Microbubbles are an excellent intravascular tracer, and both the rate of myocardial opacification (analogous to coronary microvascular perfusion) and contrast intensity (analogous to myocardial blood volume) provide unique insights into myocardial perfusion. A strong evidence base has been accumulated to show comparability with nuclear perfusion imaging and incremental diagnostic and prognostic value relative to wall motion analysis. This technique also provides the possibility to measure myocardial perfusion at the bedside. Despite all of these advantages, the technique is complicated, technically challenging, and has failed to scale legislative and financial hurdles. The development of targeted imaging and therapeutic interventions will hopefully rekindle interest in this interesting modality.
Keywords: ACS; CAD; CE; CFR; CMR; Contrast echocardiography; Coronary artery disease; DSE; Diagnosis; FDA; Food and Drug Administration; HF; LV; LV opacification; LVO; MBF; MBV; MI; MP; MP imaging; MPI; MechI; Myocardial perfusion; PET; Prognosis; RTI; SPECT; TRI; Tissue plasminogen activator; acute coronary syndrome; cardiac magnetic resonance; contrast echocardiography; coronary artery disease; coronary flow reserve; dobutamine stress echocardiography; heart failure; left ventricle; mechanical index; myocardial blood flow; myocardial blood volume; myocardial infarction; myocardial perfusion; positron emission tomography; real time imaging; single photon emission computed tomography; tPA; triggered replenishment imaging.
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