PMID- 31038768
OWN - NLM
STAT- MEDLINE
DCOM- 20200127
LR  - 20221207
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 36
IP  - 6
DP  - 2019 Jun
TI  - Safety profile of ultrasound enhancing agents in echocardiography.
PG  - 1041-1044
LID - 10.1111/echo.14344 [doi]
AB  - INTRODUCTION: Ultrasound enhancing agents (UEAs) are often utilized to enhance 
      ultrasound image quality; however, concerns about adverse reactions have limited 
      their use. Moreover, these agents had been either contraindicated or are labeled 
      with a warning in patients with intra-cardiac shunts because of a theoretic risk 
      of systemic microvascular obstruction. This labeling was recently removed in the 
      United States, but data in these patients are lacking. METHODS: Over a 15-month 
      period, patients receiving three different FDA-approved UEAs at our center were 
      prospectively evaluated for clinically significant adverse events (AEs). RESULTS: 
      A total of 5521 UEA administrations were performed (Definity((R)) : 3306, 
      Lumason((R)) : 2137, Optison((R)) : 78). There were 14 AEs (0.25%) reported 
      (Lumason((R)) : 0.05% [n = 1] vs Definity((R)) : 0.39% [n = 13], P = 0.02). Back pain 
      was the most common complaint (n = 9), followed by headache (n = 2), rash 
      (n = 2), dyspnea (n = 2), and palpitations (n = 1). Among the 33 patients known 
      to have intra-cardiac shunts, there were no AEs. Known right-to-left shunts with 
      positive saline bubble study were present in 20 patients (Lumason((R)) : n = 9, 
      Definity((R)) : n = 11). Left-to-right atrial shunts based on color Doppler were 
      present in 10 patients (Lumason((R)) : n = 5, Definity((R)) n = 5). Three patients 
      were known to have ventricular septal defect with left-to-right flow (Definity((R)) 
      : n = 2, Optison((R)) : n = 1). CONCLUSION: Adverse events were significantly 
      higher with Definity((R)) ; however, overall incidences were low, and AEs were 
      minor. Furthermore, no AEs were reported in patients with known intra-cardiac 
      shunts. UEAs showed a good safety profile in our study and should be afforded to 
      all appropriate patients, including those with known intra-cardiac shunts.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Kumar, Suwen
AU  - Kumar S
AUID- ORCID: 0000-0001-5027-6548
AD  - Oregon Health and Science University, Portland, Oregon.
FAU - Purtell, Chris
AU  - Purtell C
AD  - Oregon Health and Science University, Portland, Oregon.
FAU - Peterson, April
AU  - Peterson A
AD  - Oregon Health and Science University, Portland, Oregon.
FAU - Gibbons, Paul
AU  - Gibbons P
AD  - Oregon Health and Science University, Portland, Oregon.
FAU - Khan, Abigail M
AU  - Khan AM
AD  - Oregon Health and Science University, Portland, Oregon.
FAU - Heitner, Stephen B
AU  - Heitner SB
AUID- ORCID: 0000-0003-2189-1474
AD  - Oregon Health and Science University, Portland, Oregon.
LA  - eng
PT  - Journal Article
DEP - 20190430
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
RN  - 0 (Albumins)
RN  - 0 (Contrast Media)
RN  - 0 (FS 069)
RN  - 0 (Fluorocarbons)
RN  - CK0N3WH0SR (perflutren)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Albumins/*adverse effects
MH  - Contrast Media/*adverse effects
MH  - Echocardiography/*methods
MH  - Female
MH  - Fluorocarbons/*adverse effects
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk Factors
MH  - Ultrasonography
OTO - NOTNLM
OT  - Definity(R)
OT  - Lumason(R)
OT  - Optison(R)
OT  - contrast agents
OT  - echocardiography
OT  - ultrasound enhancing
EDAT- 2019/05/01 06:00
MHDA- 2020/01/28 06:00
CRDT- 2019/05/01 06:00
PHST- 2019/01/03 00:00 [received]
PHST- 2019/02/12 00:00 [revised]
PHST- 2019/03/30 00:00 [accepted]
PHST- 2019/05/01 06:00 [pubmed]
PHST- 2020/01/28 06:00 [medline]
PHST- 2019/05/01 06:00 [entrez]
AID - 10.1111/echo.14344 [doi]
PST - ppublish
SO  - Echocardiography. 2019 Jun;36(6):1041-1044. doi: 10.1111/echo.14344. Epub 2019 
      Apr 30.