Contrast echocardiography

2021 ◽  
pp. 111-120
Author(s):  
Roxy Senior ◽  
Harald Becher ◽  
Fausto J. Pinto ◽  
Rajdeep S. Khattar
Keyword(s):  
Contrast Agents ◽  
Stress Echocardiography ◽  
Imaging Techniques ◽  
Contrast Echocardiography ◽  
Left Ventricular ◽  
Ultrasound Contrast Agents ◽  
Left Ventricular Cavity ◽  
Aortic Diseases ◽  
Endocardial Border ◽  
Artery Disease

Contrast echocardiography has become an established technique to enhance endocardial border definition in those with suboptimal images. This has been enabled by newer intravenously administered ultrasound contrast agents that can traverse the pulmonary circulation intact, coupled with ultrasound imaging techniques designed specifically to allow good visualization of these agents in the left ventricular cavity and myocardium. Contrast echocardiography improves the evaluation of left ventricular function providing more accurate and reproducible measurements of volumes and ejection fraction. Contrast use in stress echocardiography improves the feasibility, diagnostic accuracy, and reader confidence in the test. Consequently, contrast agents enhance decision-making, shorten time to diagnosis, and reduce downstream costs in those with difficult acoustic windows. The technique is particularly useful in delineating apical pathology, and may be used to assess cardiac masses and aortic diseases. Myocardial perfusion may also be assessed during resting and stress echocardiography, improving the evaluation of coronary artery disease.

Stress echocardiography

ESC CardioMed ◽  
2018 ◽  
pp. 431-434
Author(s):  
Nikolaos Karogiannis ◽  
Roxy Senior
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Contrast Agents ◽  
Stress Echocardiography ◽  
Imaging Modality ◽  
Ultrasound Contrast Agents ◽  
Electrical Stress ◽  
Ultrasound Contrast ◽  
Artery Disease ◽  
Almost All

Stress echocardiography is a well-established imaging modality that combines echocardiography with exercise or pharmacologic or electrical stress to diagnose coronary artery disease, assess severity of valve disease and investigate potential viability of the cardiac muscle. In the era of tissue harmonic imaging and ultrasound contrast agents, stress echocardiography has established itself as an accurate technique with diagnostic images obtained in almost all patients.

Contrast echocardiography

ESC CardioMed ◽  
2018 ◽  
pp. 435-438
Author(s):  
Anastasia Vamvakidou ◽  
Roxy Senior
Keyword(s):  
Image Quality ◽  
Stress Echocardiography ◽  
Wall Motion ◽  
Contrast Echocardiography ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Regional Wall ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
Artery Disease

The major requirement for optimal echocardiographic image interpretation, reproducibility, and diagnostic accuracy is image quality. Despite the use of harmonics, a significant proportion of patients have challenging images, which has an impact on diagnosis and management. The ultrasound contrast agents (UCAs), which are administered intravenously, have been a significant development in image quality optimization and have proved to be an important aid in the assessment of structural abnormalities, detection of regional wall motion abnormalities, and calculation of left ventricular ejection fraction. The use of UCAs is also of critical importance for the detection of ischaemia and the assessment of significant coronary artery disease through detection of inducible regional wall motion abnormalities during stress echocardiography. UCAs can also assess myocardial perfusion, which improves assessment of myocardial ischaemia during stress echocardiography. Similarly the simultaneous assessment of wall motion and perfusion improves assessment of viable myocardium in patients with left ventricular dysfunction. As the use of UCAs results in increased feasibility, reproducibility, and diagnostic and prognostic accuracy of echocardiography including cost-efficiency, both European and American guidelines endorse its use in clinical cardiology.

Stress-induced Myocardial Ischaemia – Perfusion Contrast Echocardiography to Evaluate Presence and Severity of Coronary Artery Disease

2011 ◽  
Vol 7 (3) ◽  
pp. 172
Author(s):  
Benoy Nalin Shah ◽  
Roxy Senior ◽  
◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Contrast Echocardiography ◽  
Evidence Base ◽  
Suspected Coronary Artery Disease ◽  
Ultrasound Contrast Agents ◽  
Prognostic Information ◽  
Non Invasive ◽  
Artery Disease

The development of stable transpulmonary ultrasound contrast agents (UCAs) has allowed the echocardiographic assessment of myocardial perfusion, a technique known as myocardial contrast echocardiography (MCE). MCE exploits the ultrasonic properties of UCAs, which consist of acoustically active gas-filled microspheres. These are intravascular agents that have a rheology similar to red blood cells and thus allow analysis of myocardial blood flow both at rest and after stress. The combined assessment of wall motion and myocardial perfusion provides significant diagnostic and prognostic information during stress echocardiography. Functional imaging tests, such as myocardial perfusion scintigraphy and stress cardiac magnetic resonance imaging, are also used for non-invasive assessment of coronary disease. The principal advantages of MCE are that it does not expose the patient to ionising radiation or radioactive pharmaceuticals, is not contraindicated in patients with an implanted metallic device or who suffer from claustrophobia and it can be performed at the bedside. The purpose of this article is to outline the physiological principles underpinning ischaemia testing with MCE before proceeding to review the evidence base for MCE in patients with known or suspected coronary artery disease.

Transesophageal stress echocardiography: Detection of coronary artery disease in patients with normal resting left ventricular contractility

1991 ◽  
Vol 122 (5) ◽  
pp. 1456-1463 ◽  
Author(s):  
Miguel Zabalgoitia ◽  
Dipeshkumar K. Gandhi ◽  
Pierre Abi-Mansour ◽  
Paul R. Yarnold ◽  
Bassam Moushmoush ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Echocardiography ◽  
Left Ventricular ◽  
Ventricular Contractility ◽  
Left Ventricular Contractility ◽  
Artery Disease

scholarly journals Assessment of Myocardial Viability: A Review of Current Non Invasive Imaging Techniques

2015 ◽  
Vol 1 (3) ◽  
pp. 113 ◽  
Author(s):  
Ahmed Talib
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Ventricular Dysfunction ◽  
Imaging Techniques ◽  
Left Ventricular ◽  
Common Cause ◽  
Non Invasive ◽  
Artery Disease ◽  
Impaired Quality

Coronary artery disease (CAD) is the most prevalent and<br />single most common cause of morbidity and mortality1 with<br />the resulting left ventricular dysfunction (LVD) an important<br />complication2. Worldwide, CAD accounts for 5.7 million new<br />cases per year, of these 1.3 million in Europe alone3. In addition,<br />it imposes a substantial share of health service resources and<br />expenses, an impaired quality of life, disability and high social<br />cost3,4. Furthermore, LVD itself has been shown to be a powerful<br />determinant of survival2, 5.

Stress echocardiography: image acquisition and modalities

2016 ◽  
Author(s):  
Rosa Sicari ◽  
Edyta Płońska-Gościniak ◽  
Jorge Lowenstein
Keyword(s):  
Stress Echocardiography ◽  
Quantitative Methods ◽  
Wall Motion ◽  
Contrast Echocardiography ◽  
Image Interpretation ◽  
Three Dimensional ◽  
Visual Assessment ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Endocardial Border

Stress echocardiography has evolved over the last 30 years but image interpretation remains subjective and burdened by the operator’s experience. The objective operator-independent assessment of myocardial ischaemia during stress echocardiography remains a technological challenge. Still, adequate quality of two-dimensional images remains a prerequisite to successful quantitative analysis, even using Doppler and non-Doppler based techniques. No new technology has proved to have a higher diagnostic accuracy than conventional visual wall motion analysis. Tissue Doppler imaging and derivatives may reduce inter-observer variability, but still require a dedicated learning curve and special expertise. The development of contrast media in echocardiography has been slow. In the past decade, transpulmonary contrast agents have become commercially available for clinical use. The approved indication for the use of contrast echocardiography currently lies in improving endocardial border delineation in patients in whom adequate imaging is difficult or suboptimal. Real-time three-dimensional echocardiography is potentially useful but limited by low spatial and temporal resolution. It is possible that these technologies may serve as an adjunct to expert visual assessment of wall motion. At present, these quantitative methods require further validation and simplification of analysis techniques.

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