{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:28:30Z","timestamp":1788449310706,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,6]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Ultrasound enhancing agents (UEA<\/jats:styled-content>s) are often utilized to enhance ultrasound image quality; however, concerns about adverse reactions have limited their use. Moreover, these agents had been either contraindicated or are labeled with a warning in patients with intra\u2010cardiac shunts because of a theoretic risk of systemic microvascular obstruction. This labeling was recently removed in the United States, but data in these patients are lacking.<\/jats:p><\/jats:sec>Methods<\/jats:title>Over a 15\u2010month period, patients receiving three different FDA<\/jats:styled-content>\u2010approved UEA<\/jats:styled-content>s at our center were prospectively evaluated for clinically significant adverse events (AE<\/jats:styled-content>s).<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 5521 UEA<\/jats:styled-content> administrations were performed (Definity\u00ae<\/jats:sup>: 3306, Lumason\u00ae<\/jats:sup>: 2137, Optison\u00ae<\/jats:sup>: 78). There were 14 AE<\/jats:styled-content>s (0.25%) reported (Lumason\u00ae<\/jats:sup>: 0.05% [n\u00a0=\u00a01] vs Definity\u00ae<\/jats:sup>: 0.39% [n\u00a0=\u00a013], P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.02). Back pain was the most common complaint (n\u00a0=\u00a09), followed by headache (n\u00a0=\u00a02), rash (n\u00a0=\u00a02), dyspnea (n\u00a0=\u00a02), and palpitations (n\u00a0=\u00a01). Among the 33 patients known to have intra\u2010cardiac shunts, there were no AE<\/jats:styled-content>s. Known right\u2010to\u2010left shunts with positive saline bubble study were present in 20 patients (Lumason\u00ae<\/jats:sup>: n\u00a0=\u00a09, Definity\u00ae<\/jats:sup>: n\u00a0=\u00a011). Left\u2010to\u2010right atrial shunts based on color Doppler were present in 10 patients (Lumason\u00ae<\/jats:sup>: n\u00a0=\u00a05, Definity\u00ae<\/jats:sup> n\u00a0=\u00a05). Three patients were known to have ventricular septal defect with left\u2010to\u2010right flow (Definity\u00ae<\/jats:sup>: n\u00a0=\u00a02, Optison\u00ae<\/jats:sup>: n\u00a0=\u00a01).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Adverse events were significantly higher with Definity\u00ae<\/jats:sup>; however, overall incidences were low, and AE<\/jats:styled-content>s were minor. Furthermore, no AE<\/jats:styled-content>s were reported in patients with known intra\u2010cardiac shunts. UEA<\/jats:styled-content>s showed a good safety profile in our study and should be afforded to all appropriate patients, including those with known intra\u2010cardiac shunts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14344","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T03:06:06Z","timestamp":1556679966000},"page":"1041-1044","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Safety profile of ultrasound enhancing agents in echocardiography"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5027-6548","authenticated-orcid":false,"given":"Suwen","family":"Kumar","sequence":"first","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Purtell","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Peterson","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail M.","family":"Khan","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2189-1474","authenticated-orcid":false,"given":"Stephen B.","family":"Heitner","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.09.009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.11.013"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-015-0713-z"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERP-15-0018"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.005459"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2007.10.005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drudis.2017.11.006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tox.2005.07.023"},{"key":"e_1_2_6_10_1","unstructured":"PatilHR MainML.2016.Pageshttps:\/\/www.acc.org\/latest-in-cardiology\/articles\/2016\/06\/23\/08\/23\/revisiting-the-safety-profile-of-echocardiography-contrast-agentson Accessed December 17 2018."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.11.003"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.14344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.14344","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:10:41Z","timestamp":1694369441000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.14344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,30]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/echo.14344"],"URL":"https:\/\/doi.org\/10.1111\/echo.14344","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,30]]},"assertion":[{"value":"2019-01-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}