Clinical utility of contrast echocardiography in the management of patients with acute myocardial infarction

The extensive use of myocardial contrast echocardiography (MCE) in patients with acute myocardial infarction has provided critical information regarding the perfusion-contraction mismatch that is observed in post-ischaemic dysfunctioning segments. `No-reflow' phenomena, microvascular stunning, and the relation between microvascular integrity and inotropic reserve within the infarct zone represent areas in which NICE could provide useful information. Rapid technological progress has been made in echocardiographic imaging (harmonic and ultraharmonic imaging, real-time perfusion imaging), and new ultrasound contrast agents such as SonoVue (Bracco, Milan, Italy) have been introduced into the market. These have rendered non-invasive assessment of myocardial perfusion a clinical reality, and thus demonstrate the potential role of NICE in assessing myocardial salvage after reperfusion therapy and suggest that routine NICE use in a coronary care unit may be possible. (C) 2002 The European Society of Cardiology.