Echo Research and Practice最新文献

{"title":"Mid-term follow-up and outcomes of patients with prosthetic heart valves: a single-centre experience.","authors":"Sadie Bennett, Polyvios Demetriades, Keely Banks, Jacopo Tafuro, Rosie Oatham, Timothy Griffiths, Cheryl Oxley, Sally Clews, Grant Heatlie, Chun Shing Kwok, Simon Duckett","doi":"10.1186/s44156-022-00001-w","DOIUrl":"10.1186/s44156-022-00001-w","url":null,"abstract":"<p><strong>Background: </strong>Patients with prosthetic heart valves (PHV) require long-term follow-up, usually within a physiologist led heart valve surveillance clinic. These clinics are well established providing safe and effective patient care. The disruption of the COVID-19 pandemic on services has increased wait times thus we undertook a service evaluation to better understand the patients currently within the service and PHV related complications.</p><p><strong>Methods: </strong>A clinical service evaluation of the heart valve surveillance clinic was undertaken to assess patient demographics, rates of complications and patient outcomes in patients who had undergone a PHV intervention at our institute between 2010 and 2020.</p><p><strong>Results: </strong>A total of 294 patients (mean age at time of PHV intervention: 71 ± 12 years, 68.7% male) were included in this service evaluation. Follow-up was 5.9 ± 2.7 years (range: 10 years). 37.1% underwent baseline transthoracic echo (TTE) assessment and 83% underwent annual TTE follow-up. Significant valve related complications were reported in 20 (6.8%) patients. Complications included a change in patient functional status secondary to significant PHV regurgitation (0.3%) or stenosis (0.3%), PHV thrombosis (0.3%) or infective endocarditis (3.7%). Significant valve related complications resulted in ten hospital admission (3.4%), two re-do interventions (0.6%), and four deaths (1.3%).</p><p><strong>Conclusions: </strong>This service evaluation highlights the large number of patients requiring ongoing surveillance. Only a small proportion of patients develop significant PHV related complications resulting in a low incidence of re-do interventions and deaths.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48972509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The assessment of mitral valve disease: a guideline from the British Society of Echocardiography.","authors":"Shaun Robinson,&nbsp;Liam Ring,&nbsp;Daniel X Augustine,&nbsp;Sushma Rekhraj,&nbsp;David Oxborough,&nbsp;Allan Harkness,&nbsp;Patrizio Lancellotti,&nbsp;Bushra Rana","doi":"10.1530/ERP-20-0034","DOIUrl":"https://doi.org/10.1530/ERP-20-0034","url":null,"abstract":"<p><p>Mitral valve disease is common. Mitral regurgitation is the second most frequent indication for valve surgery in Europe and despite the decline of rheumatic fever in Western societies, mitral stenosis of any aetiology is a regular finding in all echo departments. Mitral valve disease is, therefore, one of the most common pathologies encountered by echocardiographers, as both a primary indication for echocardiography and a secondary finding when investigating other cardiovascular disease processes. Transthoracic, transoesophageal and exercise stress echocardiography play a crucial role in the assessment of mitral valve disease and are essential to identifying the aetiology, mechanism and severity of disease, and for helping to determine the appropriate timing and method of intervention. This guideline from the British Society of Echocardiography (BSE) describes the assessment of mitral regurgitation and mitral stenosis, and replaces previous BSE guidelines that describe the echocardiographic assessment of mitral anatomy prior to mitral valve repair surgery and percutaneous mitral valvuloplasty. It provides a comprehensive description of the imaging techniques (and their limitations) employed in the assessment of mitral valve disease. It describes a step-wise approach to identifying: aetiology and mechanism, disease severity, reparability and secondary effects on chamber geometry, function and pressures. Advanced echocardiographic techniques are described for both transthoracic and transoesophageal modalities, including TOE and exercise testing.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/7e/ERP-20-0034.PMC8495880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39054913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transthoracic echocardiography of hypertrophic cardiomyopathy in adults: a practical guideline from the British Society of Echocardiography.","authors":"Lauren Turvey,&nbsp;Daniel X Augustine,&nbsp;Shaun Robinson,&nbsp;David Oxborough,&nbsp;Martin Stout,&nbsp;Nicola Smith,&nbsp;Allan Harkness,&nbsp;Lynne Williams,&nbsp;Richard P Steeds,&nbsp;William Bradlow","doi":"10.1530/ERP-20-0042","DOIUrl":"https://doi.org/10.1530/ERP-20-0042","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is common, inherited and characterised by unexplained thickening of the myocardium. The British Society of Echocardiography (BSE) has recently published a minimum dataset for transthoracic echocardiography detailing the core views needed for a standard echocardiogram. For patients with confirmed or suspected HCM, additional views and measurements are necessary. This guideline, therefore, supplements the minimum dataset and describes a tailored, stepwise approach to the echocardiographic examination, and echocardiography's position in the diagnostic pathway, before advising on the imaging of disease complications and invasive treatments.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/07/ERP-20-0042.PMC8243716.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25433242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review.","authors":"Sadie Bennett,&nbsp;Arzu Cubukcu,&nbsp;Chun Wai Wong,&nbsp;Timothy Griffith,&nbsp;Cheryl Oxley,&nbsp;Diane Barker,&nbsp;Simon Duckett,&nbsp;Duwarakan Satchithananda,&nbsp;Ashish Patwala,&nbsp;Grant Heatlie,&nbsp;Chun Shing Kwok","doi":"10.1530/ERP-20-0013","DOIUrl":"https://doi.org/10.1530/ERP-20-0013","url":null,"abstract":"<p><strong>Background: </strong>Anthracycline agents are known to be effective in treating tumors and hematological malignancies. Although these agents improve survival, their use is associated with cardiotoxic effects, which most commonly manifests as left ventricular systolic dysfunction (LVSD). As such, guidelines recommend the periodic assessment of left ventricular ejection fraction (LVEF). However, as diastolic dysfunction likely proceeds systolic impairment in this setting, the role of Tei index may offer additional benefit in detecting subclinical LVSD.</p><p><strong>Methods: </strong>We conducted a systematic review to investigate the evidence for the use of Tei index in assessing subclinical cardiotoxicity in patients receiving anticancer agents. A search of Medline and EMBASE was performed and relevant studies were reviewed and narratively synthesized.</p><p><strong>Results: </strong>A total of 13 studies were included with a total of 800 patients (mean age range 46-62 years, percentage of male participants ranged from 0-86.9%). An increase in Tei index was observed in 11 studies, which suggested a decline in cardiac function following chemotherapy. Out of these, six studies indicated that the Tei index is a useful parameter in predicting cardiotoxic LVSD. Furthermore, five studies indicated Tei index to be superior to LVEF in detecting subclinical cardiotoxicity.</p><p><strong>Conclusions: </strong>Though there are some studies that suggest that Tei index may be a useful indicator in assessing subclinical anthracycline-related cardiotoxicity, the findings are inconsistent and so more studies are needed before the evaluation of Tei index is performed routinely in patients receiving chemotherapy.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/15/ERP-20-0013.PMC8185452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25539169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic assessment of aortic stenosis: a practical guideline from the British Society of Echocardiography.","authors":"Liam Ring, Benoy N Shah, Sanjeev Bhattacharyya, Allan Harkness, Mark Belham, David Oxborough, Keith Pearce, Bushra S Rana, Daniel X Augustine, Shaun Robinson, Christophe Tribouilloy","doi":"10.1530/ERP-20-0035","DOIUrl":"10.1530/ERP-20-0035","url":null,"abstract":"<p><p>The guideline provides a practical step-by-step guide in order to facilitate high-quality echocardiographic studies of patients with aortic stenosis. In addition, it addresses commonly encountered yet challenging clinical scenarios and covers the use of advanced echocardiographic techniques, including TOE and Dobutamine stress echocardiography in the assessment of aortic stenosis.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/ab/ERP-20-0035.PMC8115410.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25470008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Society for Echocardiography and British Cardio-Oncology Society guideline for transthoracic echocardiographic assessment of adult cancer patients receiving anthracyclines and/or trastuzumab.","authors":"Rebecca Dobson, Arjun K Ghosh, Bonnie Ky, Tom Marwick, Martin Stout, Allan Harkness, Rick Steeds, Shaun Robinson, David Oxborough, David Adlam, Susannah Stanway, Bushra Rana, Thomas Ingram, Liam Ring, Stuart Rosen, Chris Plummer, Charlotte Manisty, Mark Harbinson, Vishal Sharma, Keith Pearce, Alexander R Lyon, Daniel X Augustine","doi":"10.1530/ERP-21-0001","DOIUrl":"10.1530/ERP-21-0001","url":null,"abstract":"<p><p>The subspecialty of cardio-oncology aims to reduce cardiovascular morbidity and mortality in patients with cancer or following cancer treatment. Cancer therapy can lead to a variety of cardiovascular complications, including left ventricular systolic dysfunction, pericardial disease, and valvular heart disease. Echocardiography is a key diagnostic imaging tool in the diagnosis and surveillance for many of these complications. The baseline assessment and subsequent surveillance of patients undergoing treatment with anthracyclines and/or human epidermal growth factor (EGF) receptor (HER) 2-positive targeted treatment (e.g. trastuzumab and pertuzumab) form a significant proportion of cardio-oncology patients undergoing echocardiography. This guideline from the British Society of Echocardiography and British Cardio-Oncology Society outlines a protocol for baseline and surveillance echocardiography of patients undergoing treatment with anthracyclines and/or trastuzumab. The methodology for acquisition of images and the advantages and disadvantages of techniques are discussed. Echocardiographic definitions for considering cancer therapeutics-related cardiac dysfunction are also presented.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/db/ERP-21-0001.PMC8052569.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39075607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on UK stress echocardiography practice: insights from the EVAREST sites.","authors":"Cameron Dockerill,&nbsp;William Woodward,&nbsp;Annabelle McCourt,&nbsp;Cristiana Monteiro,&nbsp;Elena Benedetto,&nbsp;Maria Paton,&nbsp;David Oxborough,&nbsp;Shaun Robinson,&nbsp;Keith Pearce,&nbsp;Mark J Monaghan,&nbsp;Daniel X Augustine,&nbsp;Paul Leeson","doi":"10.1530/ERP-20-0043","DOIUrl":"https://doi.org/10.1530/ERP-20-0043","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare delivery is being transformed by COVID-19 to reduce transmission risk but continued delivery of routine clinical tests is essential. Stress echocardiography is one of the most widely used cardiac tests in the NHS. We assessed the impact of the first (W1) and second (W2) waves of the pandemic on the ability to deliver stress echocardiography.</p><p><strong>Methods: </strong>Clinical echocardiography teams in 31 NHS hospitals participating in the EVAREST study were asked to complete a survey on the structure and delivery of stress echocardiography as well as its impact on patients and staff in July and November 2020. Results were compared to stress echocardiography activity in the same centre during January 2020.</p><p><strong>Results: </strong>24 completed the survey in July, and 19 NHS hospitals completed the survey in November. A 55% reduction in the number of studies performed was reported in W1, recovering to exceed pre-COVID rates in W2. The major change was in the mode of stress delivery. 70% of sites stopped their exercise stress service in W1, compared to 19% in W2. In those still using exercise during W1, 50% were wearing FFP3/N95 masks, falling to 38% in W2. There was also significant variability in patient screening practices with 7 different pre-screening questionnaires used in W1 and 6 in W2.</p><p><strong>Conclusion: </strong>Stress echocardiography delivery restarted effectively after COVID-19 with adaptations to reduce transmission that means activity has been able to continue, and exceed, pre-COVID-19 levels during the second wave. Further standardization of protocols for patient screening and PPE may help further improve consistency of practice within the United Kingdom.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/c8/ERP-20-0043.PMC8111306.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic RV-E/e' for predicting right atrial pressure: a review.","authors":"A J Fletcher,&nbsp;S Robinson,&nbsp;B S Rana","doi":"10.1530/ERP-19-0057","DOIUrl":"https://doi.org/10.1530/ERP-19-0057","url":null,"abstract":"<p><p>Right atrial pressure (RAP) is a key cardiac parameter of diagnostic and prognostic significance, yet current two-dimensional echocardiographic methods are inadequate for the accurate estimation of this haemodynamic marker. Right-heart trans-tricuspid Doppler and tissue Doppler echocardiographic techniques can be combined to calculate the right ventricular (RV) E/e' ratio - a reflection of RV filling pressure which is a surrogate of RAP. A systematic search was undertaken which found seventeen articles that compared invasively measured RAP with RV-E/e' estimated RAP. Results commonly concerned pulmonary hypertension or advanced heart failure/transplantation populations. Reported receiver operating characteristic analyses showed reasonable diagnostic ability of RV-E/e' for estimating RAP in patients with coronary artery disease and RV systolic dysfunction. The diagnostic ability of RV-E/e' was generally poor in studies of paediatrics, heart failure and mitral stenosis, whilst results were equivocal in other diseases. Bland-Altman analyses showed good accuracy but poor precision of RV-E/e' for estimating RAP, but were limited by only being reported in seven out of seventeen articles. This suggests that RV-E/e' may be useful at a population level but not at an individual level for clinical decision making. Very little evidence was found about how atrial fibrillation may affect the estimation of RAP from RV-E/e', nor about the independent prognostic ability of RV-E/e' . Recommended areas for future research concerning RV-E/e' include; non-sinus rhythm, valvular heart disease, short and long term prognostic ability, and validation over a wide range of RAP.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/63/ERP-19-0057.PMC7923036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38689596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset.","authors":"Shaun Robinson, Bushra Rana, David Oxborough, Rick Steeds, Mark Monaghan, Martin Stout, Keith Pearce, Allan Harkness, Liam Ring, Maria Paton, Waheed Akhtar, Radwa Bedair, Sanjeev Bhattacharyya, Katherine Collins, Cheryl Oxley, Julie Sandoval, Rebecca Schofield MBChB, Anjana Siva, Karen Parker, James Willis, Daniel X Augustine","doi":"10.1530/ERP-20-0026","DOIUrl":"10.1530/ERP-20-0026","url":null,"abstract":"<p><p>Since cardiac ultrasound was introduced into medical practice around the middle twentieth century, transthoracic echocardiography has developed to become a highly sophisticated and widely performed cardiac imaging modality in the diagnosis of heart disease. This evolution from an emerging technique with limited application, into a complex modality capable of detailed cardiac assessment has been driven by technological innovations that have both refined 'standard' 2D and Doppler imaging and led to the development of new diagnostic techniques. Accordingly, the adult transthoracic echocardiogram has evolved to become a comprehensive assessment of complex cardiac anatomy, function and haemodynamics. This guideline protocol from the British Society of Echocardiography aims to outline the minimum dataset required to confirm normal cardiac structure and function when performing a comprehensive standard adult echocardiogram and is structured according to the recommended sequence of acquisition. It is recommended that this structured approach to image acquisition and measurement protocol forms the basis of every standard adult transthoracic echocardiogram. However, when pathology is detected and further analysis becomes necessary, views and measurements in addition to the minimum dataset are required and should be taken with reference to the appropriate British Society of Echocardiography imaging protocol. It is anticipated that the recommendations made within this guideline will help standardise the local, regional and national practice of echocardiography, in addition to minimising the inter and intra-observer variation associated with echocardiographic measurement and interpretation.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/00/ERP-20-0026.PMC7923056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38535875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Report from the Annual Conference of the British Society of Echocardiography, October 2018, ACC Liverpool, Liverpool.","authors":"V Sharma,&nbsp;L Al Saikhan,&nbsp;C Park,&nbsp;A Hughes,&nbsp;H Gu,&nbsp;S Saeed,&nbsp;A Boguslavskyi,&nbsp;G Carr-White,&nbsp;J Chambers,&nbsp;P Chowienczyk,&nbsp;M Jain,&nbsp;H Jessop,&nbsp;C Turner,&nbsp;G Bassindale-Maguire,&nbsp;W Baig,&nbsp;A Kidambi,&nbsp;S T Abdel-Rahman,&nbsp;D Schlosshan,&nbsp;A Sengupta,&nbsp;A Fitzpatrick,&nbsp;J Sandoval,&nbsp;S Hickman,&nbsp;H Procter,&nbsp;J Taylor,&nbsp;H Kaur,&nbsp;C Knowles,&nbsp;S Wheatcroft,&nbsp;K Witte,&nbsp;K Gatenby,&nbsp;J A Willis,&nbsp;A Kendler-Rhodes,&nbsp;O Slegg,&nbsp;K Carson,&nbsp;J Easaw,&nbsp;S R Kandan,&nbsp;J C L Rodrigues,&nbsp;R MacKenzie-Ross,&nbsp;T Hall,&nbsp;G Robinson,&nbsp;D Little,&nbsp;B Hudson,&nbsp;J Pauling,&nbsp;S Redman,&nbsp;R Graham,&nbsp;G Coghlan,&nbsp;J Suntharalingam,&nbsp;D X Augustine,&nbsp;J W M Nowak,&nbsp;A T Masters","doi":"10.1530/ERP-20-0037","DOIUrl":"https://doi.org/10.1530/ERP-20-0037","url":null,"abstract":"Background: Three-dimensional speckle-tracking echocardiography (3D-STE) is believed to be influenced by image quality, although quantitative evidence on this is limited. A previous evaluation indicated that sub-optimal image quality introduces a systematic bias in 3D-STE derived left ventricular (LV) deformation indices1, 2. Therefore, we aimed to quantify the extent of bias in proportion to impairment in image quality. Methods: This was a prospective experimental study. 18 healthy participants (age 31 ± 6 years, 83.3 % men) with good echocardiographic windows underwent 3D echocardiography (3DE). To impair the quality of the 3DE images of the LV in a reproducible and graded manner, a sheet of ultrasound-attenuating material, neoprene rubber, of three different thicknesses (2, 3 and 4 mm) was used to mimic mild, moderate and severe impairment in image quality respectively. 4 gated LV 3DE full-volume data-sets (including the optimal quality reference) were acquired per participant. All acquisitions were free of stitching artefacts and similar frame rates were maintained throughout. LV volumetric, and global and segmental LV deformation indices were measured. Mixed linear modelling was used to estimate the extent of bias. Results: There was a systematic bias in all global and segmental LV strains, and LV rotational indices. quality Conclusions: Abstract 2: First-phase ejection fraction is a powerful predictor of adverse events in asymptomatic patients with aortic stenosis preserved total ejection fraction Objectives First-phase ejection fraction (EF1), the ejection fraction up to the time of maximal ventricular contraction may be more sensitive than existing markers in detecting early systolic dysfunction. We examined the prognostic value of EF1 in patients with aortic stenosis (AS), a condition in which left ventricular dysfunction as measured by conventional indices is an indication for valve replacement. Methods Abstract 3: Improved Aortic Dimension Assessment With Specialist Echocardiography Clinics: A Quality Improvement Study. Background: Aortopathy is a common clinical problem. Guidelines recommend the use of double-oblique short axis imaging (CT/MRI) for significant aortic dilatation. Echocardiography is more readily available and cost effective. However accuracy and reproducibility is affected by operator variability. Good correlation between imaging techniques is vital for patient management, and may reduce health care expense and ionizing radiation. Objectives: We investigated the effect of dedicated specialist valve/aortopathy echocardiography clinics on accuracy of measurements and correlation with CT/MRI, compared to routine echocardiography performed outside these clinics. We hypothesized that a dedicated specialist based clinics would yield a better correlation with CT/MRI. Methods: 30 patients undergoing echocardiography in a specialist clinic for aortopathy, who also had correlative imaging with CT/MRI were retrospectively analyse","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/cd/ERP-20-0037.PMC8693154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38639541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}