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BioMed Research International
Volume 2017 (2017), Article ID 6086094, 6 pages
Research Article

Comparison of Different Contrast Agents in Detecting Cardiac Right-to-Left Shunt in Patients with a Patent Foramen Ovale during Contrast-Transthoracic Echocardiography

1Department of Structural Heart Disease, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
2Department of Cardiology, Xianyang Hospital of Yan’an University, Xianyang 712000, China

Correspondence should be addressed to Yushun Zhang

Received 12 August 2017; Accepted 8 November 2017; Published 3 December 2017

Academic Editor: Ramazan Akdemir

Copyright © 2017 Enfa Zhao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study is to evaluate the ability of two different contrast agents to detect cardiac right-to-left shunting in patients with a patent foramen ovale during contrast transthoracic echocardiography and transesophageal echocardiography. Eighty-four patients who had migraines or experienced cryptogenic stroke were prospectively enrolled. Contrast echocardiography of the right portion of the heart was performed using an injection of either (i) 8 ml of agitated saline, 1 ml of blood, and 1 ml of air (ASB) or (ii) 4 ml of vitamin B6 and 6 ml of sodium bicarbonate solution (VSBS). All patients underwent contrast echocardiography with different contrast agents successively before undergoing transesophageal echocardiography. The diagnostic sensitivity of VSBS and ASB for cardiac shunting diagnosis was 94.23% and 78.85%, respectively. The diagnostic sensitivity in the VSBS group was significantly higher than that in the ASB group (, ). The observed semiquantitative shunt grading suggests that the positive rate in the VSBS group was higher than that in the ASB group (, ). The use of vitamin B6 and sodium bicarbonate solution as a TTE contrast agent yielded a high sensitivity compared with ASB. However, further trials with large sample size are required to confirm this finding.