Abstract
s S191 Eur J Echocardiography Abstracts Supplement, December 2006 1099 Contrast echocardiography reduces the interobserver variability in measurements of ejection fraction:observations from the PREMIER study K.C. Kassimatis 1 ; N.L. Greenberg 1 ; M. Martin-Miklovic 1 ; M.M. Park 1 ; A.J. Morehead 1 ; M.P. Hudson 2 ; M.J. Garcia 2 ; W. Jaber 2 on behalf of: PREMIER Study 1The Cleveland Clinic Foundation, Cardiovascular Medicine Dept., Cleveland, United States of America; 2Henry Ford Hospital, Cardiovascular Medicine Dept., Detroit, United States of America Contrast Echocardiography is used for endocardial border definition. Rigorous evaluation of its impact on left ventricular volume (ESV, EDV) and ejection fraction (EF) measurements are lacking. We sought to determine the incremental value of using contrast echocardiography in comparison to non-contrast enhanced echocardiography in the setting of a controlled clinical trial. Methods: The multicenter international PREMIER trial (253 patients) used echocardiographis parameters as an endpoint to evaluate the impact of PG116800 (MMP inhibitor) in the treatment of post myocardial infarction patients. 48 pairs echocardiograms (contrast and non-contrast) were done at pre-specified times and used by the echo core laboratory for evaluation of interobserver variability in the quantitative measurement of ESV, EDV and EF. Both OPTISON® and DEFINITY® were used as conttrast agenst in this study. Each Echocardiogram was blindly reviewed and analyzed by two physician/ sonographer teams. Stdent t-test was used to detect significant differences in the absolute errors using the two echocardiographic methods. Results: See table. Conclusion: Contrast echocariography improves the interobserver variability in the evaluation of EF even when a standardized echo lab is used. A significant interobserver variability reduction was not seen for errors in measurements of ESV and EDV. When EF is used as an endpoint, this advantage of contrast echocardiography may be used to reduce the sample size needed in a clinical trial to observe true differences in outcomes. Table 1. Percentage Error
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