CUTE-CV: A Prospective Study of Enhanced Left Atrial Appendage Visualization with Microbubble Contrast Agent Use during Transesophageal Echocardiography Guided Cardioversion
CUTE-CV: A Prospective Study of Enhanced Left Atrial Appendage Visualization with Microbubble Contrast Agent Use during Transesophageal Echocardiography Guided Cardioversion
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DOI：
10.1111/echo.12240
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发表时间：
2013-10-01
影响因子：
1.5
通讯作者：
Mulvagh, Sharon L.
中科院分区：
文献类型：
--
作者：
Bernier, Mathieu;Abdelmoneim, Sahar S.;Mulvagh, Sharon L.
ObjectivesThe的目的，我们的研究是要证明，使用造影剂微泡在经食管超声心动图（TEE）引导的心脏复律将改善解释的TEE images.BackgroundTEE引导的心房扑动或颤动（AF）的心脏复律是一种安全和行之有效的方法来恢复窦性心律。然而，在左心耳（LAA）的伪影和密集的自发回声对比有时可以降低排除血栓的存在的置信水平。MethodsOne百例被称为TEE引导心脏复律的患者进行了前瞻性招募和微泡造影剂（DEFINITY）后，已作出关于心脏复律的适用性的临床决定。在随后的离线analysis.ResultsLAA尺寸和收缩指数较高，伪影显着分化，以前未被怀疑的LAA填充缺陷进行了识别，并在排除血栓的置信水平增强对比图像相比，非对比图像。4个月随访后，1例仅通过造影剂识别出左心耳血栓的患者发生了1例卒中相关死亡。在经食管超声心动图引导的心脏复律过程中，使用微泡造影剂可增强左心耳的可视化，有助于识别心内血栓。
ObjectivesThe aim of our study was to demonstrate that the use of contrast microbubbles during transesophageal echocardiography (TEE) guided cardioversion will improve interpretation of the TEE images.BackgroundTEE-guided cardioversion of atrial flutter or fibrillation (AF) is a safe and proven method to restore sinus rhythm. However, artifacts and dense spontaneous echo contrast in the left atrial appendage (LAA) can sometimes decrease the level of confidence in excluding the presence of thrombus.MethodsOne hundred patients referred for TEE-guided cardioversion were prospectively enrolled and microbubble contrast agent (DEFINITY) was administered after the clinical decision had been made regarding suitability for cardioversion. Noncontrast and contrast images were compared during subsequent offline analysis.ResultsLAA dimensions and contractility indices were higher, artifacts were significantly differentiated, previously unsuspected LAA filling defects were identified, and the level of confidence in excluding thrombus was enhanced in the contrast images when compared to the noncontrast images. After 4months follow-up, 1 stroke-associated death occurred in a patient who had LAA thrombus recognized only by contrast. Left atrial appendage visualization is enhanced with microbubble contrast agent use during transesophageal echocardiography guided cardioversion and is useful in identification of intracardiac thrombus.