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Ahmad M, Wu G, Frank L, Dimaano MM. Validation of left ventricular volume and ejection fraction measurements by high‐definition blood flow imaging: Comparisons with cardiac magnetic resonance imaging and contrast echocardiography. Echocardiography 2020; 37:1975-1980. [DOI: 10.1111/echo.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Masood Ahmad
- Division of Cardiology Department of Internal Medicine University of Texas Medical Branch Galveston TX USA
| | - Geru Wu
- Division of Cardiology Department of Internal Medicine University of Texas Medical Branch Galveston TX USA
| | - Luba Frank
- Division of Cardiology Department of Internal Medicine University of Texas Medical Branch Galveston TX USA
| | - Meneleo M. Dimaano
- Division of Cardiology Department of Internal Medicine University of Texas Medical Branch Galveston TX USA
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Wu G, Xie T, Dimaano MM, Alghrouz MI, Ahmad M. High-definition blood flow imaging in the assessment of left ventricular function: Initial experience and comparison with contrast echocardiography. Echocardiography 2019; 36:546-557. [PMID: 30786059 DOI: 10.1111/echo.14282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/26/2018] [Accepted: 01/17/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The study aimed to assess the accuracy and reproducibility of the high-definition blood flow imaging (HD-Flow) in evaluation of left ventricular (LV) function by comparison with contrast echocardiography (Contrast). BACKGROUND Contrast improves endocardial border visualization and assists in precise assessment of LV function. HD-Flow, a novel ultrasound technique that enhances blood flow discrimination in LV, could possibly be used for improving endocardial border definition without contrast. METHODS Eighty patients with technically limited transthoracic echocardiograms had HD-Flow, and contrast performed sequentially. LV endocardial visualization, image acquisition time, wall motion, volumes, ejection fraction (EF), stroke volume (SV), and stroke volume index (SVI) were compared. Inter- and intra-observer agreements were examined in a randomly selected subgroup. RESULTS Both HD-Flow and contrast significantly improved the percentage of the well-defined endocardial border segments (71% at baseline vs 94.1% by HD-Flow vs 94.9% by contrast, X2 = 401, P < 0.001). The acquisition time for HD-Flow was significantly less when compared to contrast (2.13 ± 1.18 minutes vs 10.96 ± 3.51 minutes, P < 0.001). LV end-diastolic volume (EDV), end-systolic volume (ESV), EF, SV, and SVI measured by the two methods correlated well (EDVr = 0.97, ESVr = 0.96, EFr = 0.90, SVr = 0.77, SVIr = 0.74, all P < 0.001). In comparison, HD-Flow was neither significantly different in detecting LV wall motion abnormality nor in EF, SV, and SVI measurements, but slightly underestimated LV volumes. CONCLUSIONS HD-Flow imaging is feasible and user-friendly in enhancing LV endocardial definition. This technique is useful in both qualitative and quantitative assessment of LV function.
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Affiliation(s)
- Geru Wu
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Tianrong Xie
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Meneleo M Dimaano
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Mohammad I Alghrouz
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Masood Ahmad
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
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Kim DY, Choi JH, Hong GR, Rim SJ, Kim JY, Lee SC, Sohn IS, Chung WJ, Seo HS, Yoon SJ, Cho KI, Choi SW, Lee KJ. Impact of Contrast Echocardiography on Assessment of Ventricular Function and Clinical Diagnosis in Routine Clinical Echocardiography: Korean Multicenter Study. J Cardiovasc Ultrasound 2017; 25:28-33. [PMID: 28400933 PMCID: PMC5385314 DOI: 10.4250/jcu.2017.25.1.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 11/29/2022] Open
Abstract
Background Fundamental echocardiography has some drawbacks in patients with difficult-to-image echocardiograms. The aim of this study is to evaluate impact of contrast echocardiography (CE) on ventricular function assessment and clinical diagnosis in routine clinical echocardiography. Methods Two hundred sixty patients were prospectively enrolled over 3 years in 12 medical centers in Korea. General image quality, 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 echocardiography with 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 of poor 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 making in Korean patients who undergo routine echocardiography.
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Affiliation(s)
- Doo-Youp Kim
- Department of Internal Medicine, Bongseng Memorial Hospital, Busan, Korea
| | - Jung-Hyun Choi
- Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Geu-Ru Hong
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Joong Rim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang-Chol Lee
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Il-Suk Sohn
- Department of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Heart Center, Gachon University Gil Hospital, Gachon University School of Medicine, Incheon, Korea
| | - Hye-Sun Seo
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Se-Jung Yoon
- Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Kyoung-Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Si-Wan Choi
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Kyung-Jin Lee
- Division of Cardiology, Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea
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Contrast echocardiography to assess left ventricular volume and function in Beagle dogs: Comparison with 3-Tesla dual source parallel cardiac magnetic resonance imaging. Vet J 2013; 198:450-6. [DOI: 10.1016/j.tvjl.2013.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/26/2013] [Accepted: 08/06/2013] [Indexed: 02/01/2023]
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Bergenzaun L, Gudmundsson P, Öhlin H, Düring J, Ersson A, Ihrman L, Willenheimer R, Chew MS. Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2011; 15:R200. [PMID: 21846331 PMCID: PMC3387642 DOI: 10.1186/cc10368] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 06/13/2011] [Accepted: 08/16/2011] [Indexed: 01/31/2023]
Abstract
Introduction Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE). Methods Fifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI). Results EBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ranging from 0.79 to 0.95 (P < 0.01). the Simpson correlations with the other LV parameters showed substantial variation over time, with the poorest results seen for TDIs and AVPDm. The repeatability was best for VTI (interobserver coefficient of variation (CV) 4.8%, and intraobserver CV, 3.1%), and AVPDm (5.3% and 4.4%, respectively), and worst for the Simpson method (8.2% and 10.6%, respectively). Conclusions EBEF and AVPDm provided the best, and Simpson, the worst feasibility when assessing LV systolic function in a population of mechanically ventilated, hemodynamically unstable patients. Additionally, the Simpson showed the poorest repeatability. We suggest that EBEF can be used instead of single-plane Simpson when assessing LV ejection fraction in this category of patients. TDIs and AVPDm, as markers of longitudinal function of the LV, are not interchangeable with LV ejection fraction.
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Affiliation(s)
- Lill Bergenzaun
- Department of Anaesthesiology, Institution of Clinical Sciences, Entrance 42, Skåne University Hospital, Lund University, Södra Förstadsgatan 101, S-20502 Malmö, Sweden.
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Donal E, Coquerel N, Bodi S, Kervio G, Schnell F, Daubert JC, Carre F. Importance of ventricular longitudinal function in chronic heart failure. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2011; 12:619-27. [DOI: 10.1093/ejechocard/jer089] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Van de Veire NR, Delgado V, Schuijf JD, van der Wall EE, Schalij MJ, Bax JJ. The role of non-invasive imaging in patient selection. Europace 2010; 11 Suppl 5:v32-9. [PMID: 19861389 DOI: 10.1093/europace/eup278] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cardiac resynchronization therapy (CRT) is an established therapy for patients with advanced heart failure, depressed left ventricular (LV) function and wide QRS complex. A substantial amount of patients do not respond to CRT. Recent studies suggest that assessment of mechanical dyssynchrony may allow identification of potential CRT responders. In addition, presence of scar tissue and venous anatomy may play a role in the selection of candidates. This article summarizes the role of non-invasive cardiac imaging modalities addressing these issues in the selection of CRT candidates.
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Affiliation(s)
- Nico R Van de Veire
- Department of Cardiology, Leiden University Medical Center, PO BOX 9600, 2300 RC Leiden, The Netherlands.
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Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax: An alternative to chest radiography*. Crit Care Med 2010; 38:533-8. [PMID: 19829102 DOI: 10.1097/ccm.0b013e3181c0328f] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kurt M, Shaikh KA, Peterson L, Kurrelmeyer KM, Shah G, Nagueh SF, Fromm R, Quinones MA, Zoghbi WA. Impact of Contrast Echocardiography on Evaluation of Ventricular Function and Clinical Management in a Large Prospective Cohort. J Am Coll Cardiol 2009; 53:802-10. [DOI: 10.1016/j.jacc.2009.01.005] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 01/06/2009] [Accepted: 01/12/2009] [Indexed: 10/21/2022]
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García-Vicente E, Campos-Nogué A, Gobernado Serrano MM. [Echocardiography in the Intensive Care Unit]. Med Intensiva 2009; 32:236-47. [PMID: 18570834 DOI: 10.1016/s0210-5691(08)70946-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The echocardiography can provide important and relevant information and the critically ill patient presents a challenge for the echocardiographer: from limitations in image acquisition to interpretation in the context of rapid physiological and intervention changes. The most frequent reason for requesting an echocardiogram in the ICU is probably to assess left ventricular function. In any case, information of direct relevance for clinical management can in relationship to abnormalities of structure and function can be obtained and used to estimate pulmonary arterial and venous pressures. It can help to investigate the consequences of myocardial ischemia, valvular dysfunction and pericardial disease and detect changes characteristic of specific conditions (e.g. sepsis, pulmonary thromboembolism), although this must be interpreted in the context of each individual patient. The echocardiography also can be used to monitor the therapeutic interventions. The applications of echocardiography in the critical care setting are reviewed, with special emphasis on the assessment of cardiac physiology.
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Affiliation(s)
- E García-Vicente
- Unidad de Cuidados Intensivos, Hospital Santa Bárbara, Soria, España.
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Jung PH, Rieber J, Stork S, Hoyer C, Erhardt I, Nowotny A, Voelker W, Weidemann F, Ertl G, Klauss V, Angermann CE. Effect of contrast application on interpretability and diagnostic value of dobutamine stress echocardiography in patients with intermediate coronary lesions: comparison with myocardial fractional flow reserve. Eur Heart J 2008; 29:2536-43. [DOI: 10.1093/eurheartj/ehn204] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dhir S, Ganapathy S. Use of ultrasound guidance and contrast enhancement: a study of continuous infraclavicular brachial plexus approach. Acta Anaesthesiol Scand 2008; 52:338-42. [PMID: 18269386 DOI: 10.1111/j.1399-6576.2007.01563.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE We describe our experience of combining the use of ultrasound (US) guidance with contrast enhancement and peripheral nerve stimulation for the insertion of infraclavicular brachial plexus catheters. METHODS Thirty patients scheduled to have upper limb surgery under regional block were studied. Under US guidance and peripheral nerve stimulation assistance, continuous peripheral nerve block needle and stimulating catheter were placed in the infraclavicular area. Needle and catheter tip location was confirmed with agitated 5% dextrose and seen under colour Doppler with US before injecting local anaesthetic (LA). Patients were evaluated in terms of onset times and efficacy of block. Post-operatively, on block recession a catheter was stimulated and visualization of spread of LA during injection through the catheter was done. Secondary block (subsequent to re-injection of LA) was assessed. Patients were followed-up for a week. RESULTS Mean time to onset of block was 19.7 (+/- 4.9) min. There were no incomplete blocks and all components of the plexus were blocked completely. Post-operatively, in 95.7% of patients, the spread of hand-agitated LA via the catheter could be seen by color Doppler with ultrasonography. All patients had excellent post-operative analgesia and high degree of satisfaction. There were no complications. CONCLUSION Contrast enhancement with US guidance during infraclavicular brachial plexus block enables direct visualization of needle and catheter tip location. Our early experience suggests that this leads to successful initial and subsequent post-operative block. Further controlled studies are needed to compare this technique with more prevalent and conventional techniques of catheter insertion.
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Affiliation(s)
- S Dhir
- Department of Anesthesiology and Perioperative Medicine, University of Western Ontario, London, ON, Canada.
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Abstract
Technological advances continue to expand the clinical role of echocardiography in the intensive care unit, particularly in patients with heart failure. It has many advantages over tomographic techniques such as echo cardiac magnetic resonance imaging and cardiac computed tomography, can provide rapid bedside cardiac assessment, and facilitate emergent decision-making for critically ill patients. Image quality problems in the intensive care setting have largely been overcome by the use of harmonic imaging, contrast opacification, and when indicated, transesophageal echocardiography. Newer techniques promise to advance the scope and prognostic power of echocardiography, and to expand the portability and availability of this tool.
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Hu SJ, Liu SX, Katus HA, Luedde M. The value of contrast dobutamine stress echocardiography on detecting coronary artery disease in overweight and obese patients. Can J Cardiol 2007; 23:885-9. [PMID: 17876380 PMCID: PMC2651366 DOI: 10.1016/s0828-282x(07)70844-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Dobutamine stress echocardiography (DSE) is an established method of detecting myocardial ischemia. Its diagnostic accuracy solely depends on wall motion assessment. Clear visibility of the left ventricular endocardium is essential for reliable assessment of a wall motion abnormality. However, incremental benefits of contrast DSE for the detection of coronary artery disease (CAD) have not been demonstrated in overweight or obese patients. OBJECTIVES The purpose of the present study was to test the incremental benefits of contrast DSE in detecting CAD in overweight or obese patients. METHODS Sixty-two overweight or obese patients (body mass index 26 kg/m(2) to 33 kg/m(2)) underwent DSE with or without contrast and coronary angiography. Contrast-enhanced images were achieved at rest and during peak DSE after administration of SonoVue (Bracco Diagnostics Inc, Italy) or Optison (Mallinckrodt, USA). The endocardial border resolution for each myocardial segment was graded as 0, 1 or 2. A total of 992 segments from 62 subjects were analyzed. The results of DSE with or without contrast were compared with the findings on angiography. RESULTS The differences in the score grading between the two groups with or without contrast, at rest and during peak DSE were statistically significant (P<0.001). The sensitivity, specificity and accuracy of contrast DSE in detecting CAD, compared with the studies without contrast, were improved (82% versus 70%, 78% versus 67% and 81% versus 69%, respectively). CONCLUSIONS SonoVue and Optison can enhance left ventricular endocardial border delineation in overweight or obese patients, optimizing the evaluation of wall motion both at rest and during peak stress. This increases the diagnostic value of DSE in detecting CAD.
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Affiliation(s)
- Shen-Jiang Hu
- Department of Cardiology, First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Sheng-Xiang Liu
- Department of Cardiology, First Affiliated Hospital, Zhejiang University, Hangzhou, China
- Correspondence: Dr Sheng-Xiang Liu, Department of Cardiology, First Affiliated Hospital, Zhejiang University, QingChun Road 79, Hangzhou 310003, China. Telephone 86-0571-88393513, fax 86-0571-88085336, e-mail
| | - HA Katus
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - Mark Luedde
- Department of Cardiology, University of Heidelberg, Heidelberg, Germany
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Kirkpatrick JN, Vannan MA, Narula J, Lang RM. Echocardiography in Heart Failure. J Am Coll Cardiol 2007; 50:381-96. [PMID: 17662389 DOI: 10.1016/j.jacc.2007.03.048] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 03/27/2007] [Accepted: 03/29/2007] [Indexed: 11/21/2022]
Abstract
Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure (HF) population. The recently-released American College of Cardiology/American Heart Association guidelines for the diagnosis and management of HF labeled echocardiography "the single most useful diagnostic test in the evaluation of patients with HF...," because of its ability to accurately and noninvasively provide measures of ventricular function and assess causes of structural heart disease. It can also detect and define the hemodynamic and morphologic changes in HF over time and might be equivalent to invasive measures in guiding therapy. In this article we will discuss: 1) the clinical uses of echocardiography in HF and their prognostic value; 2) the use of echocardiography to guide treatment in HF patients; and 3) promising future techniques for echocardiographic-based imaging in HF. In addition, we will highlight some of the limitations of echocardiography.
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Affiliation(s)
- James N Kirkpatrick
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Abstract
Advances in ultrasound technology continue to enhance its diagnostic applications in daily medical practice. Bedside echocardiographic examination has become useful to properly trained cardiologists, anesthesiologists, intensivists, surgeons, and emergency room physicians. Cardiac ultrasound can permit rapid, accurate, and noninvasive diagnosis of a broad range of acute cardiovascular pathologies. Although transesophageal echocardiography was once the principal diagnostic approach using ultrasound to evaluate intensive care unit patients, advances in ultrasound imaging, including harmonic imaging, digital acquisition, and contrast for endocardial enhancement, has improved the diagnostic yield of transthoracic echocardiography. Ultrasound devices continue to become more portable, and hand-carried devices are now readily available for bedside applications. This article discusses the application of bedside echocardiography in the intensive care unit. The emphasis is on echocardiography and cardiovascular diagnostics, specifically on goal-directed bedside cardiac ultrasonography.
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Affiliation(s)
- Yanick Beaulieu
- Hôpital Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada.
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Abstract
This is the second of a two-part review on the application of bedside ultrasonography in the ICU. In this part, the following procedures will be covered: (1) echocardiography and cardiovascular diagnostics (second part); (2) the use of bedside ultrasound to facilitate central-line placement and to aid in the care of patients with pleural effusions and intra-abdominal fluid collections; (3) the role of hand-carried ultrasound in the ICU; and (4) the performance of bedside ultrasound by the intensivist. The safety and utility of bedside ultrasonography performed by adequately trained intensivists has now been well demonstrated. This technology, as a powerful adjunct to the physical examination, will become an indispensable tool in the management of critically ill patients.
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Affiliation(s)
- Yanick Beaulieu
- Division of Cardiology and Critical Care Medicine, Hôpital Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin O., Montreal, Quebec, Canada, H4J 1C5.
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Abstract
Echocardiography continues to be the primary noninvasive imaging modality for the assessment of cardiac structure and function because of significant advances in ultrasound imaging technology over the last two decades, yet quantification of the LV function has remained an elusive goal. The introduction of contrast agents has represented a major advance in clinicians' ability to visualize the endocardium and to assess LV function accurately, particularly in patients who have poor acoustic windows. Ongoing and future refinements in imaging technology used with contrast enhancement have placed automated quantification of LV function on the brink of widespread clinical use.
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Affiliation(s)
- R Parker Ward
- Noninvasive Imaging Laboratories, Section of Cardiology, Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, USA.
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