Dr Mark Monaghan from London highlighted the new developments in contrast and three-dimensional echocardiography. Contrast has clearly passed into the daily clinical routine but not as extensively as one would have expected, despite overwhelming evidence that the addition of contrast to routine echo imaging improves the assessment of both global and regional wall function. Studies using cardiac magnetic resonance imaging as the new gold standard for assessing left ventricular volumes have demonstrated that echo with contrast delivers comparable results to CMR.
Dr A Pascet from Louvain showed new experimental data on quantification of coronary artery stenosis using myocardial contrast echocardiography, while the usefulness of contrast in the prediction of viability and LV remodelling following myocardial infarction was further highlighted by the groups of Paolo Colona (Bari) and William Zoghbi (Texas). Finally, a new excting application of contrast was presented by the group of Antony DeMaria (San Diego) who demonstrated the ability of BR14 (Bracco) to identify an ischaemic “hot spot”.
Three-dimensional echocardiography now enters the clinical arena for the assessment of both left and right ventricles. The group of Terje Skjaerpe in Norway showed excellent correlations between three-dimensional echocardiography and CMR for the left ventricle and the group of Petros Nihoyannopoulos in London showed similar results for the right ventricle. The other real benefit of three-dimensional echo is its potential to select patients for cardiac resynchronisation therapy and Dr Mark Monaghan’s group have developed parametric software for the easy recognition of ventricular dysynchrony.
Professor Gilbert Habib from Marseilles summarised recent advances in the Echocardiographic assessment of heart valve disease. He emphasised the importance of exercise echo in assessing severity and prognosis in ischaemic mitral regurgitation and mitral stenosis by papers presented by Drs. Lancelotti and E Brochet. The issue of infective endocarditis continues to fascinate researchers. Studies demonstrated that the length and mobility of a vegetation may predict the potential of embolic events, with vegetations greater that 10-15mm in length being at greater risk of embolisation.
Dr John Sanderson from Stoke-on-Trent reviewed several posters on cardiomyopathy and heart failure. Some new cardiomyopathies were presented; Takotsubo cardiomyopathy, which is particularly prevalent in women, presenting with an apparent anterior myocardial infarction, often after emotional stress. Dr Fraser summarised the cardiac involvement in systemic amyloidosis and Dr Perry Elliott presented new data on left ventricular non-compaction. He stressed the need for redefining diagnostic criteria as there is tendency for over diagnosis. Finally, Dr Sanderson emphasised the usefulness of tissue Doppler imaging in assessing exercise induced diastolic dysfunction. This was part of the Euroecho lecture delivered by Dr Jae Oh from the Mayo Clinic.
Dr Jens Uwe Voigt from Leuven summarised the papers on the subject of ischaemic heart disease and stress echocardiography. He reiterated the points made earlier in the session by Dr Monaghan on the new application of contrast and real-time three dimensional echocardiography during stress. In addition, he introduced the new application of speckle tracking, which may well have a future role in quantification of myocardial ischaemia during stress.