American Society of Echocardiography Cardiovascular Technology and Research Summit: A Roadmap for 2020

Pellikka, Patricia A.; Douglas, Pamela S.; Miller, James G.; Abraham, Theodore P.; Baumann, Rolf; Buxton, Denis B.; Byrd, Benjamin F.; Chen, Peter; Cook, Nakela L.; Gardin, Julius M.; Hansen, Gunnar; Houle, Hélène; Husson, Stefan; Kaul, Sanjiv; Klein, Allan L.; Lang, Roberto M.; Leong‐Poi, Howard; Lopez, Hector Sanchez; Mahmoud, Tamer M.; Maslak, Sam; McCulloch, Marti; Metz, Steve; Nagueh, Sherif F.; Pearlman, Alan S.; Pîbarot, Philippe; Picard, Michael H.; Porter, Thomas R.; Prater, David; Rodriguez, Rudy; Sarano, Maurice E.; Scherrer‐Crosbie, Marielle; Shirali, Girish S; Sinusas, Albert J.; Slosky, Jack J.; Sugeng, Lissa; Tatpati, Anand; Villanueva, Flordeliza S.; Ramm, Olaf T. von; Weissman, Neil J.; Zamani, Shaun

doi:10.1016/j.echo.2013.02.003

Cited by 36 publications

(16 citation statements)

References 19 publications

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“…Strain estimation using ultrasound has exhibited great promise for clinical integration due to its non-invasiveness, low cost, and ease of use (Pellikka et al, 2013; Thomas and Popović, 2006). The echocardiographic exam is a routine procedure in clinical cardiology used to assess cardiac tissue health and blood flow, although strain measurements are currently less utilized.…”

Section: Introductionmentioning

confidence: 99%

Stochastic precision analysis of 2D cardiac strain estimationin vivo

2014

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Ultrasonic strain imaging has been applied to echocardiography and carries great potential to be used as a tool in the clinical setting. Two-dimensional (2-D) strain estimation may be useful when studying the heart due to the complex, three-dimensional deformation of the cardiac tissue. Increasing the framerate used for motion estimation, i.e. motion estimation rate (MER), has been shown to improve the precision of the strain estimation, although maintaining the spatial resolution necessary to view the entire heart structure in a single heartbeat remains challenging at high MERs. Two previously developed methods, the temporally unequispaced acquisition sequence (TUAS) and the diverging beam sequence (DBS), have been used in the past to successfully estimate in vivo axial strain at high MERs without compromising spatial resolution. In this study, a stochastic assessment of 2-D strain estimation precision is performed in vivo for both sequences at varying MERs (65, 272, 544, 815 Hz for TUAS; 250, 500, 1000, 2000 Hz for DBS). 2-D incremental strains were estimated in five healthy volunteers using a normalized cross-correlation function and a least-squares strain estimator. Both sequences were shown capable of estimating 2-D incremental strains in vivo. The conditional expected value of the elastographic signal-to-noise ratio (E(SNRe|ε)) was used to compare strain estimation precision of both sequences at multiple MERs over a wide range of clinical strain values. The results here indicate that axial strain estimation precision is much more dependent on MER than lateral strain estimation, while lateral estimation is more affected by strain magnitude. MER should be increased at least above 544 Hz to avoid suboptimal axial strain estimation. Radial and circumferential strain estimations were influenced by the axial and lateral strain in different ways. Furthermore, the TUAS and DBS were found to be of comparable precision at similar MERs.

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Section: Introductionmentioning

confidence: 99%

Stochastic precision analysis of 2D cardiac strain estimationin vivo

2014

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“…Hopefully, the results will help improve the practice standards for the Italian cardiology and echocardiographic community across the nation and the available practice-changing scientific evidence worldwide. In a rapidly evolving SE field, SE 2020 addresses the need for standardization clearly identified by the American Society of Echocardiography roadmap to 2020 in its research and technology recommendations [76]. The development of research registries is identified as a potentially important tool for assessing and improving the quality of care and a valuable platform for clinical research.…”

Section: Discussionmentioning

confidence: 99%

Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease

Picaño

Ciampi

Citro

et al. 2017

Cardiovasc Ultrasound

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BackgroundStress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities.MethodsIn a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information. The study is endorsed by the Italian Society of Cardiovascular Echography and organized in 10 subprojects focusing on: contractile reserve for prediction of cardiac resynchronization or medical therapy response; stress B-lines in heart failure; hypertrophic cardiomyopathy; heart failure with preserved ejection fraction; mitral regurgitation after either transcatheter or surgical aortic valve replacement; outdoor SE in extreme physiology; right ventricular contractile reserve in repaired Tetralogy of Fallot; suspected or initial pulmonary arterial hypertension; coronary flow velocity, left ventricular elastance reserve and B-lines in known or suspected CAD; identification of subclinical familial disease in genotype-positive, phenotype- negative healthy relatives of inherited disease (such as hypertrophic cardiomyopathy).ResultsWe expect to recruit about 10,000 patients over a 5-year period (2016-2020), with sample sizes ranging from 5,000 for coronary flow velocity/ left ventricular elastance/ B-lines in CAD to around 250 for hypertrophic cardiomyopathy or repaired Tetralogy of Fallot. This data-base will allow to investigate technical questions such as feasibility and reproducibility of various SE parameters and to assess their prognostic value in different clinical scenarios.ConclusionsThe study will create the cultural, informatic and scientific infrastructure connecting high-volume, accredited SE labs, sharing common criteria of indication, execution, reporting and image storage of SE to obtain original safety, feasibility, and outcome data in evidence-poor diagnostic fields, also outside the established core application of SE in CAD based on regional wall motion abnormalities. The study will standardize procedures, validate emerging signs, and integrate the new information with established knowledge, helping to build a next-generation SE lab without inner walls.

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“…1 As such, the development of accurate non-invasive indices of myocardial mechanics has long been a goal in pediatric echocardiography. 2 …”

Section: Introductionmentioning

confidence: 99%

Validation of Noninvasive Measures of Left Ventricular Mechanics in Children: A Simultaneous Echocardiographic and Conductance Catheterization Study

Chowdhury

Butts

Taylor

et al. 2016

Journal of the American Society of Echocardiography

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Introduction The accuracy of echocardiography in evaluating left ventricular (LV) contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility vs. those derived from pressure-volume loop (PVL) analysis in children. Methods Patients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different methods. These estimates were calculated using a combination of non-invasive blood pressure readings, ventricular volumes derived from 3D echocardiography, and Doppler time intervals. Results Of 24 patients, 18 patients were heart transplant recipients, 6 patients had a small patent ductus arteriosus or small coronary fistula. Mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mmHg/mL. Invasive Ees correlated best with echocardiographic Ees by method of Tanoue (r = 0.85, p < 0.01) with a mean difference of −0.07 mmHg/mL (95% limits of agreement: −2.0, 1.4 mm Hg/mL). Conclusion Echocardiographic estimates of Ees correlate well with gold-standard measures obtained via conductance catheters in children with relatively normal loading conditions. The use of these non-invasive measures in accurately assessing LV contractility appears promising and merits further study in children.

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American Society of Echocardiography Cardiovascular Technology and Research Summit: A Roadmap for 2020

Cited by 36 publications

References 19 publications

Stochastic precision analysis of 2D cardiac strain estimationin vivo

Stochastic precision analysis of 2D cardiac strain estimationin vivo

Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease

Validation of Noninvasive Measures of Left Ventricular Mechanics in Children: A Simultaneous Echocardiographic and Conductance Catheterization Study

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