Myocardial contrast echocardiography for simultaneous assessment of function and perfusion in real time: a technique comes of age.

Contrast agents are now widely used in stress echocardiography (SE) to improve visualization of the endocardial border, improve confidence in wall motion assessment, and reduce the number of uninterpretable images. The use of contrast agents in SE has also been shown to improve accuracy of wall motion assessment for the detection of coronary artery disease (CAD) compared with unenhanced SE images.1 Contrast stress echocardiography has been shown to impact positively on downstream costs.2 The ability of contrast agents, which contain microbubbles that mimic red blood cell rheology, to enable visualization of myocardial perfusion resulted in rapid development of both microbubble and equipment technology that allowed the use of contrast echocardiography for the detection of myocardial perfusion in clinical cardiology.3 Numerous single and multicenter studies have proved that myocardial contrast perfusion stress echocardiography is now a clinical tool for the detection of CAD.4 The ability of myocardial contrast SE to assess function and perfusion simultaneously makes it a unique technique for the assessment of CAD.