Opacification and border delineation improvement in patients with suboptimal endocardial border definition on routine echocardiography: results of a phase III trial of sonicated albumin microspheres
| Autor: | L. J. Crouse, P. H. Kramer |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Diseases Endocardial border Ventricular Function Left Microsphere Albumins Medicine Humans In patient Wall motion Aged Observer Variation Adult patients business.industry Albumin General Medicine Middle Aged Image Enhancement Microspheres Surgery Contrast medium medicine.anatomical_structure Ventricle Echocardiography Injections Intravenous Female Cardiology and Cardiovascular Medicine business Nuclear medicine |
| Zdroj: | Clinical cardiology. 14(11 Suppl 5) |
| ISSN: | 0160-9289 |
| Popis: | To determine whether contrast medium in the left ventricle improves endocardial border delineation, enabling better assessment of left ventricular (LV) wall motion, a 5% solution of sonicated albumin microspheres was administered in 30 adult patients who exhibited endocardial border drop-out of 20% or more on routine echocardiography. The investigator and two blinded reviewers evaluated efficacy using an opacification grading system of 0 to 3+, with 0 indicating no contrast effect and 3+ indicating full opacification of the left ventricle. A score of 2+ or greater indicated effective opacification. Border delineation improvement was defined as a change from grade A (not well delineated) to grade B, C, or D (well delineated) of at least 1 of 6 LV wall segments. All patients received an initial injection of 0.08 cc/kg. If this volume produced LV opacification of at least 2+, the patient received two additional injections of 0.14 cc/kg and 0.08 cc/kg, each given 5 minutes apart. Otherwise, the patient received a final injection of 0.22 cc/kg. In all cases, the patient's arm was raised after injection to enhance venous passage. The total number of patients exhibiting 2+ or greater opacification was 29(97%) when graded by the investigator and 27(90%) when graded by the blinded observers. The investigator noted improved border delineation in 90% of patients, and the blinded observers noted improvement in 97% (excluding 1 patient who would have received a higher dose of contrast agents if scored by a blinded observer). Investigator confidence in assessing LV wall motion improved in 24 (80%) of the 30 studies. In conclusion, when results of routine echocardiography may be inconclusive because of suboptimal endocardial border delineation, the intravenous administration of sonicated albumin microspheres improves endocardial border delineation and promotes the confidence of the investigator in assessing wall motion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|