ABSTRACT
OBJECTIVE: To report our experience with the use of Levovist in echocardiographic studies. METHOD: We studied consecutively patients with suboptimal echocardiographic studies. A bolus of 4 gr @ 400 mg/ml was administered via antecubital vein and a second echocardiogram was performed during the ensuing minutes. RESULTS: Between June and July 1998 we studied 16 patients with suboptimal echocardiograms, seven males and nine females, ages 29-77. There were six patients with coronary artery disease (CAD), three with mitral regurgitation (MR), one with dynamic subaortic stenosis, five with right chambers dilatation and one with a left atrial tumor. No patient referred discomfort or had any complication-with Levovist. The mean time of the contrast effect was nine minutes. A better delineation of endocardial borders was observed this allowed better evaluation of wall motion and left ventricular function in patients with CAD. There was Doppler enhancement in patients with MR and subaortic stenosis facilitating its evaluation. We documented atrial septal defect non visualized previously in two of five patients with right chambers dilatation. There was a better delineation of the left atrial tumor. CONCLUSIONS: Levovist showed enhancement of all Doppler modalities and facilitated de evaluation of MR, left ventricular function, subaortic stenosis and a cardiac tumor. It was safe and well tolerated.
Subject(s)
Contrast Media , Echocardiography/methods , Heart Diseases/diagnostic imaging , Polysaccharides , Adult , Aged , Cardiomyopathy, Hypertrophic/diagnostic imaging , Echocardiography, Doppler, Color/methods , Evaluation Studies as Topic , Female , Heart Septal Defects, Atrial/diagnostic imaging , Humans , Male , Middle Aged , Mitral Valve Insufficiency/diagnostic imaging , Myocardial Ischemia/diagnostic imagingABSTRACT
In order to establish the sensitivity and specificity of transesophageal stress echocardiography with dobutamine (TEE-dobutamine) in the early detection of myocardial ischemia we studied 30 consecutive patients from the Coronary Care Unit (CCU) of the Hospital de Cardiología, Centro Médico Nacional Siglo XXI. The results were correlated with thallium-201-dipyridamole scintigraphy (TDS), and coronary angiography. Two groups were formed: Group I-20 patients, 18 females/2 males, aged 37-73 years (mean 55 years) within the first week of myocardial infarction and/or unstable angina; Group II-10 patients, five males/five females, aged 35-65 years (mean 48 years) with atypical chest pain but with high suspicion of CHD. All group I patients, and none of group II, had significant stenoses on coronary angiography. Twenty patients had a positive TDS (18 patients from group I and two from group II). Twenty one patients had a positive test with TEE-dobutamine, 20 from group I and one from group II, which yields a sensitivity of 100%, a specificity of 90%, positive predictive value of 95% and negative predictive value of 100%.
