J Cardiovasc Ultrasound.  2017 Mar;25(1):28-33. 10.4250/jcu.2017.25.1.28.

Impact of Contrast Echocardiography on Assessment of Ventricular Function and Clinical Diagnosis in Routine Clinical Echocardiography: Korean Multicenter Study

• Kim DY
• Choi JH
• Hong GR
• Rim SJ
• Kim JY
• Lee SC
• Sohn IS
• Chung WJ
• Seo HS
• Yoon SJ
• Cho KI
• Choi SW
• Lee KJ

• KMID: 2375294
• DOI: http://doi.org/10.4250/jcu.2017.25.1.28

Abstract

BACKGROUND
Fundamental echocardiography has some drawbacks in patients with difficult-to-image echocardiograms. The aim of this study is to evaluate impact of contrast echocardiography (CE) on ventricular function assessment and clinical diagnosis in routine clinical echocardiography.
METHODS
Two hundred sixty patients were prospectively enrolled over 3 years in 12 medical centers in Korea. General image quality, the number of distinguishable segments, ability to assess regional wall motion, left ventricular (LV) apex and right ventricle (RV) visualization, LV ejection fraction, changes in diagnostic or treatment plan were documented after echocardiography with and without ultrasound contrast agent.
RESULTS
Poor or uninterpretable general image was 31% before contrast use, and decreased to 2% (p<0.05) after contrast use. The average number of visualized LV segments was 9.53 before contrast use, and increased to 14.46 (p<0.001) after contrast use. The percentage of poor or not seen LV regional wall motion was decreased from 28.4% to 3.5% (p<0.001). The percentage of poor or not seen LV apex and RV was decreased from 49.4% to 2.4% (p<0.001), from 30.5% to 10.5% (p<0.001), respectively. Changes in diagnostic procedure and treatment plan after CE were 30% and 29.6%, respectively.
CONCLUSION
Compared to fundamental echocardiography, CE impacted LV function assessment and clinical decision making in Korean patients who undergo routine echocardiography.

Keyword

Contrast echocardiography; Multicenter study; Koreans

MeSH Terms

Asian Continental Ancestry Group
Clinical Decision-Making
Diagnosis*
Echocardiography*
Heart Ventricles
Humans
Korea
Prospective Studies
Ultrasonography
Ventricular Function*

Figure

• 

  Fig. 1 Effect of contrast echocardiography on general image quality. Image quality was significantly improved after contrast use (McNemar's test, p < 0.05).

• 

  Fig. 2 Effect of contrast echocardiography on left ventricular (LV) apex visualization. LV apex was revealed clearly after contrast use (p < 0.001).

• 

  Fig. 3 Impact of contrast echocardiography on treatment plan. Twenty-nine point six percent of subjects with contrast echocardiography have changed treatment plan.

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