Limitations and potential clinical application on contrast echocardiography.

Elisa Modonesi, Manrico Balbi, Gian Paolo Bezante
Author Information
  1. Elisa Modonesi: Department of Cardionephrology and Department of Internal Medicine, University of Genoa, Genoa, Italy.

Abstract

Myocardial contrast echocardiography (MCE) is a relatively simple myocardial perfusion imaging technique which should be used in different clinical settings. The ability of MCE to provide a comprehensive assessment of cardiac structure, function, and perfusion is likely to make it the technique of choice for non-invasive cardiac imaging.Contrast agents are encapsulated microbubbles (MB) filled with either air or high-molecular-weight gas. They are innocuous, biologically inert and when administered intravasculary, the sound backscatter from the blood poll is enhanced because MB have the enormous reflective ability due to a large acoustic impedance mismatch between the bubble gas and surrounding blood.MCE is an ideal imaging tool for the assessment of left heart contrast and the myocardial microcirculation. MCE detects contrast MB at the capillary level within the myocardium and, thus, has the potential to assess tissue viability and the duration of the contrast effect. MCE was equivalent to SPECT for the detection of CAD with a tendency toward higher sensitivity of MCE compared with SPECT in microvascular disease and CAD. MCE is also a bedside technique that can be used early in patients presenting with acute heart failure to rapidly assess LV function (regional and global) and perfusion (rest and stress).

Keywords

References

  1. Circulation. 2001 Jun 5;103(22):2724-30 [PMID: 11390344]
  2. Curr Opin Cardiol. 2002 Sep;17(5):455-63 [PMID: 12357120]
  3. Circulation. 1995 Feb 1;91(3):656-62 [PMID: 7828290]
  4. Ultrasonics. 2002 May;40(1-8):567-73 [PMID: 12160003]
  5. J Am Coll Cardiol. 1997 Apr;29(5):1081-8 [PMID: 9120163]
  6. IEEE Trans Ultrason Ferroelectr Freq Control. 2002 Jul;49(7):883-92 [PMID: 12152942]
  7. Heart. 2005 Aug;91(8):1110-7 [PMID: 16020614]
  8. Ultrasonics. 2000 Mar;38(1-8):93-8 [PMID: 10829636]
  9. Basic Res Cardiol. 2006 Sep;101(5):359-72 [PMID: 16915531]
  10. Am J Cardiol. 1999 Jan 15;83(2):211-7 [PMID: 10073823]
  11. J Am Soc Echocardiogr. 2002 Sep;15(9):849-56 [PMID: 12221399]
  12. J Am Coll Cardiol. 2001 Jul;38(1):19-25 [PMID: 11451273]
  13. Curr Opin Cardiol. 2006 Sep;21(5):473-8 [PMID: 16900011]
  14. J Am Soc Echocardiogr. 2001 Sep;14(9):910-6 [PMID: 11547277]
  15. J Am Coll Cardiol. 2008 Jan 29;51(4):473-5 [PMID: 18222359]
  16. Circulation. 2005 Sep 13;112(11):1587-93 [PMID: 16144997]
  17. Circulation. 1997 Aug 5;96(3):785-92 [PMID: 9264483]
  18. JACC Cardiovasc Imaging. 2008 Jan;1(1):107-10 [PMID: 19356413]
  19. Circulation. 1987 Oct;76(4):943-51 [PMID: 3652428]
  20. Curr Probl Cardiol. 1997 Nov;22(11):549-635 [PMID: 9395780]
  21. Am J Hypertens. 2007 May;20(5):533-8 [PMID: 17485016]
  22. Circulation. 2004 Aug 31;110(9):1108-13 [PMID: 15326066]
  23. J Am Soc Echocardiogr. 2001 May;14(5):378-85 [PMID: 11337683]
  24. J Am Coll Cardiol. 2007 Jul 24;50(4):327-34 [PMID: 17659200]
  25. J Am Coll Cardiol. 2006 Dec 5;48(11):2168-77 [PMID: 17161241]
  26. Am J Hypertens. 2007 May;20(5):539-40 [PMID: 17485017]
  27. Circulation. 1996 Jan 15;93(2):223-8 [PMID: 8548892]
  28. Eur Heart J. 2005 Mar;26(6):607-16 [PMID: 15618026]
  29. Heart. 2003 Mar;89(3):342-8 [PMID: 12591856]
  30. Am Heart J. 2005 Feb;149(2):355-62 [PMID: 15846277]

Word Cloud

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