Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017

Abstract

Contrast echocardiography is widely used in cardiology. It is applied to improve image quality, reader confidence and reproducibility both for assessing left ventricular (LV) structure and function at rest and for assessing global and regional function in stress echocardiography. The use of contrast in echocardiography has now extended beyond cardiac structure and function assessment to evaluation of perfusion both of the myocardium and of the intracardiac structures. Safety of contrast agents have now been addressed in large patient population and these studies clearly established its excellent safety profile. This document, based on clinical trials, randomized and multicentre studies and published clinical experience, has established clear recommendations for the use of contrast in various clinical conditions with evidence-based protocols.

Clinical, hemodynamic, and functional variables affecting success rate of coronary flow velocity reserve detection during vasodilator stress echocardiography

“…The lack of contrast availability for reimbursement issues or safety concerns should not avoid the implementation of CFVR assessment. Second, its use is only recommended in patients with uninterpretable coronary flow tracings, usually <5% of consecutive populations as also shown in previous studies 20,23,24 . Therefore, a selective use of contrast (in <5% of patients) to enhance an otherwise undetectable color or pulsed‐Doppler signal in challenging patients (more frequently obese women) will further increase the already excellent feasibility of the method.…”

“…Therefore, a selective use of contrast (in <5% of patients) to enhance an otherwise undetectable color or pulsed‐Doppler signal in challenging patients (more frequently obese women) will further increase the already excellent feasibility of the method. When contrast is used, any of the three commercially available agents (Optison, Definity/Luminity, Sonovue/Lumason) can be chosen 24 . Potential pitfalls for LAD flow assessment are shown in Figure 5.…”

Quantitative assessment of left ventricular size and function in cardiac transplant recipients: Side‐by‐side comparison of real time two‐dimensional echocardiography, contrast‐enhanced two‐dimensional echocardiography, three‐dimensional echocardiography, and contrast‐enhanced three‐dimensional echocardiography as compared to magnetic resonance imaging

“…Improvement in accuracy has been demonstrated with real time 3‐dimensional echocardiography (3D‐echo) because of the absence of geometric assumptions pertaining to LV shape . LV opacification with contrast agents has also shown to improve image quality and enhance endocardial border delineation …”

Persistent Microembolic Signals in the Cerebral Circulation on Transcranial Doppler after Intravenous Sulfur Hexafluoride Microbubble Infusion

“…UCAs are potentially necessary for about 20% of transcranial Doppler examinations due to poor insonation . Stabilized sulfur hexafluoride (SF6) microbubbles are a frequently used UCA in neuro‐ and cardiovascular diagnostics . It has also been used in contrast‐enhanced sonothrombolysis in acute ischemic stroke .…”

“…15 Stabilized sulfur hexafluoride (SF6) microbubbles are a frequently used UCA in neuro-and cardiovascular diagnostics. 15,16 It has also been used in contrast-enhanced sonothrombolysis in acute This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. ischemic stroke.…”