Safety and Feasibility of Real Time Adenosine Myocardial Contrast Echocardiography with Emphasis on Induction of Arrhythmias: A Study in Healthy Volunteers and Patients with Stable Coronary Artery Disease

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 26; no. 7; pp. 807 - 814
• Main Authors: Dijkmans, P. A., Juffermans, L. J. M., Van Dijk, J., Musters, R. J. P., Spreeuwenberg, , Kamp, O.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.08.2009
• Subjects: Adenosine; Adult; Computer Systems; contrast echocardiography; Contrast Media; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Echocardiography - adverse effects; Exercise Test; Female; Humans; Male; Middle Aged; Phospholipids; premature ventricular complexes; real time perfusion imaging; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; stress echocardiography; Sulfur Hexafluoride; Vasodilator Agents; Ventricular Premature Complexes - diagnosis; Ventricular Premature Complexes - etiology
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/j.1540-8175.2008.00890.x

Introduction: Some studies reported an increased incidence of premature ventricular complexes (PVCs) during triggered myocardial contrast echocardiography (MCE) using high‐intensity ultrasound destruction. Whether PVCs are also induced by real time MCE using low emission power, is unknown. The aim of the study was to assess the occurrence of arrhythmias during real time adenosine MCE in healthy volunteers and patients with stable coronary artery disease (CAD). Methods: Fifty healthy volunteers and 26 patients with stable CAD underwent real time MCE using Sonovue and power pulse inversion (ATL 5000) at rest and during adenosine stress. The occurrence of premature atrial complexes (PAC) and PVCs was analyzed before and during MCE using ECG‐tracings from videotapes. Results: In healthy subjects, the occurrence of PVCs at baseline (0.04 ± 0.23 PVCs/min) was similar at rest (0.04 ± 0.23 PVCs/min, P = NS), and adenosine stress (0.03 ± 0.14, P = NS). In CAD patients, the occurrence of PVCs at baseline was 0.30 ± 0.76 PVC/min, compared to 0.29 ± 0.74 at rest (P = NS), and 0.34 ± 0.74 during adenosine stress (P = NS). The number of subjects demonstrating PVCs did not increase during MCE. The occurrence of PACs during MCE was not increased compared to baseline. Conclusion: Real time MCE using low emission power does not increase the occurrence of premature complexes in healthy volunteers or CAD patients.