CLINICAL STUDIES
Administration of an intravenous perfluorocarbon contrast agent improves echocardiographic determination of left ventricular volumes and ejection fraction: comparison with cine magnetic resonance imaging
W. Gregory Hundley, MD, FACC*  ,
Ali M. Kizilbash, MD*,
Imran Afridi, MD, FACC*,
Fatima Franco, MD*  ,
Ronald M. Peshock, MD, FACC* and
Paul A. Grayburn, MD, FACC*
* Department of Internal Medicine (Cardiology Division), University of Texas Southwestern Medical Center, Dallas, Texas, USA
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Wake Forest University Medical Center, Winston-Salem, North Carolina, USA
Manuscript received December 29, 1997;
revised manuscript received June 25, 1998,
accepted July 15, 1998.
Address for correspondence: Dr. Paul A. Grayburn, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75235-9047
grayburn{at}ryburn.swmed.edu
Objectives. The purpose of this study was to determine whether contrast-enhanced transthoracic echocardiography improves the evaluation of left ventricular (LV) volumes and ejection fraction (EF).
Background. Echocardiographic assessment of LV volumes and EF is widely used but may be inaccurate when the endocardium is not completely visualized. Recently the intravenous (IV) administration of perfluorocarbon microbubbles has been shown to enhance opacification of the LV cavity, but the utility of these agents to improve the echocardiographic assessment of LV systolic function is unknown.
Methods. In 40 subjects (29 men and 11 women, aged 24 to 81 years) an assessment of LV volumes and EF was performed with a magnetic resonance imaging examination, followed immediately by a transthoracic echocardiogram before and after the intravenous administration of 2% dodecafluoropentane emulsion (EchoGen; Sonus Pharmaceuticals, Bothell, Washington).
Results. Contrast enhanced the echocardiographic assessment of LV end diastolic volume (p < 0.02), end systolic volume (p < 0.01) and LVEF (p < 0.03). The percentage of subjects in whom the correct echocardiographic classification EF was normal, mild to moderately depressed or severely reduced improved significantly after contrast enhancement (from 71% before contrast to 94% after, p < 0.03). These findings were most striking in the subjects with two or more adjacent endocardial segments not visualized at baseline.
Conclusions. Administration of an intravenous contrast agent improves the ability to accurately assess LV volumes and EF in humans. Contrast enhancement is most useful in subjects with two or more adjacent endocardial segments not seen at baseline.
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Abbreviations and Acronyms
| | DDFP | = dodecafluoropentane | | ECG | = electrocardiographic | | EF | = ejection fraction | | IV | = intravenous | | LV | = left ventricular | | MRI | = magnetic resonance imaging |
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