Echocardiography in the time of Covid-19: Ultrasound enhancing agents save time and augment diagnostic information

Dylan Sperling, Ashton C. Lai, Solomon W. Bienstock, Rajeev Samtani, Frans Beerkens, Mohanchandran Satish, Matthew Pulaski, Madison Edens, Connor Oates, Nikola Kocovic, Samantha Buckley, Gennaro Giustino, Stamatios Lerakis, Steve Liao, Eric Stern, Lori B. Croft, Martin E. Goldman

Research output: Contribution to journalArticlepeer-review


Background: There are currently no clear guidelines regarding the use of ultrasound enhancing agents (UEAs) with transthoracic echocardiography (TTE) for patients hospitalized with Covid-19. We investigated whether the performance of TTE with UEAs provides more diagnostic information and allows for shorter acquisition time compared to unenhanced TTE imaging in this patient population. Methods: We analyzed the TTEs of 107 hospitalized Covid-19 patients between April and June 2020 who were administered UEAs (Definity®, Lantheus). The time to acquire images with and without UEAs was calculated. A level III echocardiographer determined if new, clinically significant findings were visualized with the addition of UEAs. Results: There was a mean of 11.84±3.59 UEA cineloops/study vs 20.74±8.10 non-UEA cineloops/study (p < 0.0001). Mean time to acquire UEA cineloop images was 72.28±28.18 s/study compared to 188.07±86.04 s/study for non-UEA cineloop images (p < 0.0001). Forty-eight patients (45%) had at least one new finding on UEA imaging, with a total of 62 new findings seen. New information gained with UEAs was more likely to be found in patients with acute respiratory distress syndrome (21 vs 9, p < 0.001) and in those on mechanical ventilation (21 vs 15, p = 0.046). Conclusions: TTE with UEAs required less time and fewer cineloop images compared to non-UEA imaging in patients hospitalized with Covid-19. Additionally, Covid-19 patients with severe respiratory disease benefited most with regard to new diagnostic information. Health care personnel should consider early use of UEAs in select hospitalized Covid-19 patients in order to reduce exposure and optimize diagnostic yield.

Original languageEnglish
Pages (from-to)100-102
Number of pages3
JournalInternational Journal of Cardiology
StatePublished - 1 Jan 2022


  • Covid-19
  • Echocardiography
  • Ultrasound enhancing agents


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