Key result
Ultrasound contrast agents improve diagnostic accuracy in the ~33% of stress echocardiograms with suboptimal images.
Why the study?
More than 33% of patients undergoing stress echocardiography have suboptimal images due to a poor acoustic window, prompting the use of ultrasound contrast agents whose clinical efficacy and safety warrant review.
May salvage nondiagnostic stress echocardiograms; leaves open outcome impact in prospective trials.
Transthoracic echocardiographic examination is known to be a safe, non-invasive and reproducible method, used in every day clinical practice to obtain important information about cardiac structure and function. Unfortunately, a significant proportion of studies have highlighted the considerable technically difficultly in producing diagnostic images due to a poor acoustic window and more than 33% of patients undergoing stress echocardiography have suboptimal echocardiographic images. All these limitations have led to the use of contrast agents to improve the quality of standard ultrasound examination to provide a better delineation of left ventricle endocardial borders or to obtain information that cannot be achieved by using standard echocardiography, such as assessing myocardial microcirculation and therefore perfusion. This paper sought to review the clinical efficacy and safety of ultrasound contrast agents focusing on stress echocardiography.
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Maier et al. (2016) conducted a review in Suboptimal echocardiographic images during rest and stress echocardiography. Ultrasound contrast agents (Optison, Definity, Sonazoid, SonoVue) vs. Non-contrast-enhanced standard echocardiography was evaluated. Ultrasound contrast agents safely improve endocardial border delineation and diagnostic accuracy in the >33% of stress echocardiography patients with suboptimal images.
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