Utilità e limiti dell'ecocontrastografia durante eco-stress con dobutamina

Translated title of the contribution: Use and limits of echocontrastography during echo stress with dobutamine

Alessandra Fontana, Elena Lucca, Nedy Brambilla, Luca Lanzarini, Catherine Klersy, Mario Previtali

Research output: Contribution to journalArticle

Abstract

Background. The aim of this study was to evaluate whether the use of contrast agent in addition to second harmonic imaging during dobutamine stress echocardiography can improve endocardial visualization and interobserver agreement in the evaluation of regional wall motion in patients with suboptimal or poor acoustic window. Methods. Twenty-one patients with a poor or suboptimal acoustic window underwent dobutamine stress echocardiography. Echocardiographic images in parasternal long-axis and short-axis, apical 4- chamber and 2-chamber views were cine-looped at baseline and peak stress before and after injection of contrast medium (Levovist at a concentration of 400 mg/ml). Endocardial visualization and regional wall motion were evaluated by two blinded observers. Results. The contrast medium improved segment visualization both at baseline (complete visualization in 74% of segments with contrast vs 71% without, p = NS) and at peak stress (76 vs 64%, p <0.001). Contrast medium improved significantly segment visualization in apical 4-chamber view both at baseline (complete visualization in 87% of segments with contrast vs 72% without, p <0.01) and at peak (89 vs 66%,p <0.001) and in apical 2-chamber view both at baseline (81 vs 61%, p <0.001) and at peak (89 vs 55%, p <0.001). When individual segments were analyzed, endocardial visualization improved significantly in all segments of the anterior wall and in the mid and distal segments of the lateral wall both at baseline and at peak stress. The use of contrast medium did not improve significantly interobserver agreement in the evaluation of regional wall motion at peak stress (k = 0.63 vs 0.67 without and with contrast, respectively). Conclusions. The use of Levovist during dobutamine stress echocardiography improves significantly segment visualization in the apical views both at baseline and at peak stress and increases interobserver agreement in the evaluation of regional wall motion at peak stress.

Original languageItalian
Pages (from-to)119-124
Number of pages6
JournalItalian Heart Journal Supplement
Volume4
Issue number2
Publication statusPublished - 2003

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Dobutamine
Contrast Media
Stress Echocardiography
Acoustics
Injections

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Utilità e limiti dell'ecocontrastografia durante eco-stress con dobutamina. / Fontana, Alessandra; Lucca, Elena; Brambilla, Nedy; Lanzarini, Luca; Klersy, Catherine; Previtali, Mario.

In: Italian Heart Journal Supplement, Vol. 4, No. 2, 2003, p. 119-124.

Research output: Contribution to journalArticle

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abstract = "Background. The aim of this study was to evaluate whether the use of contrast agent in addition to second harmonic imaging during dobutamine stress echocardiography can improve endocardial visualization and interobserver agreement in the evaluation of regional wall motion in patients with suboptimal or poor acoustic window. Methods. Twenty-one patients with a poor or suboptimal acoustic window underwent dobutamine stress echocardiography. Echocardiographic images in parasternal long-axis and short-axis, apical 4- chamber and 2-chamber views were cine-looped at baseline and peak stress before and after injection of contrast medium (Levovist at a concentration of 400 mg/ml). Endocardial visualization and regional wall motion were evaluated by two blinded observers. Results. The contrast medium improved segment visualization both at baseline (complete visualization in 74{\%} of segments with contrast vs 71{\%} without, p = NS) and at peak stress (76 vs 64{\%}, p <0.001). Contrast medium improved significantly segment visualization in apical 4-chamber view both at baseline (complete visualization in 87{\%} of segments with contrast vs 72{\%} without, p <0.01) and at peak (89 vs 66{\%},p <0.001) and in apical 2-chamber view both at baseline (81 vs 61{\%}, p <0.001) and at peak (89 vs 55{\%}, p <0.001). When individual segments were analyzed, endocardial visualization improved significantly in all segments of the anterior wall and in the mid and distal segments of the lateral wall both at baseline and at peak stress. The use of contrast medium did not improve significantly interobserver agreement in the evaluation of regional wall motion at peak stress (k = 0.63 vs 0.67 without and with contrast, respectively). Conclusions. The use of Levovist during dobutamine stress echocardiography improves significantly segment visualization in the apical views both at baseline and at peak stress and increases interobserver agreement in the evaluation of regional wall motion at peak stress.",
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AU - Fontana, Alessandra

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AU - Klersy, Catherine

AU - Previtali, Mario

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N2 - Background. The aim of this study was to evaluate whether the use of contrast agent in addition to second harmonic imaging during dobutamine stress echocardiography can improve endocardial visualization and interobserver agreement in the evaluation of regional wall motion in patients with suboptimal or poor acoustic window. Methods. Twenty-one patients with a poor or suboptimal acoustic window underwent dobutamine stress echocardiography. Echocardiographic images in parasternal long-axis and short-axis, apical 4- chamber and 2-chamber views were cine-looped at baseline and peak stress before and after injection of contrast medium (Levovist at a concentration of 400 mg/ml). Endocardial visualization and regional wall motion were evaluated by two blinded observers. Results. The contrast medium improved segment visualization both at baseline (complete visualization in 74% of segments with contrast vs 71% without, p = NS) and at peak stress (76 vs 64%, p <0.001). Contrast medium improved significantly segment visualization in apical 4-chamber view both at baseline (complete visualization in 87% of segments with contrast vs 72% without, p <0.01) and at peak (89 vs 66%,p <0.001) and in apical 2-chamber view both at baseline (81 vs 61%, p <0.001) and at peak (89 vs 55%, p <0.001). When individual segments were analyzed, endocardial visualization improved significantly in all segments of the anterior wall and in the mid and distal segments of the lateral wall both at baseline and at peak stress. The use of contrast medium did not improve significantly interobserver agreement in the evaluation of regional wall motion at peak stress (k = 0.63 vs 0.67 without and with contrast, respectively). Conclusions. The use of Levovist during dobutamine stress echocardiography improves significantly segment visualization in the apical views both at baseline and at peak stress and increases interobserver agreement in the evaluation of regional wall motion at peak stress.

AB - Background. The aim of this study was to evaluate whether the use of contrast agent in addition to second harmonic imaging during dobutamine stress echocardiography can improve endocardial visualization and interobserver agreement in the evaluation of regional wall motion in patients with suboptimal or poor acoustic window. Methods. Twenty-one patients with a poor or suboptimal acoustic window underwent dobutamine stress echocardiography. Echocardiographic images in parasternal long-axis and short-axis, apical 4- chamber and 2-chamber views were cine-looped at baseline and peak stress before and after injection of contrast medium (Levovist at a concentration of 400 mg/ml). Endocardial visualization and regional wall motion were evaluated by two blinded observers. Results. The contrast medium improved segment visualization both at baseline (complete visualization in 74% of segments with contrast vs 71% without, p = NS) and at peak stress (76 vs 64%, p <0.001). Contrast medium improved significantly segment visualization in apical 4-chamber view both at baseline (complete visualization in 87% of segments with contrast vs 72% without, p <0.01) and at peak (89 vs 66%,p <0.001) and in apical 2-chamber view both at baseline (81 vs 61%, p <0.001) and at peak (89 vs 55%, p <0.001). When individual segments were analyzed, endocardial visualization improved significantly in all segments of the anterior wall and in the mid and distal segments of the lateral wall both at baseline and at peak stress. The use of contrast medium did not improve significantly interobserver agreement in the evaluation of regional wall motion at peak stress (k = 0.63 vs 0.67 without and with contrast, respectively). Conclusions. The use of Levovist during dobutamine stress echocardiography improves significantly segment visualization in the apical views both at baseline and at peak stress and increases interobserver agreement in the evaluation of regional wall motion at peak stress.

KW - Dobutamine

KW - Echocontrast

KW - Stress echocardiography

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