Myocardial contrast echocardiography in coronary artery disease

Background: Contrast echocardiography has evolved over the past two decades from a technique utilized primarily for left ventricular opacification to a sophisticated assessment of the physiologic properties of the coronary circulation. Myocardial contrast echocardiography (MCE) is a powerful tool that can provide both a qualitative and a quantitative analysis of regional myocardial blood flow. It has proven to be effective in the diagnosis and prognosis of chest pain and acute coronary syndromes. In addition, MCE can be utilized for the assessment of physiologic significant coronary artery disease and the detection of myocardial viability. Conclusions: This paper will review the origins of contrast echocardiography, the physiologic principles and techniques of contrast detection and assessment of myocardial blood flow, and the utilization of these techniques in the clinical assessment of acute coronary syndromes and chronic coronary artery disease.