The Utility of Left Ventricular Opacification with Definity Echocardiography Contrast for Calculation of Ejection Fraction in Obese and Non-Obese Patients

Background: Echocardiography is a convenient method for assessing ejection fraction (EF). However accurate EF calculation may not be possible due to poor image quality, particularly in obese patients. We assessed the interpretability of, and change in, Simpson’s biplane EF calculation before and after Definity (perflutren lipid microsphere) contrast enhancement in technically challenging studies. Method: A retrospective review of studies requiring Definity contrast was undertaken. Body mass index (BMI) and pre and post-contrast Simpson’s biplane EF were measured. Changes in EF for obese (BMI> 30 kg/m2) and non-obese patients were calculated. Result: Seventy-seven studies were reviewed. Mean BMI was 32.7± 9.2 kg/m2 with BMI> 30 kg/m2 in 48(62%) patients (mean 38.3± 8.2 kg/m2). A biplane EF could not be calculated pre-contrast in 34 (44%) reducing to 11 (14%) post-contrast. In 40 studies where biplane EFwasmeasurable pre and post-contrast there are significant changes in 476