937-3 Sonicated Albumin in Exercise Echocardiography: Technique and Feasibility of a Novel Approach to Enhance Endocardial Border Visualization

Exercise echocardiography (EE), used to assess for myocardial ischemia, is limited mainly by suboptimal endocardial visualization in the immediate postexercise (Post-Ex) images. Enhancement of LV cavity can be obtained following an intravenous injection of sonicated albumin (Albunex®). but its use in EE has not been reported. To determine the feasibility of Albunex® contrast EE and an optimum dosing technique. 15 healthy volunteers (5 men and 10 women, age 40±7 years) underwent a routine EE and a contrast EE on the same day. Albunex® was injected intravenously and continuously until contrast first appeared in LV Echo images from the apical four (A–4) and two (A–2) chamber views were obtained at rest and Post-Ex. There was no difference in the time to image acquisition between the two EE. Albunex® provided full LV opacification in 14 of 15 subjects both at rest and Post-ex. The overall percentage of endocardial visualization increased from 86% without to 91% with contrast enhancement (p<0.01). Similar increases were seen in Post-Ex A–4 (86% vs 97%, p<0.01) and Post-Ex A–2 (81% vs 88%, p=NS). Time to initial contrast in LV (transit time) and volume at rest and Post-Ex were compared:VariableRest A–4Post-Ex A–4Rest A–2Post-Ex A–2Time (sec)9.75.09.35.2Volume (ml)12.19.611.88.4p<0.01 between all rest and Post-Ex valuesTransit time (r=0.72) and volume required (r=0.57) correlated with cardiac output but not with body size.ConclusionOur method of Albunex® EE proves to be feasible in normal subjects and results in full LV opacification with a high degree of endocardial visualization in most subjects. Both the volume of Albunex® and the transit time are reduced Post-Ex. Albunex® appears to have a useful role in EE