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Background: Fundamental echocardiography has some drawbacks in patients with difficult-to-image echocardiograms. Theaim of this study is to evaluate impact of contrast echocardiography (CE) on ventricular function assessment and clinical diagnosisin routine clinical echocardiography. Methods: Two hundred sixty patients were prospectively enrolled over 3 years in 12 medical centers in Korea. General imagequality, the number of distinguishable segments, ability to assess regional wall motion, left ventricular (LV) apex and right ventricle(RV) visualization, LV ejection fraction, changes in diagnostic or treatment plan were documented after echocardiographywith and without ultrasound contrast agent. Results: Poor or uninterpretable general image was 31% before contrast use, and decreased to 2% (p < 0.05) after contrast use. The average number of visualized LV segments was 9.53 before contrast use, and increased to 14.46 (p < 0.001) after contrast use. The percentage of poor or not seen LV regional wall motion was decreased from 28.4% to 3.5% (p < 0.001). The percentage ofpoor or not seen LV apex and RV was decreased from 49.4% to 2.4% (p < 0.001), from 30.5% to 10.5% (p < 0.001), respectively. Changes in diagnostic procedure and treatment plan after CE were 30% and 29.6%, respectively. Conclusion: Compared to fundamental echocardiography, CE impacted LV function assessment and clinical decision makingin Korean patients who undergo routine echocardiography.

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