Left ventricular contrast echocardiography: role for evaluation of function and structure.

Despite the recent introduction of tissue harmonic imaging in echocardiography, in 10%-15% of patients endocardial borders of the left ventricle are poorly defined. This may lead to erroneous assessment of regional and global left ventricular (LV) function or further diagnostic imaging with another modality leading to increased cost to the healthcare system. The recent development of second generation contrast echocardiography agents such as SonoVue has resulted in several studies showing the value of these agents to outline endocardium clearly, thereby improving assessment of LV function. The use of these contrast agents has also opened the possibility of automated and qualitative LV function assessment, resulting in more accurate and reproducible assessment. Other major clinical uses of these contrast agents are evaluation of LV masses such as thrombus and tumors, and better definition of LV structure such as delineating LV aneurysm, pseudoaneurysm; and noncompaction of LV and apical cardiomyopathy. Thus, it is clear that contrast-enhanced LV assessment at rest will play an important role in echocardiography.