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Contrast echocardiography is widely used in echocardiographic laboratories. When used at rest or with a stress test, it provides complementary information concerning myocardial perfusion not available with conventional imaging. Its applications in the evaluation of left ventricular ejection fraction, the detection of coronary stenosis and the no reflow phenomenon in acute myocardial infarction have been validated. Advances in our understanding of the interaction between the microbubbles and ultrasound have led to considering the microbubble not just as a vascular tracer but also as a vector of active molecules. The detection of angiogenesis, thrombi, or intravascular inflammation are possible with contrast echocardiography. Therefore, new perspectives in myocardial contrast echo are opening up in therapeutics. Preliminary studies in the animal suggest that it may be possible to use microbubbles to deliver drugs or genetic material to the heart of the cardiomyocytes.
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