Assessment of myocardial perfusion in coronary artery disease using myocardial contrast echocardiography.

MCE has evolved over the past decade as a clinically useful technique for the assessment of myocardial perfusion in patients with coronary artery disease. At present, its applications are limited because of the necessity of injecting microbubbles directly into the arterial circulation. Newer contrast agents, capable of producing myocardial opacification from a venous injection, are likely to broaden significantly the application of this technique in patients with coronary artery disease. Advances in ultrasound technology, such as second-harmonic imaging will make MCE a valuable non-invasive method, capable of simultaneously assessing regional perfusion and function. The advent of ultrasound systems that provide a linear relationship between the tissue concentration of microbubbles and the video intensity will make the method truly quantitative. It is likely that MCE will replace nuclear cardiology for the assessment of myocardial dysfunction by the turn of the century in many patients with coronary artery disease.