[Apical filling abnormality in patients with heart failure assessed with contrast echocardiography using venous injection of Albunex].

Contrast echocardiography by venous injection of Albunex was used to visualize apical filling abnormality in patients with heart failure. 1. Contrast echocardiography was serially performed in 24 patients with acute anterior myocardial infarction. Wall motion of the infarct region was better at any stage in patients without apical filling abnormality than in patients with that. Improvement of filling abnormality was observed prior to that of wall motion abnormality. 2. Influence of tachycardia was assessed on apical filling in 20 patients with old myocardial infarction during rapid atrial pacing. Stress contrast echocardiography evidenced that tachycardia deteriorates apical filling abnormality in patients with chronic heart failure. 3. The effect of amrinone on apical filling was assessed in 60 patients with chronic anterior myocardial infarction. Apical filling abnormality improved in 46% of patients after amrinone infusion. The improvement of apical filling abnormality was closely related to the reduction of preload and improvement of asynergy in the infarct area after amrinone. Both adjunctive therapy and anticoagulant therapy should be considered if apical filling abnormalities are observed by contrast echocardiography.