Improved 3-D-echocardiographic endocardial border delineation using the contrast agent FS069 (Optison®) transesophageal studies in a porcine model

Handke, Michael; Schäfer, Dietrich Markus; Heinrichs, Gudrun; Magosaki, Etsuko; Lutter, Georg; Dern, Peter; Bode, Christoph; Geibel, Annette

doi:10.1016/s0301-5629(01)00415-x

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…Presently, three commercial USCAs are approved for the clinical application of left ventricular opacification in the USA, and other agents are under development and evaluation (Mulvagh et al 2000;Goldberg et al 2001). The three available US CAs are Optison (Mallinckrodt Inc., St. Louis, MO) (e.g., Handke et al 2001;Shimoni et al 2003), Definity (Bristol-Myers Squibb Medical Imaging, Inc., N. Billerica, MA)(e.g., Mor-Avi et al 2001;Kuersten et al 2001) and Imagent (Alliance Pharmaceutical Corp., San Diego, CA) (e.g., Mulvagh et al 1996;Galiuto et al 1998). These agents are distinctly different in their characteristics, but all three depend on the echogenicity of the stabilized gasfilled microbubbles for the contrast effect.…”

Section: Introductionmentioning

confidence: 99%

Impact of myocardial contrast echocardiography on vascular permeability: comparison of three different contrast agents

Armstrong

Miller

2004

Ultrasound in Medicine & Biology

104

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Section: Introductionmentioning

confidence: 99%

Impact of myocardial contrast echocardiography on vascular permeability: comparison of three different contrast agents

Armstrong

Miller

2004

Ultrasound in Medicine & Biology

104

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“…The LV pseudoaneurysm in our patient could not be diagnosed due to insufficient use of contrast during ventriculography, and the diagnosis was made 2 months after the myocardial infarction with the sudden onset of symptoms. In particular, patients presenting with congestive heart failure symptoms should be investigated by means of noninvasive diagnostic tools, such as magnetic resonance imaging or two‐dimensional echocardiography, by using recent techniques, such as contrast echo with or without using real‐time three‐dimensional echocardiography, to improve the endocardial delineation for differentiating the case from other pathologies, such as massive thrombus 3–6 . Because of its ease of availability and low cost, echocardiography seems to be the most valuable tool for the surgeon, especially when performed in experienced hands, even under suboptimal conditions.…”

Section: Discussionmentioning

confidence: 99%

Missed Diagnosis of Unruptured, Huge Left Ventricular Pseudoaneurysm

Akgün¹,

Keser²,

Yıldırım³

et al. 2003

Echocardiography

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“…The recording of the images was triggered by the ECG and respiration. To improve endocardial definition, 1.5–2 ml FS069 Optison was injected left atrial prior to the start of imaging 24 …”

Section: Methodsmentioning

confidence: 99%

Three‐Dimensional Echocardiographic Determination of Cardiac Output at Rest and Under Dobutamine Stress:

Handke¹,

Heinrichs²,

Magosaki³

et al. 2003

Echocardiography

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Determination of cardiac output is a potentially important clinical application of three-dimensional (3-D) echocardiography since it could replace invasive measurements with the Swan-Ganz-catheter. To date, there are no studies available to determine whether cardiac output measured by thermodilution can be predicted reliably under changing hemodynamic conditions. Fifteen pigs with ischemic myocardium were examined under four hemodynamic conditions at rest and under pharmacological stress with 5, 10, and 20 microg/kg/min dobutamine. The 3-D datasets were recorded by means of transesophageal echocardiography. The endocardial definition was enhanced by administering the contrast agent FS069 (Optison). Cardiac output was calculated as the product of stroke volume (end-diastolic - end-systolic volume) and heart rate. The invasive measurements were performed with a continuous thermodilution system. In general, there was moderate correlation between 3-D echocardiography and thermodilution(r = 0.72, P < 0.001). At rest, the 3-D echocardiographic measurements were slightly but significantly lower than the invasive measurements (mean difference 0.6 +/- 0.5L/min,P < 0.001). Under stress with 5, 10, and 20 microg/kg/min dobutamine, there was a marked increase in the deviation (1.3 +/- 0.5L/min,P < 0.001; 1.6 +/- 0.7 L/min,P < 0.001; and 2.1 +/- 1.1L/min,P < 0.001, respectively). The deviation was based on two factors: (1). Under stress, the decreasing number of frames per cardiac cycle acquired with 3-D echocardiography led to imprecise recording of end-diastolic and end-systolic volumes, and thus to an underestimation of cardiac output. At least 30 frames per cardiac cycle are needed to eliminate this effect. (2). There is a systematic difference between 3-D echocardiographic and invasive measurements, which is independent of the imaging rate. This is based on an overestimation of the true values by thermodilution. In conclusion, cardiac output can be determined correctly by 3-D echocardiography for normal heart rates at rest. At elevated heart rates, the temporal resolution of 3-D systems currently available is not adequate for reliable determination. In performing and evaluating future clinical comparative studies, the systematic difference between 3-D echocardiography and thermodilution, based on overestimation by thermodilution, must be taken into account.

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Improved 3-D-echocardiographic endocardial border delineation using the contrast agent FS069 (Optison®) transesophageal studies in a porcine model

Cited by 6 publications

References 29 publications

Impact of myocardial contrast echocardiography on vascular permeability: comparison of three different contrast agents

Impact of myocardial contrast echocardiography on vascular permeability: comparison of three different contrast agents

Missed Diagnosis of Unruptured, Huge Left Ventricular Pseudoaneurysm

Three‐Dimensional Echocardiographic Determination of Cardiac Output at Rest and Under Dobutamine Stress:

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