Noninvasive Evaluation of Cardiac Chamber Pressures Using Subharmonic-Aided Pressure Estimation With Definity Microbubbles

Esposito, Cara; Machado, Priscilla; McDonald, Maureen E.; Savage, Michael P.; Fischman, David L.; Mehrotra, Praveen; Cohen, Ira S.; Ruggiero, Nicholas J.; Walinsky, Paul; Vishnevsky, Alec; Dickie, Kristopher; Davis, Marguerite; Forsberg, Flemming; Dave, Jaydev K.

doi:10.1016/j.jcmg.2022.09.013

Cited by 13 publications

(7 citation statements)

References 27 publications

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“…In the current study, we used Definity microbubbles as these are approved in the U.S. for LV opacification studies and Definity microbubbles were used in previous clinical studies of cardiac SHAPE. 6,7 Another limitation of this in vitro study is that we did not consider how the blood-constituents and differences in viscosity (between blood and deionized water) would mediate the interaction between iodinated and microbubble contrast media. Also, we measured the change in the subharmonic signal amplitude with respect to the baseline (deionized water) after adding 0.14 and 0.85 mL of Visipaque.…”

Section: Discussionmentioning

confidence: 99%

“…2 The SHAPE technique has shown promise for noninvasive pressure estimation for different clinical applications such as evaluating portal hypertension, 3,4 monitoring response to neoadjuvant chemotherapy for breast cancer, 5 and intra-cardiac pressure estimation. 6,7 For applications such as intra-cardiac pressure measurements, clinical standard-of-care involves an invasive catheterization procedure. [7][8][9] Briefly, an incision is made to access the femoral or the radial blood vessels.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…For validation studies involving SHAPE measurements and synchronous pressure catheter measurements, 6,7 microbubble-based ultrasound contrast agents and iodinated contrast media are present together in the vasculature. The presence of iodinated contrast media may affect the microbubble oscillations producing an effect on the subharmonic signal amplitude utilized for pressure estimation using the SHAPE technique.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 For applications such as intra-cardiac pressure measurements, clinical standard-of-care involves an invasive catheterization procedure. [7][8][9] Briefly, an incision is made to access the femoral or the radial blood vessels. Then, a pressure sensing catheter is advanced from the site of the incision to the cardiac chambers and the aorta for pressure measurements.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Mixing Iodinated Contrast Media and Ultrasound Contrast Agents on Subharmonic Signals

Esposito,

Tzan,

Machado

et al. 2024

Ultrason Imaging

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Subharmonic aided pressure estimation (SHAPE) is a technique that utilizes subharmonic signals from microbubble contrast agents for pressure estimation. Validation of the SHAPE technique relies on synchronous measurements of in vivo pressures using contrast microbubbles and a pressure catheter (reference standard). For the guidance and placement of pressure catheter in vivo, iodinated contrast is used with fluoroscopy. Therefore, during data acquisition for validation studies of the SHAPE technique, both contrast microbubbles and iodinated contrast are present simultaneously within the vasculature. This study aims to elucidate the effects of iodinated contrast (Visipaque, GE HealthCare) on subharmonic signal amplitude from contrast microbubbles (Definity, Lantheus Medical Imaging, Inc.). In an acrylic water tank, 0.06 mL of Definity and varied amounts of Visipaque (0.14, 0.43, 0.85, and 1.70 mL) were added to 425 mL of deionized water. Ultrasound scanning was performed with a SonixTablet scanner (BK Medical Systems) using optimized parameters for SHAPE with Definity ( ftransmit/receive = 3.0/1.5 MHz; chirp down pulse). Subharmonic data was acquired and analyzed at 9 different incident acoustic outputs ( n = 3). Results showed an increase in subharmonic signal amplitude from Definity microbubbles in the presence of 0.14 mL Visipaque by 2.8 ± 1.3 dB ( p < .001), no change with 0.85 mL Visipaque (0.7 ± 1.2 dB; p = .09) and a decrease in subharmonic amplitude in the presence of 1.70 mL Visipaque by 1.9 ± 0.7 dB ( p < .001). While statistically significant effect on subharmonic signal amplitude of Definity microbubbles was noted due to the mixture, the magnitude of the effect was minimal (~2.8 dB) and unlikely to impact in vivo SHAPE measurements.

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Section: Discussionmentioning

confidence: 99%