ASE recently released a new guideline paper for contrast echo. First you will notice by the title of the paper that ASE is now using Ultrasonic Enhancing Agents (UEA), or ‘enhanced echo’ to replace the confusing term “contrast” echo. Thank goodness…no more stories from patients about how they are allergic to sea food and CT contrast!
To be honest, I am not usually a big fan of the topic of contrast…one too many contrast meetings back in the early days! I hesitantly began reading the newly released guideline paper and to my pleasant surprise, I found lots of useful nuggets of information worth sharing. This week we will review clinical application updates related to LV volume and EF with the use of Ultrasonic Enhanced Agents. These updated guidelines were released after extensive research conducted since the last 2008 ASE consensus paper.
It is easy to get caught up in the subjective nature of ejection fraction assessment. If you have ever attended an echo QI meeting, the peer review session can seem monotonous and sometimes even pointless. Please remember that for certain patients, both the accurateness and reproducibility of the LV EF is a matter of life and death, or at least quality of life. Think about the patients that are being considered for a defibrillator or life-vest, or the many cancer patients receiving chemo that need serial repeat echocardiograms to assess for cardiotoxicity. Getting the EF right is relevant!
The latest research shows that when using ultrasonic enhancing agents (contrast) during echo:
ASE Recommendation: “Ultrasound enhancement should be used in all patients in whom quantitative assessment of LV EF is important to prognosis or management of the clinical condition.”
ASE released updated guidelines for UEA (contrast echo) and this week we reviewed how these updates relate to LV volume quantification and ejection fraction assessment.
Keep an eye out – we will continue to review the latest UEA guideline paper in future blogs!
Judith Buckland, MBA, RDCS, FASE
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Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update