Contrast echocardiography: a practical guideline from the British Society of Echocardiography

Hampson, Reinette; Senior, Roxy; Ring, Liam; Robinson, Shaun; Augustine, Daniel X.; Becher, Harald; Anderson, Natasha; Willis, James; Chandrasekaran, Badrinathan; Kardos, Attila; Siva, Anjana; Leeson, Paul; Rana, Bushra S.; Chahal, Navtej; Oxborough, David

doi:10.1186/s44156-023-00034-9

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…UEAs are frequently used in echocardiography to improve left ventricular opacification and endocardial border resolution, as well as for evaluation of myocardial perfusion, evaluation of left ventricular masses, and quantification of left ventricular function [ 1 , 9 ]. While UEAs have shown to be safe [ 10 , 11 ] and cost-effective [ 3 ] through the reduction in downstream procedures, in single center studies, use in transthoracic echocardiography lags behind that of suboptimal image quality [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of administrative claims to identify ultrasound enhancing agent use

Strom,

Song,

Jiang

et al. 2024

Echo Res Pract

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Background Ultrasound enhancing agents (UEAs) are an invaluable adjunct to stress and transthoracic echocardiography (STE) to improve left ventricular visualization. Despite multiple single center studies evaluating UEA use, investigation into the rates, sources of variation, and outcomes of UEA use on a national level in the United States (US) has been limited by lack of validation of UEA codes for claims analyses. Methods We conducted a retrospective cross-sectional study, 2019–2022, using linked multicenter electronic medical record (EMR) data from > 30 health systems linked to all-payor claims data representing > 90% of the US population. Individuals receiving STE in both EMR and claims data on the same day during the study window were included. UEA receipt as identified by presence of a Current Procedural Terminology (CPT) or National Drug Code (NDC) for UEA use within 1-day of the index STE event. We evaluated the performance of claims to identify UEA use, using EMR data as the gold standard, stratified by inpatient and outpatient status. Results Amongst 54,525 individuals receiving STE in both EMR and claims data, 12,853 (23.6%) had a UEA claim in EMR, 10,461 (19.2%) had a UEA claim in claims, and 9140 (16.8%) had a UEA claim in both within the 1-day window. The sensitivity, specificity, accuracy, positive, and negative predictive values for UEA claims were 71.1%, 96.8%, 90.8%, 87.4%. and 91.6% respectively. However, amongst inpatients, the sensitivity of UEA claims was substantially lower (6.8%) compared to outpatients (79.7%). Conclusions While the overall accuracy of claims to identify UEA use was high, there was substantial under-capture of UEA use by claims amongst inpatients. These results call into question published rates of UEA use amongst inpatients in studies using administrative claims, and highlight ongoing need to improve inpatient coding for UEA use.

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Section: Discussionmentioning

confidence: 99%

Validation of administrative claims to identify ultrasound enhancing agent use

Strom,

Song,

Jiang

et al. 2024

Echo Res Pract

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“…Despite prolonged balloon inflation, spontaneous sealing was not achieved. To clearly define the direction of the CAP, contrast-enhanced TTE was performed after intravenous injection of 3 ml of sodium hexafluoride-based ultrasound contrast agent (UCA), SonoVue (Bracco International B.V., Amsterdam, NL), followed by 5 ml of a slow normal saline flush [ 2 ]. The echocardiographic contrast is used intravascularly and is visualized as hyperechoic spots using dedicated imaging protocols.…”

mentioning

confidence: 99%

“…Contrast-enhanced echocardiography (CEE) is an echocardiographic technique that uses UCAs, which are injectable echo-reflective microbubbles to improve imaging of the cardiac chambers and blood-filled spaces [ 2 , 4 ]. In the setting of coronary perforations, these microbubbles better define the clinical impact of the perforation.…”

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confidence: 99%

Contrast-enhanced echocardiography to define guidewire-related distal coronary artery perforation run-off and to rule out active intrapericardial bleeding

Kassimis,

Mitsiadis,

Zormpas

et al. 2024

pwki

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Echocardiographic assessment of left atrial appendage morphology and function—an expert proposal by the German Working Group of Cardiovascular Ultrasound

Hagendorff,

Stöbe,

Helfen

et al. 2024

Clin Res Cardiol

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The left atrial appendage is a blind ending cardiac structure prone to blood stasis due to its morphology. This structure is a preferred region of thrombogenesis in relation to reduced myocardial contractility of the atrial wall. Blood stasis occurs primarily in low flow conditions. One of the tasks of echocardiography is the analysis of morphology and function of the left atrial appendage. The detection of thrombi by echocardiography is difficult and must be carried out thoroughly and carefully to avoid potential complications—especially in the context of rhythm control. The assessment of thromboembolic risk, especially in patients with unknown and presumed atrial fibrillation is a second challenge by characterizing atrial function and flow conditions in the left atrial appendage. Thus, this proposal focuses on the obvious problems of echocardiography when assessing left atrial appendage and the role of this method in planning a potential interventional closure of left atrial appendage.

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Contrast echocardiography: a practical guideline from the British Society of Echocardiography

Cited by 7 publications

References 39 publications

Validation of administrative claims to identify ultrasound enhancing agent use

Validation of administrative claims to identify ultrasound enhancing agent use

Contrast-enhanced echocardiography to define guidewire-related distal coronary artery perforation run-off and to rule out active intrapericardial bleeding

Echocardiographic assessment of left atrial appendage morphology and function—an expert proposal by the German Working Group of Cardiovascular Ultrasound

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