Improved assessment of the left ventricular endocardial border by intravenous injection of a left heart contrast agent

PURPOSE: The purpose of this study was to find out whether intravenous injection of a phospholipid-based left heart echo contrast agent improves the delineation of the left ventricular endocardial border. The influence of echo contrast on the quantification of left ventricular volumes, ejection fraction, regional wall function and interobserver variability was also assessed. METHOD: Prospectively, the apical 4-chamber view was recorded in 20 adult patients before and after intravenous injection of the contrast agent. Left ventricular endocardial border resolution was assessed in 5 segments and left ventricular volumes, ejection fraction, regional wall motion and interobserver variability were measured. RESULTS: After contrast injection a diagnostically useful left ventricular opacification was present in 18 patients (90%) and an optimal opacification in 14 patients (70%). Without contrast 1.05 endocardial segments could be delineated at end diastole and 1.8 segments at end systole. After contrast injection 3.65 endocardial segments were recognizable at end diastole (p < 0.01), 2.5 segments at end systole (p < 0.02). Left heart contrast improves interobserver-variability of end diastolic volume (p < 0.006), end systolic volume (p < 0.004), ejection fraction (p < 0.0002) and regional wall motion assessment (p < 0.03). Side effects did not occur. CONCLUSIONS: The intravenous injection of the investigated phospholipid-based echo contrast agent improves left ventricular endocardial border delineation and reproducibility of left ventricular volumes, ejection fraction and regional wall motion assessment.