Albunex improves agreement between experienced and less-experienced echocardiographers for the evaluation of left ventricular wall motion during bicycle stress echocardiography

William Armstrong, Thomas Marwick, Patricia Pellikka, Thomas Ryan, Douglas Segar, Thomas Lewandowski, David Rubin, Mini Das, Chang Lim, Will Maxted

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: To determine if contrast-enhanced imaging using Albunex® during bicycle stress echocardiography (BSE) improved the degree of agreement between experienced (EX) and less-experienced (LEX) echocardiographers for the evaluation of LV wall motion (LVWM). Methods: 125 patients underwent rest echocardiography followed by unenhanced and contrast enhanced BSE. Rest images were obtained in the 4 standard views. At peak exercise, Albunex® (0.3 mL/kg) was injected after acquisition of the unenhanced images, and contrast-enhanced imaging of the A4C and A2C views was repeated. Images were captured digitally, and 2 image sets (rest/stress unenhanced and rest/stress enhanced) were independently randomized for each patient between 5 EX/LEX reader pairs. Each reader provided a blinded assessment of LVWM for each segment using a graded scoring system. The rate of agreement, an exact match for the score of each LV wall segment, within each EX/LEX reader pair was measured. The intra-reader reproducibility for the rate of agreement, and the value of disagreement, the difference in # of evaluable LV wall segments, were also measured. Results: The use of Albunex® significantly improved the ability of the EX/LEX reader pairs to agree on the WM score for the identical evaluation of each LV wall segment (p = 0.05). The intra-reader reproducibility for the rate of agreement was statistically significant for all four reader/image combinations (p = 0.001). However, the value of disagreement was only significant for the LV segment scoring of the peak stress unenhanced images (p = 0.05 for EX; p = 0.02 for LEX). Conclusions: Albunex® contrast enhancement in BSE improves agreement between EX and LEX echocardiographers for the evaluation of LVWM. Albunex® also appears to aid LEX echocardiographers in their evaluation of LVWM. The significance of the intra-reader reproducibility for the rate of agreement emphasizes test validity. In conclusion, Albunex® contrast enhancement in BSE results in a more accurate evaluation of LVWM by EX and LEX echocardiographers.

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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