Myocardial contrast quantitation during stress echocardiography

Please see page 217 for the article by Toledo et al. ( doi:10.1016/j.euje.2005.07.012 ) to which this editorial pertains. Quantification of functional and perfusion abnormalities with stress imaging techniques is an important challenge in the assessment of patients with known or suspected coronary artery disease (CAD). The standard technique for evaluation of CAD with echocardiography relies upon subjective observation of wall motion abnormalities during exercise or pharmacologic stress, with a semi-quantitative approach to evaluate the extent of functional abnormalities using a 16-segment or 3 coronary arterial territorial distribution model.1,2 This approach has permitted the diagnosis of CAD with moderate sensitivity and moderate-to-high specificity. However, the extent of CAD has been consistently underestimated with this method and the sensitivity remains modest particularly in patients with single vessel CAD.3 Furthermore, hard cardiac events are still observed in around 1% annually among patients with a normal wall motion study.4–7Real time myocardial contrast echocardiography (RTMCI) has been shown to be a safe and feasible …