Cardiovascular Business - July/August 2008 - (Page 15)

In a recent study, Il-Woo Suh, MD, and colleagues at the University of Ulsan College of Medicine in Seoul, South Korea, demonstrated that left atrial volume measured by real-time 3D TTE predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. The study, published in the May 2008 issue of the Journal of the American Society of Echocardiography, is the first to use real-time 3D echo in this patient population, according to the authors. The researchers prospectively evaluated the end-systolic, left atrial volumes of 108 patients with 3D TTE and 2D Doppler echo using the Sonos 7500 from Philips. Investigators found excellent interobserver agreement with the 3D approach, that 2D significantly underestimated volume, and that 3D measurement of volume and age were independent predictors of cardiac events. Limitations to using real-time 3D TTE, according to the authors, include the extra time needed to store and analyze the 3D images compared to calculating volumes in 2D. In addition, 3D left atrial volume measurement could not be obtained from patients with atrial fibrillation or those who cannot hold their breath long enough to acquire a full-volume real-time 3D image. “Once these technical problems are solved, left atrial volume measurement in 3D can be easily measured in clinical practice,” they wrote. Some of these limitations may already be solved. At the 2008 ASE meeting in Toronto, Siemens unveiled the Acuson SC2000 Volume Imaging Ultrasound System, which acquires full-volume 3D data pyramids—20 images per second—in a single heartbeat, compared to current systems that acquire partial data in a single heartbeat or full-volume data in four heartbeats. Acquiring a full pyramid in one heartbeat instead of four consecutive beats could be advantageous in that the data would not require any restitching, reanimation and regating, potentially saving time and improving throughput. Additionally, the patient could be imaged without any breath-holding, thereby avoiding artifacts through arrhythmias, Lang says. To Doppler echo and beyond With the advent of Doppler echo, interventional cardiologists were quick to adopt the technology for hemodynamic determi- (top) image of a balloon catheter in the left atrium using real-time 3D transesophageal echo and (bottom) real-time 3D transthoracic echo image of the apical four chambers for comparison. Both images were taken using the Philips ie33 echocardiography system. source: roberto Lang, MD, University of Chicago Medical Center cardiovascularBusiness.com cardiovascular Business 15 http://CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - July/August 2008

Cardiovascular Business - July/August 2008 Table of Contents First Word Cover Story: Planning for the Ideal Cath Lab Requires the Multidisciplinary Approach Clinical Study Digest: Cell Phone Technology Speeds Ecgs As Real-Time 3d Echo Matures, It Finds a Clinical Niche Ecg Image Management Brings Increased Productivity and Confidence Overcoming Barriers to Cath Lab Inventory Control Maximizing Reimbursement, Minimizing Penalties News & Views Calendar Reader Resources The Back Page

Cardiovascular Business - July/August 2008

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