Efficacy of Doppler Contrast Enhancement to Evaluate the Pulmonary Vein Flow

ABSTRACT

BACKGROUND: Sometimes adequate pulmonary venous flow signal could not be obtained in transthoracic echocardiogram. It has been reported that contrast agent that has transpulmonary passage capability could be used in the enhancement of Doppler signal in the left side of the heart. We evaluated the Levovist(R)-enhanced pulmonary vein flow signals obtained by transthoracic echocardiogram and compared with those obtained by transesophageal echocardiogram. METHOD: Ten patients(male 8, female 10, mean age 46+/-11) with sinus rhythm who underwent transesophageal echocardiogram were enrolled. Spectral Doppler signal intensity(score; 0-5), systolic time velocity integral(Stvi), diastolic time velocity integral(Dtvi) of pulmonary vein flow before and after intravenous injection of the contrast were obtained and compared with those obtained by transesophageal echocardiogram. RESULTS: There was no serious side effect related to Levovist(R). Spectral Doppler signal intensity score of pulmonary vein flow with nonenhanced transthoracic echocardiogram was 2.1 / 5, and adequate Doppler signal could not be obtained in two patients. After contrast enhancement, Doppler signal intensity score rose up to 4.3 / 5 and adequate Doppler signal could be obtained in all patients. Time velocity integrals of systolic and diastolic pulmonary vein flow obtained by transthoracic echocardiogram correlated well with those obtained by transesophageal echocardiogram. CONCLUSION: Contrast enhancement of Doppler signal with the agent that has transpulmonary passage capability(Levovist(R)) is useful in the evaluation of pulmonary vein flow in patient whose transthoracic echocardiographic Doppler signal is inadequate.