Key result
Sonicated albumin microspheres achieved effective left ventricular opacification (score ≥2+) in 97% of patients by investigator assessment and 90% by blinded observers.
Why the study?
Does a 5% solution of sonicated albumin microspheres improve endocardial border delineation in adult patients with suboptimal endocardial border definition on routine echocardiography?
Does a 5% solution of sonicated albumin microspheres improve endocardial border delineation in adult patients with suboptimal endocardial border definition on routine echocardiography?
Sonicated albumin microspheres effectively improve left ventricular opacification and endocardial border delineation in patients with suboptimal routine echocardiograms.
Answers are grounded in this paper and cite their sources.
May aid LV opacification in suboptimal echocardiograms; leaves open randomized confirmation of diagnostic or outcome benefit.
To determine whether contrast medium in the left ventricle improves endocardial border delineation, enabling better assessment of left ventricular (LV) wall motion, a 5% solution of sonicated albumin microspheres was administered in 30 adult patients who exhibited endocardial border drop-out of 20% or more on routine echocardiography. The investigator and two blinded reviewers evaluated efficacy using an opacification grading system of 0 to 3+, with 0 indicating no contrast effect and 3+ indicating full opacification of the left ventricle. A score of 2+ or greater indicated effective opacification. Border delineation improvement was defined as a change from grade A (not well delineated) to grade B, C, or D (well delineated) of at least 1 of 6 LV wall segments. All patients received an initial injection of 0.08 cc/kg. If this volume produced LV opacification of at least 2+, the patient received two additional injections of 0.14 cc/kg and 0.08 cc/kg, each given 5 minutes apart. Otherwise, the patient received a final injection of 0.22 cc/kg. In all cases, the patient's arm was raised after injection to enhance venous passage. The total number of patients exhibiting 2+ or greater opacification was 29 (97%) when graded by the investigator and 27 (90%) when graded by the blinded observers. The investigator noted improved border delineation in 90% of patients, and the blinded observers noted improvement in 97% (excluding 1 patient who would have received a higher dose of contrast agents if scored by a blinded observer). Investigator confidence in assessing LV wall motion improved in 24 (80%) of the 30 studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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Crouse et al. (2009) studied Suboptimal endocardial border definition (n=30). Sonicated albumin microspheres (5% solution) was evaluated on Effective opacification (score of 2+ or greater). Sonicated albumin microspheres achieved effective left ventricular opacification (score ≥2+) in 97% of patients by investigator assessment and 90% by blinded observers.
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