REDUCED FORWARD OUTPUT STATES AFFECT THE LEFT-VENTRICULAR OPACIFICATION OF INTRAVENOUSLY ADMINISTERED ALBUNEX

Albunex is an Food and Drug Administration-approved ultrasound contras t agent used for the enhancement of left ventricular endocardial borde rs. To determine the efficacy of intravenously administered Albunex wi th regard to left ventricular opacification (LVO), a retrospective ana lysis of 117 patients who received 202 injections of Albunex for enhan cement of endocardial borders was done (dose 0.08 to 0.22 ml/kg). Pati ents were routinely referred to our echocardiography laboratory for st ress echocardiography for standard indications. Optimized settings for contrast enhancement (3.5 MHz transducer frequency and maximum dynami c range) were used. Four observers graded LVO on a scale from 0 to 3 ( 0 = no Albunex seen in the ventricular cavity; 3 = Albunex densely see n in the ventricular cavity). Overall, LVO was reported in 166 (82%) o f 202 injections or in 91 (78%) of 117 patients. A significant reducti on in LVO was noted in patients with mitral regurgitation, tricuspid r egurgitation, atrial fibrillation, systolic dysfunction, or pulmonary hypertension (increased pulmonary artery systemic pressure). LVO was s een in 88% of the patients without these conditions. However, only 12 (44%) of 27 patients with one or more of the above conditions had LVO (p < 0.05). LVO can be achieved in the majority of patients after intr avenously administered Albunex when imaged with optimal transducer set tings. A subset of patients with systolic dysfunction, mitral regurgit ation, tricuspid regurgitation, atrial fi brillation, or increased pul monary artery systemic pressure has less effective LVO with Albunex. H eart disease associated with decreased forward how appears to be assoc iated with diminished LVO.