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No harm from contrast agent use during stress echo

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The use of microbubble contrast agents during stress echocardiography in patients with elevated right ventricular systolic pressure was not associated with changes in short-term or long-term safety, results from an analysis suggested.

Researchers from the Mayo Clinic in Rochester, Minn., retrospectively examined data from a cohort of 16,434 patients who underwent stress echocardiography and had their right ventricular systolic pressure measured. Of those, 6,164 (37.5%) received a contrast agent for LV opacification and 10,270 (62.5%) did not. The primary study endpoint was short-term safety (≤72 hours and ≤30 days) of contrast agents given to patients with elevated right ventricular systolic pressure; specifically, the researchers analyzed all-cause mortality and MI following stress echocardiography. A total of 1,900 (31%) of patients in the contrast group had right ventricular systolic pressure ≥35 mm Hg, 414 (7%) had pressure ≥50 mm Hg and 118 (2%) had pressure ≥60 mm Hg.

Study results indicated that the contrast cohort had similar short-term event rates vs. the noncontrast group. One patient in the contrast cohort and two in the noncontrast group died within 72 hours of stress echocardiography. Three patients in the contrast group and five in the noncontrast group experienced MI. The researchers also reported no long-term differences in outcomes between the cohorts for the endpoints of death (adjusted HR=1.10; 95% CI, 0.80-1.50) or MI (adjusted HR=0.34; 95% CI, 0.11-1.03). Contrast group patients tended to be older and were more likely to have positive stress echocardiography results vs. the noncontrast group (35% vs. 30%, P<.001).

“In this study population, the use of contrast agents during stress echocardiography in patients with elevated right ventricular systolic pressure determined from tricuspid regurgitation velocity measurements as a measure of pulmonary hypertension was not associated with increased short-term or long-term rates of death or MI,” the researchers concluded. “The study also provided further evidence for the safety of contrast agent use during stress echocardiography in particular.”

Abdelmoneim S. Circ Cardiovasc Imaging. 2010;3:240-248.

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