History of Contrast Echocardiography

The development of contrast echocardiography spans over more than 50 years. Ultrasound contrast agents are unique because significant contrast effects can only be achieved when gas containing microbubbles are present in the injection solution. In addition to suitable contrast agents, specific echocardiographic techniques were developed. Milestones included the approval of stable, intravenously injectable contrast agents and the availability of harmonic imaging and contrast-specific ultrasound methods on the echocardiography devices. German scientists and clinicians were leaders or co-investigators in major experimental and clinical research projects, which led to the global establishment of contrast echocardiography for clinical diagnostics. The essential studies and the involved scientists and clinicians are presented. The translation of study results into clinical practice can be found in the instructions for contrast echocardiography in the manual for the indications and implementation of special echocardiographic applications from 2021 of the Cardiovascular Ultrasound Working Group of the German Cardiac Society (DGK).