Conventional Two-Dimensional Echocardiography Versus Contrast Echocardiography in the Assessment of Left Ventricular Volumes and Function in Patients with Poor Acoustic Window

Abstract

Aim: To compare the number of left ventricular (LV) segments visualized, detection of regional wall motion, and LV volumes and function with conventional two-dimensional echocardiography versus that with contrast echocardiography in patients with poor acoustic windows. Materials and Methods: This was a prospective study done over a duration of 1 year, on 50 consenting patients with poor echocardiographic image quality. Basic information and baseline echocardiograms were recorded. SonoVue contrast was administered intravenously as per a preset protocol through a peripheral line, and LV endocardial border delineation was recorded in various comparable views. Results: There was a significant change in the quality of the echocardiographic images postcontrast enhancement, with no study images remaining uninterpretable and only 16% remaining technically difficult. The remaining studies became adequate in terms of endocardial border delineation. Myocardial segment visualization changed significantly after contrast, with the number of well-visualized segments per patient improving from 10.66 before contrast to 16.26 after contrast, on average. There was a significant change in the estimation of LV volumes after contrast administration. The biplane ejection fraction was also significantly different after contrast. The study detected new regional wall motion abnormalities in 10 (20%) patients out of the total 50. There was only one case of an adverse event in terms of three isolated ventricular premature complexes in one of the patients after contrast administration. Conclusion: Contrast echo appears to be an easy, safe, and reliable investigation in patients with poor echo windows. Our study shows that endocardial border delineation is best with contrast enhancement, which improves physician's confidence and hence can impact the overall diagnosis, management, and prognosis of patients based on the better and reliable echo findings.