Author + information
- Nicola Gaibazzi, MD, PhD⁎ ()
- ↵⁎University of Parma, Cardiology Department, Via Gramsci 14, Parma 43100, Italy
I read with interest the recently published paper by Greupner et al. (1), and would like to comment on the surprising absence of contrast echocardiography among the tested methods for volume and ejection fraction measurement.
At least 2 previously published studies, which were not appropriately referenced and discussed in the paper, conducted in wider samples (120 and 50 subjects, respectively), demonstrated that both 2- and 3-dimensional echocardiograms benefit significantly from contrast administration in terms of accuracy and reduced interobserver variability compared with standard echocardiography and cardiac magnetic resonance, as long as volumes and ejection fraction measurements are considered (2,3).
Furthermore, the study by Hoffmann et al. (2) was a multicenter study, and demonstrated that the interobserver variability of contrast echocardiography (both mean percentage of error and intraclass correlation) for ejection fraction was even lower than that of cardiac magnetic resonance, which is usually considered the reference method.
Why was there no testing of echocardiography with contrast, which is cheap, widely available, and approved for endocardial border enhancement indication?
A slightly modified old-fashioned ultrasound technique has the potential to outperform more costly, glittering, and technically demanding techniques, or at least it should be given a fair chance.
This happens in front of the widespread urge to cut the world health costs, and a clear and common sense European Union European Atomic Energy Community directive, which compels the use of nonradiating diagnostic methods in medicine when they can be used in substitution of methods using ionizing radiations.
Please note: Dr. Gaibazzi reports that he has received research grants from GE- Imaging and Bracco Imaging.
- American College of Cardiology Foundation
- Greupner J.,
- Zimmermann E.,
- Grohmann A.,
- et al.
- Hoffmann R.,
- von Bardeleben S.,
- ten Cate F.,
- et al.
- Jenkins C.,
- Moir S.,
- Chan J.,
- Rakhit D.,
- Haluska B.,
- Marwick T.H.