Advanced Cardiovascular Sonographer: a proposal of the American Society of Echocardiography Advanced Practice Sonographer Task Force.

Echocardiographic examinations require a well-trained and competent sonographer to obtain proper anatomic and physiologic data to establish an accurate diagnosis for clinical decision-making and patient management. Although the formal education and training of cardiovascular sonographers are evolving, many entry-level and staff sonographers may not have sufficient practical or clinical knowledge of the necessary components of the echocardiographic study for the individual patient's clinical presentation. In many clinical settings, echocardiograms are read after the patient has left the laboratory.

American Society of Echocardiography Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography.

Unlabelled: ACCREDITATION STATEMENT: The American Society of Echocardiography (ASE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASE designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit.trade mark Physicians should only claim credit commensurate with the extent of their participation in the activity.

Comparison of myocardial contrast echocardiography derived myocardial perfusion reserve with invasive determination of coronary flow reserve.

Aims: Invasive measurements of coronary flow reserve (CFR) by Doppler flow wire are an established method for determining coronary blood flow physiology. Myocardial contrast echocardiography (MCE) is a potential non-invasive method for quantifying myocardial blood flow (MBF). However, few studies have compared MCE-derived myocardial perfusion reserve (MPR) with Doppler flow wire-derived CFR, measured simultaneously in human subjects.

Serial changes in systolic and diastolic echocardiographic indices as predictors of outcome in patients with decreased left ventricular ejection fraction.

Background: Echocardiographic estimation of left ventricular ejection fraction aids in predicting adverse outcomes in coronary artery disease. However, in patients with impaired left ventricular function, further risk stratification is difficult.

Methods: A 2 year retrospective review was performed to identify patients with ejection fraction < or=30%.

Efficacy of atropine as a chronotropic agent in heart transplant patients undergoing dobutamine stress echocardiography.

Background: After heart transplant (HTX), the heart is completely denervated. While sympathetic reinnervation is likely to occur, there is conflicting evidence regarding parasympathetic reinnervation. Accordingly, it is unclear if atropine is efficacious as a chronotropic agent in HTX patients undergoing dobutamine stress echocardiography (DSE), since cholinergic cardiac stimulation is required for atropine to exert its effect.

Improved visualization of aortic intima-media thickening with the use of perflutren lipid microspheres.

Background: Transesophageal echocardiography (TEE) has been used to diagnose atherosclerotic disease for patients who present with systemic embolic events. The primary aim of this study was to assess the supplemental value of echocardiographic contrast to standard TEE in identifying the aortic intima-medial thickness.

Methods: An aorta phantom was used to validate the accuracy of border delineation with and without contrast during TEE imaging.

Clinical application of harmonic power Doppler imaging in the assessment of myocardial perfusion by contrast echocardiography.

Myocardial contrast echocardiography has moved from the research laboratory to clinical echocardiography. As with any emerging technology, background information and understanding the process of image acquisition will help to integrate the technology into everyday practice. Harmonic power Doppler imaging (HPDI) is a high-power, triggered imaging modality used to assess myocardial perfusion.

The research grant process: a reference guide for cardiovascular sonographers.

Opportunities for sonographer-initiated research have increased during the past decade. Although research has traditionally been viewed as a nonclinical activity, funding is available for clinical problems. This article aims to increase sonographer awareness of this unique opportunity, encourage the submission of grant proposals, and enhance the understanding of the grant writing process.

Instantaneous quantitative video intensity heterogeneity: evaluation with low mechanical index contrast echocardiography.

Background: Instantaneous video intensity of myocardium has been poorly characterized. Myocardial video intensity is usually displayed in the fitted curve from the exponential equation, y = a(1 - e (-bt)). However, information from the fitted curve will be as accurate as the original video intensity data from the perfusion image.

Tertiary care improves the chance for vaginal delivery in women with preeclampsia.

Objective: The purpose of this study was to determine whether the level of hospital care affects cesarean delivery rates for women with preeclampsia.

Study Design: We conducted a population-based cohort study using Missouri birth certificate data for 1993 through 1999. Logistic regression was used to analyze data from 13,646 nulliparous women with preeclampsia who were delivered of singleton live births.

Tissue Doppler imaging: a useful echocardiographic method for the cardiac sonographer to assess systolic and diastolic ventricular function.

Tissue Doppler imaging (TDI) has evolved to become a useful noninvasive method that can complement other echocardiographic techniques in the assessment of left ventricular myocardial velocities in a variety of clinical conditions. Color 2-dimensional and color M-mode TDI are used for quantification of systolic myocardial velocities during myocardial ischemia at rest and with pharmacologic stress testing. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities, and it is particularly useful in the identification of abnormalities of left ventricular diastolic relaxation.

Evaluation of a bileaflet aortic valve prosthesis before and after thrombolytic tissue plasminogen activator therapy by continuous wave Doppler ultrasound.

Thrombotic obstruction of mechanical prosthetic valves is a frequently encountered cause of prosthetic valve dysfunction, which can result in stenosis and regurgitation. We present a case of thrombotic obstruction of a bileaflet mechanical aortic valve prosthesis that resulted in severe stenosis and regurgitation. Considering the known risk factors associated with both surgical and thrombolytic treatments, a decision was made to use tissue plasminogen activator therapy to relieve the burden of the thrombotic valvular obstruction.