{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:43:33Z","timestamp":1793295813284,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:sec id=\"jah310836-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Ultrasound enhancing agents (UEAs) are an important diagnostic tool for transthoracic or stress echocardiography (TTE\/SE) but recent concerns have been raised about their safety in reports from individual health systems. As such, we aimed to identify if UEAs for TTE\/SE are associated with serious adverse events within 2\u2009days of administration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310836-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              All\u2010payor nationwide claims from 11.4 million insured individuals across the United States, 2018 to 2022 were used to evaluate rates of death, anaphylaxis, myocardial infarction, ventricular tachycardia, or cardiac arrest within 2\u2009days of TTE\/SE among adults receiving and not receiving UEAs. Of the 11\u2009421\u2009463 individuals included (mean age 57.5\u00b116.2, 54.0% female, 46.2% White), a total of 500\u2009073 (4.4%) received TTE\/SE with UEAs. After propensity score matching, the odds of death were lower in those receiving UEAs (receipt versus nonreceipt, 0.02% versus 0.14%, odds ratio [OR], 0.23 [95% CI, 0.19\u20130.28],\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001) and were not different across agents (Definity: 0.02%, OR, 0.22 [95% CI, 0.18\u20130.28]; Lumason: 0.03%, OR, 0.33 [95% CI, 0.20\u20100.57]; Optison: 0.01%, OR, 0.17 [95% CI, 0.08\u20130.38]; all\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              \u2009&lt;\u20090.001). Rates of nondeath outcomes were similar to those observed in individuals not receiving UEAs, overall, and across specific agents. Rates of all outcomes were stable across years, including considering pre\u2010 and post\u2010COVID periods.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah310836-sec-0004\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this large nationwide claims analysis from 2018 to 2022, serious adverse events associated with UEAs for TTE\/SE were uncommon and overall consistent across agents and years of study. Compared with nonreceipt, receipt of UEAs was associated with a lower odds of death within 2\u2009days of TTE\/SE.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039480","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:11:41Z","timestamp":1747217501000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Contemporary Safety of Ultrasound Enhancing Agents in a Nationwide Analysis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6592-6141","authenticated-orcid":false,"given":"Jordan B.","family":"Strom","sequence":"first","affiliation":[{"name":"Beth Israel Deaconess Medical Center","place":["Boston, USA"]},{"name":"Beth Israel Deaconess Medical Center","place":["Boston, USA"]},{"name":"Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7377-4053","authenticated-orcid":false,"given":"Sharon L.","family":"Mulvagh","sequence":"additional","affiliation":[{"name":"Dalhousie University","place":["Halifax, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0881-946X","authenticated-orcid":false,"given":"Thomas R.","family":"Porter","sequence":"additional","affiliation":[{"name":"University of Nebraska","place":["Omaha, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wei","sequence":"additional","affiliation":[{"name":"Oregon Health Sciences University","place":["Portland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Stout","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center","place":["Boston, USA"]},{"name":"Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Main","sequence":"additional","affiliation":[{"name":"St. Luke\u2019s Mid\u2010America Heart Institute","place":["Kansas City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/hco.0000000000000973"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.05.011"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.11.013"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.005"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.07.008"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.05.008"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2003.164"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.08.012"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.04.006"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.04.034"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.07.019"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.09.009"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.05.002"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.10.010"},{"key":"e_1_3_1_16_2","unstructured":"Bracco Diagnostics B . 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