Contrast Enhanced Doppler Echocardiography in Chronic Obstructive Airway Disease to Assess Peak Pulmonary Artery Systolic Pressure


Abstract: Background: Evaluation of pulmonary artery pressure is essential in the management of chronic obstructive airway disease. Aim of the study: Evaluation of commonly used infusion fluids as contrast media to improve the attenuated transthoracic Doppler echocardiographic estimation of pulmonary artery systolic pressure in chronic obstructive airway disease patients with poor acoustic window.Methods: Peak pulmonary artery systolic pressure (PPASP) in 60 healthy adults detected by trans-thoracic Doppler/echo was compared with that of similar number of difficult to image chronic obstructive pulmonary disease (COPD) patients before and after a contrast enhancement of the acoustic signal using commonly available infusion fluids (5% Glucose water, 0.9% normal saline, and 20% albumin and 5% albumin solutions) prepared by hand agitation. Results: Contrast enhancement has significantly improved the color display and the spectral velocity envelope, and although albumin was the best contrast medium among the tested fluids, its diluted solution had reported the best profiles. Conclusion: Hand agitated diluted albumin as contrast agent provide safe, inexpensive mean of improving the limited capabilities of the conventional Doppler/echocardiographic estimation of PPASP in COPD patients with poor acoustic window. Key words: COPD, contrast echocardiography