For Left Ventricular Opacification and Endocardial Border Definition: is it Really Important Which Contrast Agent we Use, or is it the Imaging Modality we Choose?

Aims: The purpose of this study was to prospectively compare the effect of three imaging modalities (fundamental, harmonics, and power harmonics) on left ventricular opacification and endocardial border definition with two different echo agents, Optison and Albunex. Methods: A total of 84 patients who had suboptimal transthoracic images were studied with echo contrast agents Albunex (n=41) and Optison (n=43). Each contrast agent was examined with three different imaging modalities, fundamental, harmonics and power harmonics, respectively. Left ventricular opacification was obtained by videodensitometric analysis. Percentage of endocardial border visualization was determined by indexing circumference of visualized endocardium to total circumference. Variables were compared with respect to three imaging modalities between two different echo agents. Results: Higher videointensities and higher percentages of endocardial visualization were achieved with Optison compared to Albunex with fundamental and harmonics. However, there was no significant difference between Optison and Albunex with respect to LV opacification and border visualization by power harmonics. Conclusion: These results indicate that left ventricular opacification and endocardial border visualization is significantly improved by using power harmonic imaging as compared to harmonics or fundamental imaging following both echo contrast agents. Furthermore, although Optison is clearly superior to Albunex in opacifying left ventricle, power harmonic imaging compensates for the less robust agent. (Eur J Echocardiography 2001; 2: 154–162) 2001 The European Society of Cardiology