Contrast echocardiography for left ventricular opacification.

Intravenous contrast agents are clinically useful for objective assessment of left ventricular (LV) regional and global function in patients with sub-optimal echocardiography images. Recent concerns over the safety of second generation microbubble contrast agents have now been largely abated with the emergence of robust clinical data supporting its safety and clinical utility. With proper technique and use of available imaging modalities, contrast can help eliminate technically difficult examinations. This review highlights the concepts and techniques for intravenous contrast for LV opacification, clinical utility, relative merit in assessing structural and functional abnormalities of the left ventricle and the evolving applications in assessing two-dimensional (2D) LV intracavitary flow sequence during phases of cardiac cycle. Integration of a variety of imaging techniques including 3D echocardiography and newer applications such as echo particle imaging velocimetry promise to improve diagnostic application of intravenous contrast for defining new markers for cardiac function.