Diagnostic impact of contrast echocardiography for assessment of left ventricular function and myocardial perfusion in patients with coronary artery disease

Abstract

The benefit of ultrasound contrast media in enhancing left ventricular (LV) border delineation has been demonstrated in numerous clinical studies. SonoVue (Bracco, Milan, Italy) and other agents have demonstrated improvement in image quality and diagnostic confidence, and their utility is now widely accepted. Contrast studies for LV opacification are best performed using contrast-specific imaging modalities. Particularly with the new low-power imaging modalities, segmentation between myocardial tissue and the LV cavity has become so clear that automatic tracing of the endocardial borders can be used, allowing user-friendly quantitative analysis of regional and global LV function. One of the strengths of contrast echocardiography is the potential to integrate optimal imaging of LV function (by analysis of wall motion) and imaging of myocardial perfusion. In clinical trials, using various contrast-specific methods, several contrast agents have been shown to provide excellent myocardial contrast effects. In two recent studies that evaluated stress-induced ischaemia, perfusion imaging by contrast echocardiography provided incremental information over conventional wall motion analysis. The techniques for deriving quantitative information from contrast echocardiographic images are still primarily used in research rather than in the clinical setting. Conclusions Contrast echocardiography offers a comprehensive evaluation of LV function and myocardial perfusion with high spatial and temporal resolution, and has the potential to allow quantification.