336 Efficacy With Use of Ultrasound Enhancing Agents at the Townsville Hospital

Abstract

The use of Ultrasound Enhancing Agents (UEAs) has become an integral part in Echocardiography. The Cardiac Investigation Unit (CIU) at the Townsville Hospital uses Definity. The indications are left ventricular (LV) opacification and delineation of LV endocardial border but off-label clinical applications are very useful in clinical echocardiography. The only contraindication is hypersensitivity to perflutren. Aim of our study is to demonstrate the indications, effectiveness and influence on clinical decision making using UEAs in echocardiography. This is an audit of UEA use in echocardiograms done in CIU during 2017. 202 echocardiograms were examined. The demographics revealed 73% of the patients were male; median age was 62. Transthoracic echocardiograms were majority (79%), with stress-echocardiogram (20%) and trans-oesophageal echocardiogram (1%). 46% were outpatients and the rest were inpatients [CCU (24%), Wards (10%), and ICU (2%)]. Indications were enhancement of endocardial definition (80%), quantification of LV ejection fraction and LV volumes (59%), assessment of LV apex (24%), exclusion of intra-cardiac masses (12%), and Doppler enhancement (2.5%). The success rates were 95%, 96%, 98%, 90% and 69% respectively. Clinical implications showed no change in management (79%), medication change (9%), procedural change (7%), changes in both (2%) and inadequate imaging (3%). Only one patient had complication as back pain. Use of UEAs in our Echo Lab has shown to be very effective in multiple clinical applications, avoiding other down-stream investigations without causing major complications. It also helps in clinical decision making leading to changes in management in 18% of the cases.