Comparison of three different acoustic contrast agents for detecting right to left shunt in patients with patent foramen ovale by contrast transthoracic echocardiography

AIM To explore the detection sensitivity and developing effect of three kinds of acoustic contrast agents in right heart contrast echocardiography for diagnosis of patent foramen ovale (PFO). METHODS Eighty-four patients with migraine and cryptogenic stroke (aged 18 to 65 years) were enrolled and the right heart contrast echocardiography was conducted using three contrast agents. Real-time observation and comparison of the appearance of microbubble and microbubble density determined whether PFO with right to left shunt (RLS), and the detection rate and the developing effect of PFO using three contrast agents were compared. RESULTS All 84 patients underwent right heart contrast echocardiography examinations three times using three contrast agents. The positive rate of detection was 25% in the agitated saline solution (AS) group, 27% in the agitated saline solution with blood (ASB) group, and 36% in the Vitamin B6 and sodium bicarbonate solution (VSBS) group, which was higher than those of the former two groups. For developing effects, the VSBS group ranked top, followed by the ASB group, and the two groups were better than the AS group. CONCLUSION For detection sensitivity and developing effect, Vitamin B6 and sodium bicarbonate solution is superior to agitated saline solution and agitated saline solution with blood in right heart contrast echocardiography for diagnosis of patent foramen ovale, which is worthy of clinical popularization and application.