The purpose of this study was to determine in an in vitro model the effect of pulsatile pressure on the decay of echocardiographic contrast agents. Use of contrast agents for quantitative assessment of perfusion requires understanding of the factors controlling their rates of disappearance. Prior studies have shown that constant pressure affects the rate of disappearance of these agents. It is not known whether pulsatile pressure influences the rate of decay of contrast agents. In an in vitro chamber, three contrast agents (Albunex, hand-agitated saline solution, and hand-agitated Angiovist) were exposed to pulses of pressure at three rates (30, 60, and 120 pulsations/min), keeping pressure characteristics (peak, nadir, and mean) within a narrow range. Five injections were performed for each agent at each rate. Two-dimensional echocardiographic images of the effects of contrast material were recorded from injection until total disappearance. Videointensity was measured and time-intensity curves were generated. These curves of intensity decay were fitted to an exponential decay function (I = Ae-lambda t) and the velocity of decay (lambda) was used for comparisons. For all agents, intensity of contrast decreased over time. Saline solution and Angiovist, but not Albunex, showed pulsatile decreases in intensity of contrast with each peak pressure and partial recovery of contrast intensity with each nadir pressure. (ABSTRACT TRUNCATED AT 250 WORDS)