Dataset Information

Perflutren microspheres for contrast echocardiography in a bloody pericardiocentesis.

ABSTRACT: We report the cases of 2 patients who presented with clinical and echocardiographic evidence of cardiac tamponade. Therapeutic echocardiographic-guided pericardiocentesis yielded bloody fluid. In both patients, Definity perflutren lipid microspheres were used for echocardiographic contrast, which helped to assess the needle's location. To the best of our knowledge, this is the 1st reported use of perflutren microspheres for this purpose.

SUBMITTER: Escabi-Mendoza JE

PROVIDER: S-EPMC1524699 | biostudies-literature | 2006

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Perflutren microspheres for contrast echocardiography in a bloody pericardiocentesis.

Escabí-Mendoza José E JE Martínez-Díaz Jorge D JD Avilés-Rivera Eric D ED

Texas Heart Institute journal 20060101 2

We report the cases of 2 patients who presented with clinical and echocardiographic evidence of cardiac tamponade. Therapeutic echocardiographic-guided pericardiocentesis yielded bloody fluid. In both patients, Definity perflutren lipid microspheres were used for echocardiographic contrast, which helped to assess the needle's location. To the best of our knowledge, this is the 1st reported use of perflutren microspheres for this purpose. ...[more]

PMID: 16878630

Similar Datasets

Project description:KEY POINTS:Imaging techniques such as contrast echocardiography suggest that anatomical intra-pulmonary arteriovenous anastomoses (IPAVAs) are present at rest and are recruited to a greater extent in conditions such as exercise. IPAVAs have the potential to act as a shunt, although gas exchange methods have not demonstrated significant shunt in the normal lung. To evaluate this discrepancy, we compared anatomical shunt with 25-µm microspheres to contrast echocardiography, and gas exchange shunt measured by the multiple inert gas elimination technique (MIGET). Intra-pulmonary shunt measured by 25-µm microspheres was not significantly different from gas exchange shunt determined by MIGET, suggesting that MIGET does not underestimate the gas exchange consequences of anatomical shunt. A positive agitated saline contrast echocardiography score was associated with anatomical shunt measured by microspheres. Agitated saline contrast echocardiography had high sensitivity but low specificity to detect a ?1% anatomical shunt, frequently detecting small shunts inconsequential for gas exchange. ABSTRACT:The echocardiographic visualization of transpulmonary agitated saline microbubbles suggests that anatomical intra-pulmonary arteriovenous anastomoses are recruited during exercise, in hypoxia, and when cardiac output is increased pharmacologically. However, the multiple inert gas elimination technique (MIGET) shows insignificant right-to-left gas exchange shunt in normal humans and canines. To evaluate this discrepancy, we measured anatomical shunt with 25-µm microspheres and compared the results to contrast echocardiography and MIGET-determined gas exchange shunt in nine anaesthetized, ventilated canines. Data were acquired under the following conditions: (1) at baseline, (2) 2 µg kg-1 min-1 i.v. dopamine, (3) 10 µg kg-1 min-1 i.v. dobutamine, and (4) following creation of an intra-atrial shunt (in four animals). Right to left anatomical shunt was quantified by the number of 25-µm microspheres recovered in systemic arterial blood. Ventilation-perfusion mismatch and gas exchange shunt were quantified by MIGET and cardiac output by direct Fick. Left ventricular contrast scores were assessed by agitated saline bubble counts, and separately by appearance of 25-µm microspheres. Across all conditions, anatomical shunt measured by 25-µm microspheres was not different from gas exchange shunt measured by MIGET (microspheres: 2.3 ± 7.4%; MIGET: 2.6 ± 6.1%, P = 0.64). Saline contrast bubble score was associated with microsphere shunt (? = 0.60, P < 0.001). Agitated saline contrast score had high sensitivity (100%) to detect a ?1% shunt, but low specificity (22-48%). Gas exchange shunt by MIGET does not underestimate anatomical shunt measured using 25-µm microspheres. Contrast echocardiography is extremely sensitive, but not specific, often detecting small anatomical shunts which are inconsequential for gas exchange.

Project description:The small size of the mouse heart frequently imparts technical challenges when applying conventional in vivo imaging methods for assessing heart function. Here, we describe the use of high-frequency ultrasound imaging in conjunction with a size-tuned blood pool contrast agent for quantitatively assessing myocardial perfusion in living mice. A perflurocarbon microbubble formulation exhibiting a narrow size distribution was developed, and echogenicity was assessed at 18 MHz in vitro. Adult mice were subjected to permanent ligation of the left anterior descending artery. Ultrasound imaging was performed on day 7, and a cohort of intact mice was used as a control. Parasternal long-axis cine clips were acquired at 18 MHz before and after contrast administration. Reduced ejection fraction and increased end-systolic volume were observed in infarcted compared with control mice. In control animals, washin of the contrast agent was visible in all myocardial segments. Reduced contrast enhancement was observed in apical-posterolateral regions of all infarcted mice. A novel method for reslicing of the imaging data through the time domain provided a two-dimensional presentation of regional contrast agent washin, enabling convenient identification of locations exhibiting altered perfusion. Myocardial segments exhibiting diminished contractility were observed to have correspondingly low relative myocardial perfusion. The contrast agent formulation and methods demonstrated here provide the basis for simplifying routine in vivo estimation of infarct size in mice and may be particularly useful in longitudinal evaluation of revascularization interventions and assessment of peri-infarct ischemia. NEW & NOTEWORTHY Murine myocardial contrast echocardiography frequently suffers from poor sensitivity to contrast. Here, we formulated a novel size-tuned microbubble contrast agent and validated it for use with ultra-high-frequency ultrasound. A novel data method for evaluating myocardial perfusion based on reslicing the imaging data through the time domain is presented.

Dataset Information

Perflutren microspheres for contrast echocardiography in a bloody pericardiocentesis.

Publications

Perflutren microspheres for contrast echocardiography in a bloody pericardiocentesis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets