Clinical use of contrast echocardiography with microbubble-based.

Mailing address: Jeane Mike Tsutsui • InCor Av. Dr. Enéas de Carvalho Aguiar, 44 05403-000 São Paulo, SP Brazil E-mail: [email protected] Manuscript received June 15, 2006; revised received September 24, 2006; accepted October 5, 2006. Contrast echocardiography is a technique that uses a peripheral intravenous injection of microbubble contrast agents to improve the echocardiographic signal. It is indicated for left ventricular opacification and to enhance the endocardial border delineation in patients with suboptimal echocardiographic images at rest and during stress. Technological advances and the use of commercially available contrast agents that provide more stability in the circulatory system have established the contrast echocardiography as a safe and efficient technique to assess myocardial perfusion. Clinical applications of myocardial contrast echocardiography include: evaluation of patients with suspected or known coronary artery disease; determination of area at risk and efficacy of reperfusion therapies in patients with acute myocardial infarction; assessment of post-infarction viability (identification of the no-reflow phenomenon); and viability in the setting of chronic coronary artery disease (identification of hibernating myocardium). Recent studies have demonstrated that myocardial perfusion analysis using real-time myocardial contrast echocardiography presents higher sensitivity and accuracy for the detection of coronary artery disease than the analysis of wall motion during stress echocardiography. As an additional benefit, quantification of regional myocardial flow and myocardial flow reserve using contrast echocardiography may also be able to estimate the severity of the coronary disease.