Research in Brief: Ultrasound Enhancing Agents Shown Safe and Associated with Reduced Death in Contemporary Study

In new research now published in the Journal of the American Heart Association, researchers at Beth Israel Deaconess Medical Center demonstrate the continued safety of ultrasound enhancing agents (UEAs) for echocardiograms (heart ultrasounds) in contemporary practice. They found that patients who receive UEAs are often sicker than those who don’t receive them. Remarkably, after accounting for these differences, those who received UEAs had reduced mortality, emphasizing their safety and importance in routine clinical care.

Jordan B. Strom, MD, MSc, Section Head of Cardiovascular Imaging Research at the Richard A. and Susan F. Smith Center for Outcomes Research at BIDMC, and colleagues used nationwide claims from 11.4 million insured individuals across the US between 2018-2022 to evaluate rates of death, anaphylaxis, myocardial infarction, ventricular tachycardia or cardiac arrest within 2 days of receiving or not receiving an UEA for a transthoracic echocardiogram or stress echocardiogram.

Key findings include:

Ultrasound enhancing agents (UEAs) are contrast agents used for patients with echocardiograms to make the borders of the heart clearer on the ultrasound images. Unlike other types of contrast, however, they are not associated with risk of kidney damage. Their use has been shown to reduce downstream testing, costs, and improve diagnoses and workflows. Despite these benefits, they continue to be underused across the US, in part due to fears over their safety. Last year, a study raised concerns about increasing rates of serious adverse reactions to UEAs, suggesting a potential link with COVID-19 vaccinations. However, this larger and nationwide analysis found no such link, regardless of the agent or year of study evaluated. The findings reinforce the continued safety of UEAs and indicate that their use may be associated with lower risk of death.

“Understanding the safety and potential benefits of UEAs is crucial for our medical community,” says Dr. Jordan B. Strom, Director of the Echocardiography Laboratory, Section Head of Cardiovascular Imaging Research at the Smith Center at BIDMC, and Associate Professor at Harvard Medical School. “Our study not only reaffirms the safety of these agents but also highlights their association with reduced mortality. We believe that these findings will help alleviate any existing concerns and pave the way for broader usage of UEAs. The goal is to enhance diagnostic accuracy, improve patient outcomes, and ultimately save more lives.”

Dr. Strom serves as Secretary on the Board of Directors of the International Contrast Ultrasound Society. This work was supported by Bracco Diagnostics. Dr. Strom additionally serves as a consultant for Bracco Diagnostics.