Contrast Echocardiography In Clinical Practice

Echocardiography has now reached its maturity and plays a key role in the clinical assessment of cardiac function. However, its ability to assess myocardial perfusion remains a clinical challenge. Myocardial contrast echocardiography is a technique that uses microbubbles. These microbubbles remain entirely within the intravascular space and their presence in any myocardial region denotes the status of microvascular perfusion within that region. During the last few years, a large number of research studies have been dedicated to this topic. The latest developments in echocardiographic techniques and second-generation contrast agents allow for the potential assessment of myocardial perfusion and provide an accurate endocardial border delineation. In the present book, these new echocardiographic techniques dedicated to the assessment of myocardial perfusion are described in detail by experts from both sides of the Atlantic. Tips and tricks are included, explaining the basic concepts that are needed to understand and perform contrast echocardiography.

This book provides a comprehensive overview of the practical aspects of contrast echocardiography. It also covers all the material in the guidelines published by the American Society of Echocardiography (ASE) in 2018 and the recommendations set out by the European Association of Cardiovascular Imaging (EACVI) in 2017. Contrast echocardiography at present is only used in 5-10% of cases, but this is expected to grow rapidly following the recommendations of the ASE and EACVI. The chapters cover the approved indications and provide practical advice on how to administer the contrast agents and how to optimize the recordings as well as how to deal with the pitfalls. The reader will find all the information on how to use contrast agents for assessment of shunts, LV volumes and function as well as myocardial diseases and masses. Detailed protocols are included for stress echocardiography and myocardial perfusion imaging. Other topics covered include the use of contrast agents for coronary sonography and transesophageal echocardiography. Contrast Echocardiography: Compendium for Clinical Practice comprehensively covers all aspects of the clinical use of contrast echocardiography and has been written by two cardiologists who share their experience from their high volume echo laboratories. One of the authors has been a member of both the ASE guidelines and EACVI recommendation writing groups. It is therefore, a critical text for echocardiographers and sonographers who perform echocardiography.

Echocardiography has now reached its maturity and plays a key role in the clinical assessment of cardiac function. However, its ability to assess myocardial perfusion remains a clinical challenge. Myocardial contrast echocardiography is a technique that uses microbubbles. These microbubbles remain entirely within the intravascular space and their presence in any myocardial region denotes the status of microvascular perfusion within that region. During the last few years, a large number of research studies have been dedicated to this topic. The latest developments in echocardiographic techniques and second-generation contrast agents allow for the potential assessment of myocardial perfusion and provide an accurate endocardial border delineation. In the present book, these new echocardiographic techniques dedicated to the assessment of myocardial perfusion are described in detail by experts from both sides of the Atlantic. Tips and tricks are included, explaining the basic concepts that are needed to understand and perform contrast echocardiography.

Why a book on contrast echocardiography? Over the past dozen years enough experience has accumulated to warrant a more extensive treatment of this method. Furthermore, there are new developments that suggest increased clinical utility for contrast echocardiography in the future. This book aims to summarize the "state of the art" for those interested in echocardiography - presumably mainly cardiologists, but here and there those of a more technical bent will find useful information as well. We feel that a more basic understanding of microbubble dynamics is necessary to advance research for such applications as transmission through the lungs, videodensitometric quantitation of cardiac output, intracardiac shunts, etc. All of these topics are extensively dealt with. The reader will note that many of the clinical chapters are written by pediatric cardiologists. This is only natural, since shunt detection and analysis of flow relationships are relatively more important in congenital heart diseases, and cur rently represent the most important uses for contrast echo cardiography in day-to day practice.

This review of the impact of echocardiographic data on patient management and clinical outcome - emphasizes data acquisition analysis, potential technical limitations, and the results of studies. It looks at the role of the echocardiographer as a clinician, not just as imaging specialist.

This book will familiarize the reader with recent advances in echo imaging technology with special emphasis on echo enhancing agents. Several important strides have been made in this field during the past few years, especially in the contrast enhancement of conventional and color Doppler images. The book begins with chapters on the history of contrast echocardiography, the principles of contrast echo and descriptions of new contrast agents capable of transpulmonary passage following intravenous injection. Safety issues in contrast echocardiography are also discussed. The second section of the book deals with clinical uses of echo contrast agents. Their usefulness in the identification of cardiac structures and assessment of pathological lesions using both transthoracic and transesophageal echocardiography are fully discussed. Technical and practical considerations in the use of various contrast agents are also described. The use of contrast echo in the identification of cardiac sources of embolism as well as possible mechanisms and clinical significance of spontaneous contrast echoes are also covered. Six chapters fully discuss the basics of contrast enhancement of conventional and color Doppler images and its clinical utility in the noninvasive assessment of pulmonary artery pressure, regurgitant and stenotic lesions and in the delineation of coronary arteries. Another chapter describes the non-cardiac applications of the echo contrast enhancement technique. The final section of the book investigates the role of echo contrast enhancement in quantitative cardiovascular analysis.

Ideally suited for those clinicians who have already mastered basic principles, The Practice of Clinical Echocardiography, 6th Edition, provides expert guidance on interpreting echocardiographic images and Doppler flow data. Through practical, clear, and carefully edited content, world-renowned expert Dr. Catherine M. Otto and her team of more than 65 leaders in echocardiography demonstrate how to apply advanced knowledge to daily clinical decision making. Newly reorganized sections cover advanced principles for the echocardiographer, best practices for echocardiography laboratories, transthoracic and transesophageal echocardiography, intraoperative and interventional echocardiography, and point-of-care cardiac ultrasound. Provides an in-depth, clear, and concise review of the latest clinical applications of echocardiography with an advanced level of discussion, now thoroughly updated with new clinical knowledge, new treatments and guidelines, the latest evidence, and innovations in advanced echocardiographic imaging. Reviews the technical aspects of data acquisition and analysis with an emphasis on outcomes. Covers key topics such as transcatheter interventions for valvular heart disease, prosthetic valve dysfunction, the athletic heart, cardiac assist devices, cardio-oncology, heart disease in pregnancy, advanced 3D echocardiography, strain imaging, stress echocardiography, and much more. Includes updated illustrations throughout—nearly 1,000 echocardiograms, Doppler tracings, anatomic drawings, and flow charts for diagnostic approaches—as well as hundreds of echo video clips keyed to images in the text. Discusses limitations, pitfalls, and alternate approaches. Features chapter summary boxes with new “Quick Reviews” and a practical approach to echocardiographic data acquisition, measurement, and interpretation.