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An enhanced method for left ventricular volume and ejection fraction by triggered harmonic contrast echocardiography

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Abstract

To elucidate the validity and reproducibility of the use of intravenous echo-contrast agent in the evaluation of left ventricular (LV) performance, we measured LV volume and ejection fraction (EF) in 42 patients with triggered harmonic contrast imaging (THCI), compared with continuous harmonic imaging without contrast agent (CHI) and with cineventriculography (CVG). In 10 of 42 patients, THCI improved LV border delineation which could not be obtained even with CHI. LV end-diastolic, end-systolic volumes and EF by both CHI and THCI correlated well with those by CVG. Although LV volumes are underestimated, THCI lessened the mean differences to about in half, compared with CHI. The observer variabilities obtained using THCI were smaller than those by CHI. These results indicate the validity of LV enhancement and the measurement of EF using THCI. We suggest that this method noninvasively provides more accurate LV systolic function with the acceptable reproducibility.

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References

  1. Schiller NB, Acquatella H, Ports TA, et al. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 1979; 60: 547-555.

    Google Scholar 

  2. Folland ED, Parisi AF, Moynihan PF, Jones DR, Feldman CL, Tow DE. Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography: a comparison of cineangiographic and radionuclide techniques. Circulation 1979; 60: 760-766.

    Google Scholar 

  3. Jenni R, Vieli A, Hess O, Anliker M, Krayenbuehl HP. Estimation of left ventricular volume from apical orthogonal 2-D echocardiograms. Eur Heart J 1981; 2: 217-225.

    Google Scholar 

  4. Kan G, Visser CA, Lie KI, Durrer D. Left ventricular volumes and ejection fraction by single plane two-dimensional apex echocardiography. Eur Heart J 1981; 2: 339-343.

    Google Scholar 

  5. Starling MR, Crawford MH, Sorensen SG, Levi B, Richards KL, O'Rourke RA. Comparative accuracy of apical biplane cross-sectional echocardiography and gated equilibrium radionuclide angiography for estimating left ventricular size and performance. Circulation 1981; 63: 1075-1084.

    Google Scholar 

  6. Tsujita-Kuroda Y, Zhang G, Sumita Y, et al. Validity and reproducibility of echocardiographic measurement of left ventricular ejection fraction by acoustic quantification with tissue harmonic imaging technique. J Am Soc Echocardiogr 2000; 13: 300-305.

    Google Scholar 

  7. Erbel R, Schweizer P, Lambertz H, et al. Echoventriculography — a simultaneous analysis of two-dimensional echocardiography and cineventriculography. Circulation 1983; 67: 205-215.

    Google Scholar 

  8. Van Reet RE, Quinones MA, Poliner LR, et al. Comparison of two-dimensional echocardiography with gated radionuclide ventriculography in the evaluation of global and regional left ventricular function in acute myocardial infarction. J Am Coll Cardiol 1984; 3: 243-252.

    Google Scholar 

  9. Freeman AP, Giles RW, Walsh WF, Fisher R, Murray IP, Wilcken DE. Regional left ventricular wall motion assessment: comparison of two-dimensional echocardiography and radionuclide angiography with contrast angiography in healed myocardial infarction. Am J Cardiol 1985; 56: 8-12.

    Google Scholar 

  10. Erbel R, Schweizer P, Meyer J, Krebs W, Yalkinoglu O, Effert S. Sensitivity of cross-sectional echocardiography in detection of impaired global and regional left ventricular function: prospective study. Int J Cardiol 1985; 7: 375-389.

    Google Scholar 

  11. Spencer KT, Bednarz J, Rafter PG, Korcarz C, Lang RM. Use of harmonic imaging without echocardiographic contrast to improve two-dimensional image quality. Am J Cardiol 1998; 82: 794-799.

    Google Scholar 

  12. Kornbluth M, Liang DH, Paloma A, Schnittger I. Native tissue harmonic imaging improves endocardial border definition and visualization of cardiac structures. J Am Soc Echocardiogr 1998; 11: 693-701.

    Google Scholar 

  13. Kasprzak JD, Paelinck B, Ten Cate FJ, et al. Comparison of native and contrast-enhanced harmonic echocardiography for visualization of left ventricular endocardial border. Am J Cardiol 1999; 83: 211-217.

    Google Scholar 

  14. Schroder K, Agrawal R, Voller H, Schlief R, Schroder R. Improvement of endocardial border delineation in suboptimal stress-echocardiograms using the new left heart contrast agent SH U 508 A. Int J Card Imaging 1994; 10: 45-51.

    Google Scholar 

  15. Lindner JR, Dent JM, Moos SP, Jayaweera AR, Kaul S. Enhancement of left ventricular cavity opacification by harmonic imaging after venous injection of Albunex. Am J Cardiol 1997; 79: 1657-1662.

    Google Scholar 

  16. Crouse LJ, Cheirif J, Hanly DE, et al. Opacification and border delineation improvement in patients with suboptimal endocardial border definition in routine echocardiography: results of the Phase III Albunex Multicenter Trial. J Am Coll Cardiol 1993; 22: 1494-1500.

    Google Scholar 

  17. Falcone RA, Marcovitz PA, Perez JE, Dittrich HC, Hopkins WE, Armstrong WF. Intravenous albunex during dobutamine stress echocardiography: enhanced localization of left ventricular endocardial borders. Am Heart J 1995; 130: 254-258.

    Google Scholar 

  18. Zotz RJ, Genth S, Waaler A, Erbel R, Meyer J. Left ventricular volume determination using Albunex. J Am Soc Echocardiogr 1996; 9: 1-8.

    Google Scholar 

  19. Wei K, Skyba DM, Firschke C, Jayaweera AR, Lindner JR, Kaul S. Interactions between microbubbles and ultrasound: in vitro and in vivo observations. J Am Coll Cardiol 1997; 29: 1081-1088.

    Google Scholar 

  20. Porter TR, Xie F. Transient myocardial contrast after initial exposure to diagnostic ultrasound pressures with minute doses of intravenously injected microbubbles. Demonstration and potential mechanisms. Circulation 1995; 92: 2391-2395.

    Google Scholar 

  21. Porter TR, Xie F, Kricsfeld D, Armbruster RW. Improved myocardial contrast with second harmonic transient ultrasound response imaging in humans using intravenous perfluorocarbon-exposed sonicated dextrose albumin. J Am Coll Cardiol 1996; 27: 1497-1501.

    Google Scholar 

  22. Wyatt HL, Haendchen RV, Meerbaum S, Corday E. Assessment of quantitative methods for 2-dimensional echocardiography. Am J Cardiol 1983; 52: 396-401.

    Google Scholar 

  23. Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989; 2: 358-367.

    Google Scholar 

  24. Bland JM, Altman DG. Comparing methods of measurement: why plotting difference against standard method is misleading. Lancet 1995; 346: 1085-1087.

    Google Scholar 

  25. Schiller NB, Acquatella H, Ports TA, et al. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 1979; 60: 547-555.

    Google Scholar 

  26. Carr KW, Engler RL, Forsythe JR, Johnson AD, Gosink B. Measurement of left ventricular ejection fraction by mechanical cross-sectional echocardiography. Circulation 1979; 59: 1196-1206.

    Google Scholar 

  27. Vandenbossche JL, Kramer BL, Massie BM, Morris DL, Karliner JS. Two-dimensional echocardiographic evaluation of the size, function and shape of the left ventricle in chronic aortic regurgitation: comparison with radionuclide angiography. J Am Coll Cardiol 1984; 4: 1195-1206.

    Google Scholar 

  28. Mercier JC, DiSessa TG, Jarmakani JM, et al. Two-dimensional echocardiographic assessment of left ventricular volumes and ejection fraction in children. Circulation 1982; 65: 962-996.

    Google Scholar 

  29. Albin G, Rahko PS. Comparison of echocardiographic quantitation of left ventricular ejection fraction to radionuclide angiography in patients with regional wall motion abnormalities. Am J Cardiol 1990; 65: 1031-1032.

    Google Scholar 

  30. Porter TR, Xie F, Kricsfeld A, Chiou A, Dabestani A. Improved endocardial border resolution during dobutamine stress echocardiography with intravenous sonicated dextrose albumin. J Am Coll Cardiol 1994; 23: 1440-1443.

    Google Scholar 

  31. Hundley WG, Kizilbash AM, Afridi I, Franco F, Peshock RM, Grayburn PA. Administration of an intravenous perfluorocarbon contrast agent improves echocardiographic determination of left ventricular volumes and ejection fraction: comparison with cine magnetic resonance imaging. J Am Coll Cardiol 1998; 32: 1426-1432.

    Google Scholar 

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Hirooka, K., Yasumura, Y., Tsujita, Y. et al. An enhanced method for left ventricular volume and ejection fraction by triggered harmonic contrast echocardiography. Int J Cardiovasc Imaging 17, 253–261 (2001). https://doi.org/10.1023/A:1011607012559

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