Study Finds Decrease in Percentage of Uninterpretable, Technically Difficult Studies with Contrast Echocardiography
February 24, 2009 - Lantheus Medical Imaging Inc. today said a paper published online in the February 2009 issue of the Journal of the American College of Cardiology reinforces the clinical use and impact of its echocardiography contrast agent DEFINITY Vial For (Perflutren Lipid Microsphere) Injectable Suspension in hospitalized and critically ill cardiac patients.
New data from a prospective, single center, cohort study of more than 600 patients finds the use of contrast echocardiography with DEFINITY in technically difficult cases improves endocardial visualization and significantly impacts cardiac diagnosis, resource utilization and patient management decisions. The study authors include William A. Zoghbi, M.D., FACC, and his colleagues at Cardiovascular Imaging Institute, The Methodist DeBakey Heart and Vascular Center in Houston, TX.
The prospective study was designed to evaluate the impact of echocardiographic contrast utilization on patient diagnosis and management. While contrast echocardiography (CE) has improved left ventricular opacification and delineation of endocardial borders, its impact on physician decision-making has not been evaluated in a large study.
The study shows the use of DEFINITY helps better define left ventricular opacification and endocardial border delineation to help physicians significantly improve left ventricular functional assessments and the detection of left ventricular thrombus, the company said. In doing so, other more costly tests were avoided and drug therapies were better tuned to patient needs.
A total of 632 consecutive patients (545 hospitalized inpatients and 87 outpatients) with technically difficult studies who underwent a rest echocardiogram and received DEFINITY for endocardial enhancement from June to October 2007 were enrolled in the study. A technically difficult study was defined as a study in which >2 myocardial segments were not visualized at baseline from any imaging window. Quality of the studies, number of left ventricular (LV) segments visualized, estimated left ventricular ejection fraction (LVEF), the presence, absence or suspicion of apical thrombus, and management decisions were compared before and after contrast.
The study found the percent of uninterpretable studies decreased from 11.7% to 0.3% and the number of technically difficult studies decreased from 86.7% to 9.8% (p<0.0001) after contrast echocardiography. An LV thrombus was suspected in 35 patients and was definite in three patients before CE. After contrast, only one patient had a suspected thrombus, and five additional patients with thrombus were identified (p<0.0001).
A significant impact of CE on management was observed. In particular, additional diagnostic procedures were avoided in 32.8 percent of patients and drug management was altered in 10.4 percent, with a total impact (procedures avoided, change in drugs, or both) observed in 35.6 percent of patients. The impact of contrast increased with worsening quality of baseline non-enhanced study, the highest being in intensive care units. Lantheus did not provide funding for the study.
Online copies of the article can be found at Journal of the American College of Cardiology: “Impact of Contrast Echocardiography on Evaluation of Ventricular Function and Clinical Management in a Large Prospective Cohort,” by Mustafa Kurt, M.D., et al, at http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.01.005v1
For more information: www.lantheus.com
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