The ability of real-time intravenous myocardial contrast echocardiography to predict left ventricular remodeling after reperfused acute myocardial infarction was assessed in 47 patients. Intravenous myocardial contrast echocardiography was an independent predictor of left ventricular dilation after acute myocardial infarction. In particular, normal contrast opacification within dyssynergic segments indicated a very low risk of remodeling.