Purpose: Cardiac allograft vasculopathy (CAV) remains a major long-term complication after heart transplantation (HTx) which is usually monitored by coronary angiography and intravascular ultrasound (IVUS). Myocardial contrast echocardiography (MCE) is a new, promising noninvasive technique to evaluate microvascular perfusion and to identify significant coronary stenosis. The aim of the study was to assess the prognostic value of stress MCE in comparison to coronary angiography including IVUS and stress 99mTC Sestamibi perfusion imaging.