The effect of albunex on the interpretation of supine bicycle stress echocardiograms

William C. Maxted, Roxanne Kovacs, Susan T. Swanson, Stephen G. Sawada, Harvey Feigenbaum, Douglas S. Segar

Research output: Contribution to journalArticle

Abstract

Sonicated albumin (Albunex) has been shown to increase endocardial visualization and to improve assessment of the left ventricle in both resting and stress echocardiography studies. Whether it ultimately affects the echocardiographic diagnosis has not been clearly demonstrated. The purpose of this study was to determine if Albunex alters the interpretation of supine bicycle echocardiograms. Methods: 43 patients underwent supine bicycle stress echocardiography. Standard images were obtained at rest and peak. Immediately after peak images were obtained, 0.24 - 0.30 ml/kg of Albunex was injected into an antecubital vein and apical two and four chamber peak views were again obtained. After reviewing the resting images, the unenhanced and Albunex enhanced and stress images were interpreted separately by a single reviewer. Results: One patient had images that were uninterpretable with and without Albunex. There was a different diagnosis rendered from review of the enhanced and unenhanced images in 7 patients or 16%. In each of these 7 patients, the unenhanced views provided nondiagnostic views of the endocardium (anterior wall - 3 patients, inferior base - 3 patients, apex - 1 patient) . In 6 of these patients Albunex enhanced images appeared normal, hi one patient the Albunex enhanced image demonstrated a stress induced anterior wall motion abnormality. None of the patients whose images were felt to be normal in the Albunex enhanced images demonstrated clinical or electrocardiographic evidence of ischemia during their stress test, and the one person whose anterior wall was found to become hypokinetic with the Albunex enhanced images demonstrated a high grade LAD lesion on arteriography Conclusions: 1.) In this small group, Albunex did provide a more definitive or alternate diagnosis in a significant number of patients. 2.) Albunex infusion may predictably improve diagnostic accuracy if the endocardium of the anterior wall, apex, or inferior base are not well visualized on peak stress images. 3.) Larger trials are needed to determine if Albunex is indicated for routine use in all stress echocardiograms.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - Dec 1 1997

    Fingerprint

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this