Madu Ernest C, Potu Chiranjivi, Baugh Dainia, Tulloch-Reid Edwin
Department of Medicine, Division of Cardiovascular Medicine, Heart Institute of the Caribbean, Kingston, Jamaica; Center of Excellence for Cardiovascular Medicine and Sports Physiology, University of Technology, Kingston, Jamaica.
Cardiol Res. 2011 Dec;2(6):259-268. doi: 10.4021/cr93w. Epub 2011 Nov 20.
Myocardial contrast echocardiography (MCE) has an established role in left ventricular assessment by improving the ventricular opacification and endocardial border definition especially in patients with sub-optimal echocardiographic images. With advances in cardiac ultrasound imaging technology and the development of new contrast agents, the clinical utility of this technique has greatly expanded to include assessment of coronary reperfusion in the setting of acute myocardial infarction, determination of myocardial viability within infarct zones as well as assessment of coronary microcirculation and flow reserve in patients with microvascular coronary disease. Improvements in image quality with intravenous contrast agents can facilitate image acquisition and enhance delineation of regional wall motion abnormalities at peak levels of exercise. Numerous studies have confirmed the clinical utility of contrast enhancement during echocardiographic studies, particularly in patients undergoing stress testing. In this paper, we explore the evidence in support of MCE and its potential clinical applications. Our review aims to summarize (1) the basic principles of myocardial contrast echocardiography including recent advances in the ultrasound technology and contrast agents (2) its clinical applications in the diagnosis of cardiovascular diseases and finally, (3) its potential role in risk stratification and assessment of microvascular perfusion in patients with hypertensive heart disease.
心肌对比超声心动图（MCE）在左心室评估中具有既定作用，可通过改善心室显影和心内膜边界清晰度来实现，尤其是对于超声心动图图像欠佳的患者。随着心脏超声成像技术的进步和新型造影剂的研发，该技术的临床应用范围已大幅扩展，包括评估急性心肌梗死时的冠状动脉再灌注、梗死区域内心肌存活情况，以及评估微血管性冠心病患者的冠状动脉微循环和血流储备。静脉注射造影剂可提高图像质量，有助于在运动高峰时采集图像并增强对局部室壁运动异常的描绘。大量研究证实了超声心动图检查期间造影增强的临床实用性，特别是在进行负荷试验的患者中。在本文中，我们探讨支持MCE及其潜在临床应用的证据。我们的综述旨在总结：（1）心肌对比超声心动图的基本原理，包括超声技术和造影剂的最新进展；（2）其在心血管疾病诊断中的临床应用；最后，（3）其在高血压性心脏病患者风险分层和微血管灌注评估中的潜在作用。
