Clinical applications of contrast echocardiography.
BACKGROUND
Contrast media, used in conjunction with newly developed echocardiographic techniques, can currently be used in several clinical settings: (1) the study of myocardial perfusion, (2) delineation of the endocardial border in technically difficult echocardiographic examinations, and (3) enhancement of low-intensity blood flow, especially coronary blood flow, to study coronary flow reserve.


METHODS
Published studies were reviewed to identify the advantages of associating contrast perfusion with classic or new echocardiographic and ultrasonographic imaging techniques in the study of myocardial perfusion and coronary artery flow.


RESULTS
Several studies demonstrated the usefulness of contrast echocardiography, even in patients with a bad acoustic window, in evaluating opacification of the left ventricle or in enhancing echocardiographic color Doppler studies of coronary flow and coronary flow reserve. Preliminary results of transthoracic echocardiographic studies of myocardial perfusion are described.


CONCLUSIONS
The clinical applications of contrast echocardiography are effective in exploiting examinations that provide poor diagnostic information (ventricular cavity opacification) or in obtaining new physiopathologic data (microvascular opacification/perfusion and coronary flow reserve). The evaluation of coronary flow reserve by contrast-enhanced transthoracic Doppler ultrasonography is an attractive new diagnostic modality that points the way toward important new clinical applications of contrast echocardiography. This technique is useful in evaluating the severity of coronary artery disease of the left anterior descending coronary artery and in all clinical conditions in which the effects of therapeutic interventions aimed at improving coronary flow reserve need to be monitored.
Colonna
P
P
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Italy. pcolcard@pacs.unica.it
Cadeddu
C
C
Chen
L
L
Iliceto
S
S
D001783:Blood Flow Velocity; D003287:Contrast Media / Q000008:administration & dosage / Q000592:standards; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color / Q000379:methods* / Q000592:standards; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D009200:Myocardial Contraction; D012720:Severity of Illness Index; D016277:Ventricular Function, Left
D003287:Contrast Media