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STATE-OF-THE-ART PAPER

Myocardial Contrast Echocardiography Evolving as a Clinically Feasible Technique for Accurate, Rapid, and Safe Assessment of Myocardial Perfusion

The Evidence So Far

Pieter A. Dijkmans, MD^_*,_*, Roxy Senior, MD, PhD, Harald Becher, MD, PhD, Thomas R. Porter, MD, PhD, Kevin Wei, MD^||, Cees A. Visser, MD, PhD^_* and Otto Kamp, MD, PhD^_*

^_* Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, United Kingdom
Department of Cardiology, John Radcliffe Hospital, Headington, Oxford, United Kingdom
Section of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
^|| Oregon Health and Science University, Portland, Oregon.

Manuscript received February 28, 2006; revised manuscript received April 21, 2006, accepted May 15, 2006.

^_* Reprint requests and correspondence: Dr. Pieter A. Dijkmans, Department of Cardiology 6D-120, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. (Email: pa.dijkmans{at}vumc.nl).

Intravenous myocardial contrast echocardiography (MCE) is a recently developed technique for assessment of myocardial perfusion. Up to now, many studies have demonstrated that the sensitivity and specificity of qualitative assessment of myocardial perfusion by MCE in patients with acute and chronic ischemic heart disease are comparable with other techniques such as cardiac scintigraphy and dobutamine stress echocardiography. Furthermore, quantitative parameters of myocardial perfusion derived from MCE correlate well with the current clinical standard for this purpose, positron emission tomography. Myocardial contrast echocardiography provides a promising and valuable tool for assessment of myocardial perfusion. Although MCE has been primarily performed for medical research, its implementation in routine clinical care is evolving. This article is intended to give an overview of the current status of MCE.

Abbreviations and Acronyms   ACS = acute coronary syndrome   AMI = acute myocardial infarction   CAD = coronary artery disease   DSE = dobutamine stress echocardiography   MBF = myocardial blood flow   MBV = myocardial blood volume   MCE = myocardial contrast echocardiography   VI = video intensity

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