大倉 宏之, 吉川 純一, 吉田 清, 赤阪 隆史, 赤土 正洋, 穂積 健之, 高木 力, 三宅 仁, 本多 康浩

Hiroyuki OKURA, Junichi YOSHIKAWA, Kiyoshi YOSHIDA, Takashi AKASAKA, Masahiro SHAKUDO, Takeshi HOZUMI, Tsutomu TAKAGI, Shinobu MIYAKE, Yasuhiro HONDA

神戸市立中央市民病院循環器センター内科

Department of Cardiology, Kobe General Hospital

キーワード : Contrast echocardiography, Atrial septal defect, Sonicated albumin, Left-to-right shunt

A new transpulmonary contrast agent, sonicated albumin, has been shown to cross the pulmonary circulation and opacify the left side of the heart without inducing hemodynamic change. Use of this agent to quantitate left-to-right shunts has not been previously reported. The purpose of this study is to investigate whether contrast echocardiography can be used to quantitate left-to-right shunts, based on indicator-dilution theory, in cases of secundum artial septal defect. Ten patients with secundum artial septal defect were examined. Two-dimensional echocardiograms were obtained during intravenous injection of sonicated albumin (0.01-0.04 mL/kg). Time-intensity curves were obtained from the right ventricular cavity. Curves were then analysed based on indicator-dilution theory to calculate a left-to-right shunt ratio. Values thus obtained by two-dimensional contrast echocardiography were compared with those obtained by cardiac catheterization using oximetry and the Fick's method. To test injection to injection reproducibility of the method, contrast echo analysis was performed for duplicate contrast injections. There was a good correlation between the shunt ratio calculated by two-dimensional contrast echocardiography and cardiac catheterization (r=0.95, p