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Clinical Applications of Left Ventricular Opacification

Department of Cardiology, Northwick Park Hospital, Harrow, United Kingdom

^_* Reprint requests and correspondence: Prof. Roxy Senior, Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow HA1 3UJ, United Kingdom (Email: roxysenior{at}cardiac-research.org).

The significant advances made in ultrasound microbubble technology now permits reliable, reproducible left ventricular opacification, and this review reiterates the evidence that has shown contrast echocardiography to be clinically effective, to reduce downstream costs and to spare patients further, potentially hazardous investigations. Despite the evidence and the advances, there remains ambivalence towards the administration of contrast agents in echocardiography laboratories throughout the world, particularly in the performance of rest studies. Therefore, this review also addresses some of the reasons for the suboptimal uptake of contrast agents and encourages physicians, sonographers, and accreditatory bodies to adopt a different approach towards the difficult-to-image patient.

Key Words: left ventricular • opacification • echocardiography

Abbreviations and Acronyms   2DE = 2-dimensional echocardiography   3DE = 3-dimensional echocardiography   CAD = coronary artery disease   CMR = cardiac magnetic resonance   EAE = European Association of Echocardiography   EF = ejection fraction   FDA = Food and Drug Administration   LV = left ventricular   LVEF = left ventricular ejection fraction   MI = mechanical index

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