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SHU 508 A (Levovist)‐Enhanced Doppler Echocardiography Improves the Assessment of Valvular Heart Disease
Author(s) -
Lepper Wolfgang,
Franke Andreas,
Von Bibra Helene,
Becher Harald,
Holz Kerstin,
Näbauer M.,
Vered Zvi,
Hoffmann Rainer,
Flachskampf Frank A.,
Hanrath Peter
Publication year - 2001
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1046/j.1540-8175.2001.00363.x
Subject(s) - medicine , cardiology , stenosis , mitral regurgitation , doppler echocardiography , radiology , cardiac catheterization , grading (engineering) , regurgitation (circulation) , doppler effect , valvular heart disease , diastole , blood pressure , civil engineering , physics , astronomy , engineering
Objective: To investigate whether intravenous injection of SHU 508 A improves the diagnostic accuracy of Doppler echocardiography in the assessment of valvular pathologies. Methods and Results: One hundred and twenty‐five consecutive patients with valvular pathology (aortic stenosis, n = 48 ; aortic regurgitation, n = 20 ; mitral stenosis, n = 21 ; and mitral regurgitation, n = 36 ) and diagnostically insufficient Doppler signal were enrolled in this multicenter study. The severity of valvular pathology was graded on a four‐point scale using unenhanced and contrast‐enhanced Doppler echocardiography as well as cardiac catheterization. Agreement with cardiac catheterization findings increased from 63% using the unenhanced examination to 73% using the contrast‐enhanced Doppler examination. Grading was possible in all patients using SHU 508 A, whereas the unenhanced Doppler examination remained inconclusive in six patients. The weighted kappa coefficient between contrast‐enhanced Doppler and cardiac catheterization for all diagnoses was 0.76 as compared to 0.68 between unenhanced Doppler and cardiac catheterization. Agreement was especially improved in aortic stenosis (kappa 0.69 unenhanced vs 0.81 contrast‐enhanced) and in aortic regurgitation (kappa 0.45 unenhanced vs 0.75 contrast‐enhanced). Patients with mitral stenosis and mitral regurgitation experienced less improvement. Conclusions: In case of an inconclusive unenhanced Doppler echo study, the administration of a left heart contrast agent should be considered. SHU 508 A is especially useful in improving the severity grading of aortic stenosis and aortic regurgitation, while grading of mitral stenosis and mitral regurgitation is less improved.