Miguel Osman Dias Aguiar et al. Alessandra Joslin Oliveira Carolina Stangenhaus Wilson Mathias Junior
Introduction
Contrast echocardiography (CE) uses ultrasound enhancing agents (UEA) that, when introduced into the bloodstream and subjected to ultrasound (US), contrast the blood due to the great reflective capacity of microbubbles. It completely opacifies the left ventricle (LV), with better definition of endocardial borders, Doppler signal enhancement, and myocardial perfusion (MP).
Commercially available second-generation UEA are composed of high molecular weight gases surrounded by an outer shell of albumin, phospholipid, or polymer. These inert structures aggregate and remain within the intravascular space, presenting kinetics similar to those of red blood cells but at less than half their size (1.0–4.5 µm), which allows them to pass the pulmonary capillary barrier and reach the left chambers. They are predominantly excreted through the lungs, have a high metabolism (half-life, 10–12 min), do not deposit in the tissues, and, unlike iodinated contrast agents, present no known risk factors of nephrotoxicity.,
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