Succeeding at Heart Failure

If you can’t see it, you can’t diagnose it

Image quality continues to be the most important aspect of any echo system.  Better image quality supports your ability to look at and assess patients quickly and accurately.  It also serves as the foundation for accurate measurement and quantification.  2D images from PureWave crystal technology and 3D images  from Live 3D Echo imaging produce superb image quality.

“With the iE33, in just minutes I have a 3D image, an accurate ejection fraction, and can measure synchronicity – right at the patient’s bedside.” –Dr. Roberto Lang, Director of Noninvasive Cardiac Imaging Labs at University of Chicago Hospitals

Accurate LV volume and ejection fraction

Ejection fraction is the most widely used measurement to assess cardiac function.  Although 2D ejection fractions are currently the standard in echo, even very experienced clinicians have difficulties with foreshortened images leading to inaccurate EF calculations.  Using Live 3D images with 3DQ and 3DQ Advanced  quantification tools is a better alternative because it reduces the problem of apical foreshortening and enables you to easily align the heart for better quantification.

Accurate analysis of true LV volumes – using all voxels in the 3D dataset to avoid geometric assumptions rather than simply using a collection of rotated or stacked planes – can be easily performed, providing an ejection fraction in under a minute.  According to recent articles, LV volumes and ejection fractions computed from true volume Live 3D resulted in high levels of agreement with MR with lower interobserver variability.  

Improving quality of life with CRT

Cardiac Resynchronization Therapy (CRT) is significantly improving the quality of life and exercise capacity in patients who respond to CRT.  Complementary 2D and 3D QLAB quantification tools help to better assess the suitability of heart failure patients for CRT and subsequent optimization of pacing parameters.

Strain Quantification provides a comparison of peak myocardial velocities from specified LV segments, as well as the ability to obtain strain and strain rate information from the same areas.  Strain Q incorporates temporal processing that improves the display of waveforms so that they are very easy to use while enabling an efficient workflow for the daily management of CRT patients.

3DQ Advanced is a 3D approach that provides additional data for CRT by allowing comparisons of multiple left ventricular regions by looking at regional LV volumes. 3DQ Advanced quantifies LV synchronicity by evaluating all 17 LV segments and calculating the time it takes for each regional segment to reach its minimal systolic volume.

Recent Articles

Cardiac Imaging

 Echocardiography in Heart Failure—Current Applications

 Echocardiography in the Detection and Monitoring of Heart Failure

by Jose L Zamorano

 Echocardiographic Assessment of Dyssynchrony for Predicting a Favorable Response to Cardiac Resynchronization Therapy by J M Prutkin , M A Chen, R W Rho, and E A Gill

Technology & Services

 The Importance of Two-dimensional Echocardiographic Image Quality in Managing Heart Failure by James N Kirkpatrick and Mani A Vannan

Circulation 2004, 110, 1814-1818.
Mor-Avi V, Sugeng L, Weinert L, MacEneaney P, Caiani EG, Koch R, Salgo I, Lang RM. 
Fast measurement of Left Ventricular Mass with Real-time Three-dimensional Echocardiography, Comparison with Magnetic Resonance Imaging.   

Circulation 2005 112: 992 – 1000.
Kapetanakis S, Kearney MT, Siva A, Gall N, Cooklin M, Monaghan MJ.
Three-dimensional Echocardiography: A novel technique to quantify global left ventricular mechanical dyssynchrony. 

European Heart Journal  Nov 30, 2005(subscription required)

Jacobs L, Salgo I, Goonewardena, Weinert L, Coon P, Bardo D, Gerard O, Allain P, Zamorano J, de Islan L, Mor-Avi V, Lang RM.   
Rapid on-line quantification of left ventricular volume from real-time three-dimensional echocardiographic data.    

The American Journal of Cardiology  Jan 1 2005, 95: 126-128. (subscription required)

Zhang Q, Yu CM, Fung J, Zhang Y, Chan Y, Chang H, Yip G, Sanderson J.
Assessment of the Effect of Cardiac Resynchronization Therapy on Intraventricular Mechanical Synchronicity by Regional Volumetric Changes.    

	Keeping the Beat With echo solutions for comprehensive heart failure management.