Enhancement of mitral regurgitation and normal left atrial color Doppler flow signals with peripheral venous injection of a saccharide-based contrast agent
Objectives. The saccharide ultrasound contrast agent SHU 508 A was used to test the hypothesis that an intravenous, transpulmonary contrast method can enhance color Doppler flow signals in the left atrium in a clinically useful manner. Background. Color Doppler display of mitral regurgiation may be...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1993-08, Vol.22 (2), p.521-528 |
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| creator | Von Bibra, Hellen Becher, Harald Firschke, Christian Schlief, Reinhard Peter Emslander, Hans Schömig, Albert |
| description | Objectives. The saccharide ultrasound contrast agent SHU 508 A was used to test the hypothesis that an intravenous, transpulmonary contrast method can enhance color Doppler flow signals in the left atrium in a clinically useful manner.
Background. Color Doppler display of mitral regurgiation may be unreliable because of variable signal to noise ratios that are at times poor. Traditional contrast agents enhance color Doppler flow signals in the right heart chambers. This study describes our observation of a recently developed contrast agent, SHU 508 A, capable of pulmonary transit after peripheral venous injection.
Methods. Control subjects (n = 10) and patients with suspected mitral regurgitation (n = 23) were studied by color Doppler flow imaging before and after 3-g intravenous doses of SHU 508 A. Reference grading of mitral regurgitation (0 to 3) was formulated from left ventricular angiography. In the four-chamber view of the left atrium, we selected for analysis the systolic frame with the maximal retrograde jet of mitral regurgitation (aliased/blue) and the diastolic frame with the maximal color coding from anterograde pulmonary venous flow (red) for planimetry and for grading the intensity of the color Doppler signal (0 to 5).
Results. The score of the color Doppler signal intensity increased by ≥2.5 after 3 g of SHU 508 A (p < 0.001). Flow detection improved, as shown by the increased jet area of mitral regurgitation (≥170%), after 3 g of SHU 508 A (3 ± 3 vs. 12 ± 8 cm2, p < 0.001) and by a ≥200% increase in normal anterograde flow area (p < 0.001) in both the mitral regurgitation group and the control group. After contrsast enhancement, the correlation between angiography grading and the relation of jet area to the left atrial area increased from r = 0.79 to r = 0.91.
Conclusions. Contrast-mediated incresed echogenicity of the left atrial blood pool improves the signals to noise ratio of Doppler images of mitral regurgitation and anterograde atrial flow. The technique is safe and simple and seems to minimize variability due to instrument design and anatomic signals attenuation. |
| doi_str_mv | 10.1016/0735-1097(93)90059-A |
| format | Article |
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Background. Color Doppler display of mitral regurgiation may be unreliable because of variable signal to noise ratios that are at times poor. Traditional contrast agents enhance color Doppler flow signals in the right heart chambers. This study describes our observation of a recently developed contrast agent, SHU 508 A, capable of pulmonary transit after peripheral venous injection.
Methods. Control subjects (n = 10) and patients with suspected mitral regurgitation (n = 23) were studied by color Doppler flow imaging before and after 3-g intravenous doses of SHU 508 A. Reference grading of mitral regurgitation (0 to 3) was formulated from left ventricular angiography. In the four-chamber view of the left atrium, we selected for analysis the systolic frame with the maximal retrograde jet of mitral regurgitation (aliased/blue) and the diastolic frame with the maximal color coding from anterograde pulmonary venous flow (red) for planimetry and for grading the intensity of the color Doppler signal (0 to 5).
Results. The score of the color Doppler signal intensity increased by ≥2.5 after 3 g of SHU 508 A (p < 0.001). Flow detection improved, as shown by the increased jet area of mitral regurgitation (≥170%), after 3 g of SHU 508 A (3 ± 3 vs. 12 ± 8 cm2, p < 0.001) and by a ≥200% increase in normal anterograde flow area (p < 0.001) in both the mitral regurgitation group and the control group. After contrsast enhancement, the correlation between angiography grading and the relation of jet area to the left atrial area increased from r = 0.79 to r = 0.91.
Conclusions. Contrast-mediated incresed echogenicity of the left atrial blood pool improves the signals to noise ratio of Doppler images of mitral regurgitation and anterograde atrial flow. The technique is safe and simple and seems to minimize variability due to instrument design and anatomic signals attenuation.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(93)90059-A</identifier><identifier>PMID: 8335824</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Atrial Function, Left ; Biological and medical sciences ; Blood Flow Velocity ; Cardiovascular system ; Case-Control Studies ; Contrast Media - administration & dosage ; Echocardiography, Doppler - methods ; Evaluation Studies as Topic ; Female ; Humans ; Image Enhancement - methods ; Injections, Intravenous ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - physiopathology ; Polysaccharides - administration & dosage ; Ultrasonic investigative techniques</subject><ispartof>Journal of the American College of Cardiology, 1993-08, Vol.22 (2), p.521-528</ispartof><rights>1993</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-9c7cd0193fcdc769160191329d1f9672fbfaac416fabb5ca5b65ebb65163a0423</citedby><cites>FETCH-LOGICAL-c432t-9c7cd0193fcdc769160191329d1f9672fbfaac416fabb5ca5b65ebb65163a0423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(93)90059-A$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4852157$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8335824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Von Bibra, Hellen</creatorcontrib><creatorcontrib>Becher, Harald</creatorcontrib><creatorcontrib>Firschke, Christian</creatorcontrib><creatorcontrib>Schlief, Reinhard</creatorcontrib><creatorcontrib>Peter Emslander, Hans</creatorcontrib><creatorcontrib>Schömig, Albert</creatorcontrib><title>Enhancement of mitral regurgitation and normal left atrial color Doppler flow signals with peripheral venous injection of a saccharide-based contrast agent</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. The saccharide ultrasound contrast agent SHU 508 A was used to test the hypothesis that an intravenous, transpulmonary contrast method can enhance color Doppler flow signals in the left atrium in a clinically useful manner.
Background. Color Doppler display of mitral regurgiation may be unreliable because of variable signal to noise ratios that are at times poor. Traditional contrast agents enhance color Doppler flow signals in the right heart chambers. This study describes our observation of a recently developed contrast agent, SHU 508 A, capable of pulmonary transit after peripheral venous injection.
Methods. Control subjects (n = 10) and patients with suspected mitral regurgitation (n = 23) were studied by color Doppler flow imaging before and after 3-g intravenous doses of SHU 508 A. Reference grading of mitral regurgitation (0 to 3) was formulated from left ventricular angiography. In the four-chamber view of the left atrium, we selected for analysis the systolic frame with the maximal retrograde jet of mitral regurgitation (aliased/blue) and the diastolic frame with the maximal color coding from anterograde pulmonary venous flow (red) for planimetry and for grading the intensity of the color Doppler signal (0 to 5).
Results. The score of the color Doppler signal intensity increased by ≥2.5 after 3 g of SHU 508 A (p < 0.001). Flow detection improved, as shown by the increased jet area of mitral regurgitation (≥170%), after 3 g of SHU 508 A (3 ± 3 vs. 12 ± 8 cm2, p < 0.001) and by a ≥200% increase in normal anterograde flow area (p < 0.001) in both the mitral regurgitation group and the control group. After contrsast enhancement, the correlation between angiography grading and the relation of jet area to the left atrial area increased from r = 0.79 to r = 0.91.
Conclusions. Contrast-mediated incresed echogenicity of the left atrial blood pool improves the signals to noise ratio of Doppler images of mitral regurgitation and anterograde atrial flow. The technique is safe and simple and seems to minimize variability due to instrument design and anatomic signals attenuation.</description><subject>Adult</subject><subject>Aged</subject><subject>Atrial Function, Left</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Cardiovascular system</subject><subject>Case-Control Studies</subject><subject>Contrast Media - administration & dosage</subject><subject>Echocardiography, Doppler - methods</subject><subject>Evaluation Studies as Topic</subject><subject>Female</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Injections, Intravenous</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - physiopathology</subject><subject>Polysaccharides - administration & dosage</subject><subject>Ultrasonic investigative techniques</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAUtBCoLIV_AJIPCJVDwI7jJL5UWrWlIFXiAmfrxXnedZXYwfa26m_hz-LtrvbIxR-aeTNPM4S85-wLZ7z9yjohK85Ud6HEZ8WYVNX6BVlxKftKSNW9JKsT5TV5k9I9Y6ztuTojZ70Qsq-bFfl747fgDc7oMw2Wzi5HmGjEzS5uXIbsgqfgR-pDnAswoc0UcnTlbcIUIr0OyzJhpHYKjzS5jYcp0UeXt3TB6JYt7vUe0Iddos7fo3mWLFZAExizhehGrAZIOBZFX-xTcdiUfd6SV7aI4bvjfU5-f7v5dfW9uvt5--NqfVeZRtS5UqYzI-NKWDOarlW8LR8uajVyq9qutoMFMA1vLQyDNCCHVuJQDt4KYE0tzsmng-4Sw58dpqxnlwxOE3gsW-tO9k0nm74QmwPRxJBSRKuX6GaIT5ozve9E7wPX-8C1Evq5E70uYx-O-rthxvE0dCyh4B-POCQDk42lEJdOtKaXNZddoV0eaFiyeHAYdTIOS3ejiyVVPQb3_z3-AfWDrA8</recordid><startdate>19930801</startdate><enddate>19930801</enddate><creator>Von Bibra, Hellen</creator><creator>Becher, Harald</creator><creator>Firschke, Christian</creator><creator>Schlief, Reinhard</creator><creator>Peter Emslander, Hans</creator><creator>Schömig, Albert</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19930801</creationdate><title>Enhancement of mitral regurgitation and normal left atrial color Doppler flow signals with peripheral venous injection of a saccharide-based contrast agent</title><author>Von Bibra, Hellen ; Becher, Harald ; Firschke, Christian ; Schlief, Reinhard ; Peter Emslander, Hans ; Schömig, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-9c7cd0193fcdc769160191329d1f9672fbfaac416fabb5ca5b65ebb65163a0423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Atrial Function, Left</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Cardiovascular system</topic><topic>Case-Control Studies</topic><topic>Contrast Media - administration & dosage</topic><topic>Echocardiography, Doppler - methods</topic><topic>Evaluation Studies as Topic</topic><topic>Female</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Injections, Intravenous</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve Insufficiency - diagnostic imaging</topic><topic>Mitral Valve Insufficiency - physiopathology</topic><topic>Polysaccharides - administration & dosage</topic><topic>Ultrasonic investigative techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Von Bibra, Hellen</creatorcontrib><creatorcontrib>Becher, Harald</creatorcontrib><creatorcontrib>Firschke, Christian</creatorcontrib><creatorcontrib>Schlief, Reinhard</creatorcontrib><creatorcontrib>Peter Emslander, Hans</creatorcontrib><creatorcontrib>Schömig, Albert</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Von Bibra, Hellen</au><au>Becher, Harald</au><au>Firschke, Christian</au><au>Schlief, Reinhard</au><au>Peter Emslander, Hans</au><au>Schömig, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhancement of mitral regurgitation and normal left atrial color Doppler flow signals with peripheral venous injection of a saccharide-based contrast agent</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1993-08-01</date><risdate>1993</risdate><volume>22</volume><issue>2</issue><spage>521</spage><epage>528</epage><pages>521-528</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. The saccharide ultrasound contrast agent SHU 508 A was used to test the hypothesis that an intravenous, transpulmonary contrast method can enhance color Doppler flow signals in the left atrium in a clinically useful manner.
Background. Color Doppler display of mitral regurgiation may be unreliable because of variable signal to noise ratios that are at times poor. Traditional contrast agents enhance color Doppler flow signals in the right heart chambers. This study describes our observation of a recently developed contrast agent, SHU 508 A, capable of pulmonary transit after peripheral venous injection.
Methods. Control subjects (n = 10) and patients with suspected mitral regurgitation (n = 23) were studied by color Doppler flow imaging before and after 3-g intravenous doses of SHU 508 A. Reference grading of mitral regurgitation (0 to 3) was formulated from left ventricular angiography. In the four-chamber view of the left atrium, we selected for analysis the systolic frame with the maximal retrograde jet of mitral regurgitation (aliased/blue) and the diastolic frame with the maximal color coding from anterograde pulmonary venous flow (red) for planimetry and for grading the intensity of the color Doppler signal (0 to 5).
Results. The score of the color Doppler signal intensity increased by ≥2.5 after 3 g of SHU 508 A (p < 0.001). Flow detection improved, as shown by the increased jet area of mitral regurgitation (≥170%), after 3 g of SHU 508 A (3 ± 3 vs. 12 ± 8 cm2, p < 0.001) and by a ≥200% increase in normal anterograde flow area (p < 0.001) in both the mitral regurgitation group and the control group. After contrsast enhancement, the correlation between angiography grading and the relation of jet area to the left atrial area increased from r = 0.79 to r = 0.91.
Conclusions. Contrast-mediated incresed echogenicity of the left atrial blood pool improves the signals to noise ratio of Doppler images of mitral regurgitation and anterograde atrial flow. The technique is safe and simple and seems to minimize variability due to instrument design and anatomic signals attenuation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8335824</pmid><doi>10.1016/0735-1097(93)90059-A</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Atrial Function, Left Biological and medical sciences Blood Flow Velocity Cardiovascular system Case-Control Studies Contrast Media - administration & dosage Echocardiography, Doppler - methods Evaluation Studies as Topic Female Humans Image Enhancement - methods Injections, Intravenous Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - physiopathology Polysaccharides - administration & dosage Ultrasonic investigative techniques |
| title | Enhancement of mitral regurgitation and normal left atrial color Doppler flow signals with peripheral venous injection of a saccharide-based contrast agent |
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