Myocardial contraste chocardiography : clinical applications in acute myocardial infarction

The myocardial contrast echocardiography is a technique used to assess myocardial perfusion. Air-filled micro-bubbles are injected into the coronary circulation where they act as intra-vascular tracers. These microbubbles exaggerate ultrasound reflection: nor-mally-perfused myocardial territories, passed through by microbubbles, will appear as white areas in echocardiography, in contrast with non-perfused territories which will appear as grey areas. The main clinical application of myocardial contrast echocardiography in acute myocardial infarction is the assessment of “no-reflow” phenomenon, defined as the absence of myocardial perfusion despite the re-opening of the infarct-related artery. The diagnosis of no-reflow has major prognostic implications, since the absence of myocardial perfusion in the area at risk after coronary recanalization is associated with poor functional and global prognosis, and specifically with an absence of left ventricular contractile recovery. The development of new intravenous contrast media will allow non invasive assessment of myocardial perfusion. The main application of intravenous myocardial contrast echocardiography is the non-invasive assessment of myocardial reperfusion after thrombolysis.