Myocardial Contrast Echocardiography in Coronary Artery Disease

摘要

Recent developments in the evaluation of coronary artery disease (CAD) have included major advances in myocardial contrast echocardiography (MCE). MCE is being used to evaluate: (1) ventricular segmental wall motion using myocardial contrast for left ventricular (LV) opacification; (2) myocardial perfusion (despite some remaining problems delaying widespread implementation) using bolus injections or continuous infusion of contrast with transient response imaging to evaluate qualitative and quantitative perfusion of myocardial regions;(3) myocardial viability and remodeling using contrast during Dobutamine stress echocardiography (DSE) to evaluate wall motion and perlusion;(4) coronary flow reserve using contrast-enhanced transthoracic echocardiography (echo) to look for enhanced coronary flow after administration of adenosine; and (5) detection of LV thrombus using niyocardial contrast enhancement. Consequently, MCE should have a promising role in evaluating patients with a possible ischemic etiology for chest pain, establishing the diagnosis and prognosis in acute myocardial infarction, assessing the efficacy of thrombolytic and catheter-based reperfusion techniques, and differentiating myocardial necrosis from stunning. Exciting potential applications include: ultrasound-assisted thrombolysis, targeted drug delivery using ultrasound microbubbles, and detection of inflammation, thrombus, etc. using microbubble -encapsulated antibodies (or other agents).