Difficulty Introducing Contrast Echocardiography in Daily Clinical Practice in South America: A Matter of Economy?

Contrast echocardiography has shown invaluable utility in the clinical setting during the last 20 years. Most studies have demonstrated its successful application in different clinical scenarios. Ultrasound contrast agents (UCA) have evolved incredibly since their first-generation iterations at the end of the last century. From weak and short-term duration agents like Levovist™ to the development of fluorocarbons with simple storage requirements like Definity™ and Sonovue™, significant improvements have been achieved and the logistics in echocardiography labs became easier. Nevertheless, their clinical application did not increase as expected, especially in South America.

To analyze this fact, we must consider the probability of a new diagnostic technique becoming a regular and widespread diagnostic tool. A new diagnostic technique should be superior to its predecessors and available in different clinical scenarios; feature simple instrumentation, simple interpretation, well-defined normal patterns; be attractive and comprehensive in terms of image quality; and be cost-effective to ensure acceptance by health system financiers.^, ()

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