heart failure [SHF], diastolic heart failure [DHF], a narrow QRS [N-QRS] interval, right ventricular [RV] pacing, and myocardial infarction). Additionally, the effects of cardiac resynchronization therapy (CRT) on atrial function, exerciseinduced mitral regurgitation (MR), and clinical and echocardiographic parameters of cardiac function in patients with both prolonged (P-QRS) and N-QRS intervals have been explored. In other areas, 2 excellent studies have examined: 1) the potential of contrast echocardiography using targeted microbubbles to detect remote ischemia based on 'ischemic memory'; and 2) the potential clinical toxicity of contrast echocardiography. Several large studies have examined the relationship of a negative stress echocardiogram and cardiovascular events during long-term followup, the association between patent foramen ovale (PFO) and stroke in a prospectively followed population, the relationship of aortic atheroma and long-term outcomes in a surgical population, and the significance of wall motion abnormalities in a population without evidence of cardiovascular disease. Studies in valvular heart disease have described the significance of low flow/low gradient severe aortic stenosis in patients with normal ejection fraction (EF), the shape of the proximal flow convergence region by RT3D echocardiography and its impact on the quantitation of MR, and the effects of ischemic MR on post-infarct remodeling. As always, it is impossible to review all of the studies published in the past year, and as a result this review attempts to focus on new observations, areas of particular focus, and confirmation of small group data in larger populations. LV DYSIn patients with DHF. A number of studies have validated the role of (TDI and ST in assessing mechanical systolic DYS in patients with congestive heart failure, prolonged QRS intervals and poor systolic LV function. Less is known about the presence of systolic and diastolic DYS in patients with DHF. Wang et al. (1) compared the prevalence and significance of systolic and diastolic DYS in patients with SHF (n ϭ 60), DHF (n ϭ 60), and control subjects (n ϭ 35). Systolic DYS was based on the maximal time difference between the shortest and longest interval from the onset of the QRS complex to both onset and peak of TDI systolic velocity for the 4 basal LV segments. Diastolic DYS was measured from the QRS to the onset of the early diastolic velocity in the same segments. In the DHF group, there were 20 patients (33%)...

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“…This "petechiae bioeffect" phenomenon has also raised concerns about the clinical safety of contrast ultrasound. [22][23][24][25] The creation of petechiae bioeffects is dependent on ultrasound power [18][19][20]22,24 and pulsing interval. 26 Modeling studies predict that increasing peak-negative acoustic pressure from 0.2 to 0.5 MPa increases the level of microvessel wall stress caused by MB expansion by 2 orders of magnitude, to a value above the critical threshold for vessel rupturing.…”

mentioning

confidence: 99%

Acoustic Attenuation by Contrast Agent Microbubbles in Superficial Tissue Markedly Diminishes Petechiae Bioeffects in Deep Tissue

Song

Klibanov²,

Hossack³

et al. 2008

Investigative Radiology

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Acoustic attenuation by MBs in skin markedly reduces petechiae creation in deep muscle. Petechiae inhibition is dependent on [MB]2.1 and, therefore, dominates the otherwise proportional relationship between petechiae and [MB] in muscle. The drop of peak-negative pressure below a critical microvessel rupturing threshold is the probable mechanism for petechiae inhibition. These results indicate that high MB doses could, paradoxically, reduce the potential for petechiae creation and may have important bearing on the design of contrast ultrasound-based therapeutics.

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Release of cardiac bio-markers during high mechanical index contrast-enhanced echocardiography in humans

Abstract: Our data suggest that high-MI contrast-enhanced echocardiography can cause subclinical release of cardiac bio-markers in humans, while low-MI real-time imaging appears to be safer.

Cited by 41 publications

References 27 publications

Effect of High-Intensity Ultrasound–Targeted Microbubble Destruction on Perfusion and Function of the Rat Heart Assessed by Pinhole-Gated SPECT

Effect of High-Intensity Ultrasound–Targeted Microbubble Destruction on Perfusion and Function of the Rat Heart Assessed by Pinhole-Gated SPECT

The Year in Echocardiography

Acoustic Attenuation by Contrast Agent Microbubbles in Superficial Tissue Markedly Diminishes Petechiae Bioeffects in Deep Tissue

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