American Society of Echocardiography Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography

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Continuing Medical Education Course for “American Society of Echocardiography Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography”

Accreditation Statement

The American Society of Echocardiography (ASE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The ASE designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit.™ Physicians should only claim credit commensurate with the extent of their participation in the activity.

The American Registry of Diagnostic Medical Sonographers and Cardiovascular Credentialing International recognize the ASE's certificates and have agreed to honor the credit hours toward their registry requirements for sonographers.

The ASE is committed to resolving all conflict-of-interest issues, and its mandate is to retain only those speakers with financial interests that can be reconciled with the goals and educational integrity of the educational program. Disclosure of faculty and commercial support sponsor relationships, if any, have been indicated.

Target Audience

This activity is designed for all cardiovascular physicians, cardiac sonographers, and nurses with a primary interest and knowledge base in the field of echocardiography; in addition, residents, researchers, clinicians, sonographers, and other medical professionals having a specific interest in contrast echocardiography may be included.

Objectives

Upon completing this activity, participants will be able to: 1. Demonstrate an increased knowledge of the applications for contrast echocardiography and their impact on cardiac diagnosis. 2. Differentiate the available ultrasound contrast agents and ultrasound equipment imaging features to optimize their use. 3. Recognize the indications, benefits, and safety of ultrasound contrast agents, acknowledging the recent labeling changes by the US Food and Drug Administration (FDA) regarding contrast agent use and safety information. 4. Identify specific patient populations that represent potential candidates for the use of contrast agents, to enable cost-effective clinical diagnosis. 5. Incorporate effective teamwork strategies for the implementation of contrast agents in the echocardiography laboratory and establish guidelines for contrast use. 6. Use contrast enhancement for endocardial border delineation and left ventricular opacification in rest and stress echocardiography and unique patient care environments in which echocardiographic image acquisition is frequently challenging, including intensive care units (ICUs) and emergency departments. 7. Effectively use contrast echocardiography for the diagnosis of intracardiac and extracardiac abnormalities, including the identification of complications of acute myocardial infarction. 8. Assess the common pitfalls in contrast imaging and use stepwise, guideline-based contrast equipment setup and contrast agent administration techniques to optimize image acquisition.

Author Disclosures

Sharon L. Mulvagh: research grant, Lantheus Medical Imaging, GE Healthcare, and Astellas Pharma; consultant/advisory, Acusphere, Point Biomedical. Mani A. Vannan: research grant, other research support, speaker bureau/honoraria, and consultant/advisory board, Lantheus Medical Imaging. Harald Becher: research grant, Philips, Sonosite, and Toshiba; speaker bureau/honoraria, Lantheus Medical Imaging; consultant/advisory board, Point Biomedical, Bracco, Acusphere, ICON, Lantheus Medical Imaging. S. Michelle Bierig: research grant, Lantheus Medical Imaging, Amersham. Peter N. Burns: consultant/advisory board, Philips Ultrasound, Lantheus Medical Imaging. Dalane W. Kitzman: research grant, Lantheus Medical Imaging, IMCOR, Sonus; speakers bureau, Lantheus Medical Imaging; consultant/advisory board, Lantheus Medical Imaging, Acusphere. Itzhak Kronzon: research grant, GE Healthcare. Arthur J. Labovitz: consultant/advisory board, ICON Medical. Roberto M. Lang: research grant, Acusphere, Point Biomedical; speaker bureau, Lantheus Medical Imaging; consultant/advisory board, Lantheus Medical Imaging. Julio E. Perez: consultant/advisory board, Biomedical Systems. Thomas R. Porter: research grant, Lantheus Medical Imaging; consultant/advisory board, Acusphere, ImaRx. Judy Rosenbloom: paid consultant with ultrasound equipment manufacturers. Kevin Wei: research grant, Lantheus Medical Imaging, Philips Ultrasound; consultant/advisory board, Acusphere. The following stated no disclosures: Harry Rakowski, Sahar S. Abdelmoneim, Ramon Castello, Patrick D. Coon, Mary E. Hagen, James G. Jollis, Thomas R. Kimball, Joseph Mathew, Stuart Moir, Sherif F. Nagueh, Alan S. Pearlman, G. Monet Strachan, Srihari Thanigaraj, Anna Woo, Eric H. C. Yu, and William A. Zoghbi.

Conflicts of Interest: The authors have no conflicts of interest to disclose except as noted above.

Estimated Time to Complete This Activity: 1 hour

Keywords

Ultrasound contrast agents
Contrast microbubbles
Echocardiography
Cardiac imaging
Contrast echocardiography
Real-time contrast echocardiography
Left ventricular opacification
Left ventricular ejection fraction
Endocardial border definition
Wall motion analysis
Stress echocardiography
Coronary artery disease
Power Doppler imaging
Myocardial contrast echocardiography
Myocardial perfusion imaging

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