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The European Association of Echocardiography

HIGHLIGHTS FROM EUROECHO 2009 :


3D ECHOCARDIOGRAPHY
Luigi P. Badano**, MD, FESC
**Dr. Badano has received honoraries and research grants from GE
Healthcare, Sorin cardio S.p.A., Actelion, Edwards Lifesciences
*No off-label use of device
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Thursday 9th, Imaging Campus: 3D Echo and cardiac anatomy x 4
Thursday 9th, DICE Spanih: 3D Echo for guiding cath procedures
Thursday 9th, Special Session: 3D Echo in congenital disease
Friday 10 th, Imaging Campus: 3D Wall Motion Tracking x4
Friday 10th, Main Session: 3D Echo. A new dimension to assess the heart
1 Poster Session: 3D Echo is real 3D world
1 oral abstract Session: 3D Echo: a new window to the heart
PROGRESS IN ULTRASOUND TECHNOLOGY
2D 3D 1D
A-Mode
M-Mode
1953 Edler & Hertz
2002
3D ECHO AT EUROECHO 2009
Reliable Assesment of LV Size and Function, by R. Lang
Mean difference SD vs MRI
RT3DE 2DE
Jenkins 2004 EDV (ml) -49 -5433
ESV (ml) -318 -2828
EF (%) 07 -113
Caiani 2005 EDV (ml) -429 -2386
ESV (ml) -433 -1960
EF (%) -814 +416
Jacobs 2006 EDV (ml) -1417 -2329
ESV (ml) -716 -1524
EF (%) -16 19
3D ECHO AT EUROECHO 2009
Reliable Assesment of LV Mass, by A.S. Gopal
Longitudinal Strain Circumferential Strain
Radial Strain Area Strain
3D ECHO AT EUROECHO 2009
3D Strain, by H.J. Nesser
1 Apical Full-Volume Acquisition
Calculation Time = 332 79 s
Badano LP, et al. Data on file
3D ECHO AT EUROECHO 2009
Reliable Assesment of LV Size and Function
The European Association of Echocardiography
Hare JL et al. Heart 2008
3D ECHO AT EUROECHO 2009
Clinical Significance of Increased Accuracy, by M Monaghan
2D EF band 2D pts (no) Re-allocation
by EF 35%
Re-allocation
by EF 40%
25% 32 2 (6%) 1 (3%)
26-35% 36 14 (39%) 5 (14%)
36-40% 13 1 (8%) 7 (54%)
41-45% 10 2 (20%) 5 (50%)
> 45% 129 0 2 (2%)
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Mitral Valve Disease, by J. Hung
Normal MItral Valve
Atrial View
P2 Prolapse
Atrial View
Anterior
Leaflet Cleft
3D ECHO AT EUROECHO 2009
Mitral Valve Disease, by J. Hung
The European Association of Echocardiography
Mild MR Moderate MR Severe MR
3.6 cm
2
/0.19 cm
2
5.44 cm
2
/0.26 cm
2
6.98 cm
2
/0.37 cm
2
0.27 cm
2
0.19 cm
2
0.40 cm
2
PISA/ERO
VC/ERO
3D ECHO AT EUROECHO 2009
Quantification of Mitral Regurgitation, by N. De Michelis
The European Association of Echocardiography
Real time 3D is feasible, accurate, and highly
reproducible for assessing Mitral valve area .
It has the best agreement with invasive
technique.
More accurate than 2D area, PHT, or PISA.
3D ECHO AT EUROECHO 2009
Mitral Valve Disease, by J. Hung
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Aortic Root and Valve Modelling, by M. Vannan
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Aortic Root and Valve Modelling, by M. Vannan
3D ECHO AT EUROECHO 2009
Right Ventricular Size and Function, by L. Sugeng
The European Association of Echocardiography
EDV= 77 ml
ESV= 28 ml
RVEF= 64%
3D ECHO AT EUROECHO 2009
Right Ventricular Size and Function, by L. Sugeng
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Tricuspid Valve Disease, by L.P. Badano
Normal Tricuspid Valve
VentricularView
Tricuspid Valve Stenosis
VentricularView
Tricuspid Valve Area= 3.6 cm
2
1= 2.6 cm
2= 3,8 cm
3= 2.9 cm
1= 2.6 cm
Badano LP, et al. Eur J Echocardiogr 2009
3D ECHO AT EUROECHO 2009
Tricuspid Valve Disease, by L.P. Badano
3D ECHO AT EUROECHO 2009
Transesophageal 3D Echo by RM Lang
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Transesophageal 3D Echo by RM Lang
Normal St Jude Mitral Valve Endocarditis on Mitral Valve Prostheses
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
3D TEE Guiding Cath Procedures, by JL Zamorano
TAVI
Paraprosthetic
devices
ASD
closure
Mitral
Clip
The European Association of Echocardiography
3D ECHO AT EUROECHO 2009
Atrial Septal septum, by T. Lopez-Fernandez
Atrial Septal Defect Patent Foramen Ovale
More accurate and reproducible quantification of LV
geometry and function than 2D;
Unprecedented opportunity to quantify RV geometry
and function;
New way to assess pathology of valve diseases;
Accurate and reproducible quantification of valve area
in mitral and tricuspid stenosis;
3D TEE essential in monitoring interventional
procedures in the cath lab.
3D ECHO AT EUROECHO 2009
Summary

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