Safety profile of ultrasound enhancing agents in echocardiography.

Autor: Kumar S; Oregon Health and Science University, Portland, Oregon., Purtell C; Oregon Health and Science University, Portland, Oregon., Peterson A; Oregon Health and Science University, Portland, Oregon., Gibbons P; Oregon Health and Science University, Portland, Oregon., Khan AM; Oregon Health and Science University, Portland, Oregon., Heitner SB; Oregon Health and Science University, Portland, Oregon.
Jazyk: angličtina
Zdroj: Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2019 Jun; Vol. 36 (6), pp. 1041-1044. Date of Electronic Publication: 2019 Apr 30.
DOI: 10.1111/echo.14344
Abstrakt: Introduction: Ultrasound enhancing agents (UEAs) are often utilized to enhance ultrasound image quality; however, concerns about adverse reactions have limited their use. Moreover, these agents had been either contraindicated or are labeled with a warning in patients with intra-cardiac shunts because of a theoretic risk of systemic microvascular obstruction. This labeling was recently removed in the United States, but data in these patients are lacking.
Methods: Over a 15-month period, patients receiving three different FDA-approved UEAs at our center were prospectively evaluated for clinically significant adverse events (AEs).
Results: A total of 5521 UEA administrations were performed (Definity ® : 3306, Lumason ® : 2137, Optison ® : 78). There were 14 AEs (0.25%) reported (Lumason ® : 0.05% [n = 1] vs Definity ® : 0.39% [n = 13], P = 0.02). Back pain was the most common complaint (n = 9), followed by headache (n = 2), rash (n = 2), dyspnea (n = 2), and palpitations (n = 1). Among the 33 patients known to have intra-cardiac shunts, there were no AEs. Known right-to-left shunts with positive saline bubble study were present in 20 patients (Lumason ® : n = 9, Definity ® : n = 11). Left-to-right atrial shunts based on color Doppler were present in 10 patients (Lumason ® : n = 5, Definity ® n = 5). Three patients were known to have ventricular septal defect with left-to-right flow (Definity ® : n = 2, Optison ® : n = 1).
Conclusion: Adverse events were significantly higher with Definity ® ; however, overall incidences were low, and AEs were minor. Furthermore, no AEs were reported in patients with known intra-cardiac shunts. UEAs showed a good safety profile in our study and should be afforded to all appropriate patients, including those with known intra-cardiac shunts.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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