Does cardiac function modify left heart opacification with transpulmonary echo contrast agents?

Dependence of left heart opacification on ventricular function was evaluated for the new transpulmonary echo enhancing agent (SH U 508-A. The contrast agent was injected intravenously in 5 patients with normal cardiac function (ejection fraction [EF] > 60% and echocardiographic left ventricular end-diastolic diameter [LVED] < 56 mm) and in five patients with pathological ventricular function (EF < 40%, LVED > 65 mm). A concentration of 400 mg/mL with dosages of 5, 9, and 16 mL was used in all patients. The visually assessed signal enhancement as well as the videodensitometrically determined peak intensity and duration of signal enhancement did not differ significantly between the two patient groups, while the transit times were markedly prolonged in patients with impaired ventricular function. No significant alteration was found for systemic blood pressure and heart rate. Side effects were transitory and dose related. The noninvasive nature of the procedure and the absence of hemodynamic effects make repeated studies of left ventricular performance with SH U 508-A in patients with varied hemodynamic status possible.