Failure of digital echocardiography to accurately diagnose intracardiac shunts

Hind Rahmouni, Martin G. Keane, Frank E. Silvestry, Martin G. St. John Sutton, Victor A. Ferrari, Craig H. Scott, Susan E. Wiegers

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Intravenous agitated saline injection during transthoracic echocardiography assists in the detection of right to left intracardiac and intrapulmonary shunts. Whether digital echocardiography offers comparable sensitivity and specificity to analog tape recording to assess shunts is unknown. Technical differences between methods could lead to significant differences in shunt detection. Methods: Agitated saline was injected intravenously at rest and with Valsalva in 189 consecutive patient studies (406 injections). Echocardiographers assessed presence and degree of left ventricle contrast on simultaneously recorded analog tape and digital echocardiography images in blinded fashion. Results: Digital echocardiography had low overall sensitivity (rest 0.50, valsalva 0.63, late 0.39) compared to analog tape. Longer clip lengths improved sensitivity for detection of late contrast passage (rest 0.50, valsalva 0.67, late 0.46). Conclusion: Digital echocardiography saline contrast studies have poor sensitivity for assessment of intracardiac shunts versus analog tape, and increasing clip length only modestly increases sensitivity. Joint Photographic Experts Group digital compression losses may be an important cause of failure to detect intracardiac shunts, including patent foramen ovale.

Original languageEnglish (US)
Pages (from-to)161-165
Number of pages5
JournalAmerican Heart Journal
Volume155
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

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Echocardiography
Surgical Instruments
Tape Recording
Patent Foramen Ovale
Injections
Heart Ventricles
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rahmouni, H., Keane, M. G., Silvestry, F. E., St. John Sutton, M. G., Ferrari, V. A., Scott, C. H., & Wiegers, S. E. (2008). Failure of digital echocardiography to accurately diagnose intracardiac shunts. American Heart Journal, 155(1), 161-165. https://doi.org/10.1016/j.ahj.2007.08.032

Failure of digital echocardiography to accurately diagnose intracardiac shunts. / Rahmouni, Hind; Keane, Martin G.; Silvestry, Frank E.; St. John Sutton, Martin G.; Ferrari, Victor A.; Scott, Craig H.; Wiegers, Susan E.

In: American Heart Journal, Vol. 155, No. 1, 01.2008, p. 161-165.

Research output: Contribution to journalArticle

Rahmouni, H, Keane, MG, Silvestry, FE, St. John Sutton, MG, Ferrari, VA, Scott, CH & Wiegers, SE 2008, 'Failure of digital echocardiography to accurately diagnose intracardiac shunts', American Heart Journal, vol. 155, no. 1, pp. 161-165. https://doi.org/10.1016/j.ahj.2007.08.032
Rahmouni H, Keane MG, Silvestry FE, St. John Sutton MG, Ferrari VA, Scott CH et al. Failure of digital echocardiography to accurately diagnose intracardiac shunts. American Heart Journal. 2008 Jan;155(1):161-165. https://doi.org/10.1016/j.ahj.2007.08.032
Rahmouni, Hind ; Keane, Martin G. ; Silvestry, Frank E. ; St. John Sutton, Martin G. ; Ferrari, Victor A. ; Scott, Craig H. ; Wiegers, Susan E. / Failure of digital echocardiography to accurately diagnose intracardiac shunts. In: American Heart Journal. 2008 ; Vol. 155, No. 1. pp. 161-165.
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