Agitated saline versus polygelatine for the echocardiographic assessment of patent foramen ovale

Buttignoni, Sonja Cukon; Khorsand, Aliasghar; Mundigler, Gerald; Bergler‐Klein, Jutta; Heger, Maria; Zehetgruber, Manfred; Baumgartner, H.; Binder, Thomas

doi:10.1016/j.echo.2004.06.010

Cited by 28 publications

(15 citation statements)

References 19 publications

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“…However, the bubbles are of similar size to those reported for saline under microscopic evaluation (27 Ϯ 7 m) (26), and so differences might be expected to be minor. In other clinical and research settings, the two agents have been found to yield similar results (1,10,14,33) or have been used interchangeably (11). Also, our finding of PTAC in 95% of subjects is very similar to that described by Eldridge et al (91%;Ref.…”

Section: Limitationssupporting

confidence: 89%

“…The total volume infused was Ͻ150 ml for each subject. This solution was used in preference to saline because of its superiority in Doppler signal enhancement (43), previous demonstration that pulmonary transit of gelatin bubbles do not occur in healthy subjects at rest (33), and its greater sensitivity and specificity in identification of intracardiac (1,10,11) and intrapulmonary shunts (14,33). The agitated succinylated gelatin solution was examined under a digital microscope, and the average diameter of 105 measured bubbles was 21.2 Ϯ 6.2 m (Fig.…”

Section: Measurementsmentioning

confidence: 99%

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Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise

Gerche

MacIsaac

Burns

et al. 2010

Journal of Applied Physiology

149

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Pulmonary transit of agitated contrast (PTAC) occurs to variable extents during exercise. We tested the hypothesis that the onset of PTAC signifies flow through larger-caliber vessels, resulting in improved pulmonary vascular reserve during exercise. Forty athletes and fifteen nonathletes performed maximal exercise with continuous echocardiographic Doppler measures [cardiac output (CO), pulmonary artery systolic pressure (PASP), and myocardial velocities] and invasive blood pressure (BP). Arterial gases and B-type natriuretic peptide (BNP) were measured at baseline and peak exercise. Pulmonary vascular resistance (PVR) was determined as the regression of PASP/CO and was compared according to athletic and PTAC status. At peak exercise, athletes had greater CO (16.0 ± 2.9 vs. 12.4 ± 3.2 l/min, P < 0.001) and higher PASP (60.8 ± 12.6 vs. 47.0 ± 6.5 mmHg, P < 0.001), but PVR was similar to nonathletes (P = 0.71). High PTAC (defined by contrast filling of the left ventricle) occurred in a similar proportion of athletes and nonathletes (18/40 vs. 10/15, P = 0.35) and was associated with higher peak-exercise CO (16.1 ± 3.4 vs. 13.9 ± 2.9 l/min, P = 0.010), lower PASP (52.3 ± 9.8 vs. 62.6 ± 13.7 mmHg, P = 0.003), and 37% lower PVR (P < 0.0001) relative to low PTAC. Right ventricular (RV) myocardial velocities increased more and BNP increased less in high vs. low PTAC subjects. On multivariate analysis, maximal oxygen consumption (VO(2max)) (P = 0.009) and maximal exercise output (P = 0.049) were greater in high PTAC subjects. An exercise-induced decrease in arterial oxygen saturation (98.0 ± 0.4 vs. 96.7 ± 1.4%, P < 0.0001) was not influenced by PTAC status (P = 0.96). Increased PTAC during exercise is a marker of pulmonary vascular reserve reflected by greater flow, reduced PVR, and enhanced RV function.

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Section: Limitationssupporting

confidence: 89%

Section: Measurementsmentioning

confidence: 99%

Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise

Gerche

MacIsaac

Burns

et al. 2010

Journal of Applied Physiology

149

View full text Add to dashboard Cite

show abstract

“…False-negative rates of up to 20% for PFO detection have been reported when the Valsalva maneuver is not used, 9 while polygelatine is reported to be more sensitive than agitated saline for PFO detection. 10 Twenty-one of the 24 studies in this review that reported rates of PFO detection used the Valsalva maneuver, and all of the studies used contrast, mainly agitated saline. We found no difference in rates of PFO detection between studies that used the Valsalva maneuver and those that did not.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

McGrath

Paikin

Motlagh

et al. 2014

American Heart Journal

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“…Agitated saline bubbles were widely used as echocardiographic contrast agents for the diagnosis of intracardiac shunt (8). Clinical research nevertheless reported that the chronic and recurrent exposure to microbubbles of dialysis patient contributes to the development of pulmonary hypertension and CNS injury.…”

Section: Discussionmentioning

confidence: 99%

Agitated Saline Bubble–Enhanced Transthoracic Echocardiography

Wen

Stock

Heemann

et al. 2014

Critical Care Medicine

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Agitated saline versus polygelatine for the echocardiographic assessment of patent foramen ovale

Cited by 28 publications

References 19 publications

Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise

Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise

Transesophageal echocardiography in patients with cryptogenic ischemic stroke: A systematic review

Agitated Saline Bubble–Enhanced Transthoracic Echocardiography

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