[Improved endocardial border delineation during dobutamine stress echocardiography using the left heart contrast medium BY 963].

Abstract

UNLABELLED:

The interpretation of induced wall motion abnormalities during dobutamine stress echocardiography is affected in the case of impaired image quality. In 48 consecutive patients (mean age 62 +/- 9 years, 32 males, 16 females) with suspected coronary disease undergoing coronary angiography, the transpulmonary contrast agent BY 963 was given i.v. as bolus during dobutamine stress echocardiography (10-40 micrograms kg min, plus max. 1 mg atropine) to analyze improvements in endocardial border delineation. For each of the 16 segments of the left ventricle, the endocardial border delineation was evaluated. Using BY 963 the average number of non-evaluable segments decreased by 58% from 5.2% to 2.2% at rest (p = 0.008) and by 56% from 5.9% to 2.6% at maximal stress (p = 0.003) as compared to the non-contrast study for all patients. In patients with impaired image quality, defined as at least 1 non-evaluable segment at rest without contrast enhancement (N = 14), the number of non-evaluable segments decreased from 19.2% to 8.2% (p = 0.004) at rest and from 19.2% to 9.6% (p = 0.006) at maximal stress. The greatest decrease of non-evaluable segments was seen in the lateral and anterior segments of the apical views (maximum of 80%). The improved endocardial border delineation resulted in an improved agreement between two observers in the interpretation of the dobutamine stress echocardiograms as positive or negative (kappa = 0.38 without contrast, kappa = 0.58 with contrast). Contrast application resulted in a slight improvement of diagnostic accuracy of dobutamine stress echocardiography in the detection of angiographically proven significant coronary artery disease.

CONCLUSION:

In patients with impaired endocardial border delineation the use of the echo contrast agent BY 963 reduces the number of non-evaluable segments. Improvement of endocardial delineation is greatest for lateral and anterior segments in the apical views.

• Authors: R Frieske, H Kühl, D Yuan, W Lepper, A Franke, R Hoffmann
• Journal: Zeitschrift fur Kardiologie (Z Kardiol) Vol. 89 Issue 3 Pg. 186-94 (Mar 2000) ISSN: 0300-5860 [Print] Germany
• Vernacular Title: Verbesserte Endokarderkennung der Dobutamin-Belastungsechokardiographie durch Einsatz des Linksherzkontrastmittels BY 963.
• PMID: 10798274 (Publication Type: Comparative Study, Journal Article)

Chemical References

• BY 963
• Cardiotonic Agents
• Contrast Media
• Phosphatidylcholines
• Dobutamine

Topics

• Aged
• Cardiotonic Agents
• Contrast Media
• Coronary Angiography
• Coronary Disease (diagnostic imaging)
• Dobutamine
• Echocardiography (methods)
• Endocardium (diagnostic imaging)
• Exercise Test
• Female
• Humans
• Male
• Middle Aged
• Phosphatidylcholines