Echo in the Slopes 2010
The annual mid winter program of the Michigan Society of Echocardiography was a tremendous success. The academic program blended new developments in three dimensional echo with comprehensive review of important topics; Echo Jeopardy was again rollicking entertainment. Outdoors the mix was not so successful: cloudy skies, slushy snow, and intermittent rain. At least there were no injuries and no one was battered and bruised like the icy meeting of a few years ago.
The Next Dimension.
Roberto Lang, M.D., President of the American Society of Echocardiography was the keynote speaker. He gave a state-of-the-art presentation on three dimensional imaging, focusing on the left ventricle and the mitral valve. This third dimension fulfills the promise of ultrasound, providing new imaging perspectives, methods of validation of left ventricular size, geometry and function, tissue Doppler and assessment of synchrony. It is clear that this leads to the next step of fusion imaging, with CT and cardiac MR. Even though he spoke from the frontier of the latest research, Dr. Lang focused on the practical aspects of his topic. For example, what information does the surgeon need about the mitral valve?
The Chamber.
Several speakers filled in our knowledge base on the left ventricle. Amr Abbas, M.D. addressed diastolic function and pericardial hemodynamics. He asked us to think in terms of the e wave dominant mitral valve as equivalent to the d wave dominant pulmonary vein. He returned Sunday morning to talk about pericardial hemodynamics and the diagnosis of constriction. He must have found a few blank faces when he looked out on the audience because he patiently reviewed the material until it was certain that all of us had the concept down pat.
Mouaz al-Mallah, M.D. discussed myocardial viability from the perspective of stress echocardiography, PET scanning and cardiac MR. Karthik Ananth, M.D., provided an overlay for the discussion framing it in terms of both anatomic and physiologic responses to respiratory maneuvers especially breathing and the Valsalva maneuver.
A Potpourri.
John Gorscan, Director of the Echocardiography Laboratory at the University of Pittsburgh Medical Center is not only the lynch-pin for Echo Jeopardy but also a solid contributor to the echocardiography literature. He provided an in-depth review of infective endocarditis, updating to the modern era. Felix Rogers, D.O., our community hospital representative, introduced valvular arterial impedance as a more comprehensive way to look at aortic stenosis and discussed the arcane complications of aortic valve replacement, patient-prosthesis mismatch, and pseudoaneurysm of the LV outflow tract. Karthik Ananth, M.D. took us on a tour of the world of echo artifact, a phenomenon that is disturbingly just as a common as the items we are looking for on a daily basis.
The Abassian Empire, Part II.
Echo Jeopardy matched the young guns of metro Detroit with one of the altekhakers (very old people). Talk about quick on the trigger: Billy the Kid (Amr Abbas) and Wyatt Earp (Karthik Ananth) showed extraordinary response times in decoding John Gorscan’s difficult echo puzzles. Felix was usually left with his gun in the holster or was shooting wildly into the left atrium. Time didn’t permit Amr to tell us more about the Abbasian Empire, but your MSE editor, not normally Google-avid, learned the Abassian Caliph of Baghdad ruled from 758 to 1258. This was an age of great intellectual achievement. Amr now reigns as Echo Jeopardy Champion, at least as of January 24, 2010. We look forward to another era of enlightenment.
Most Important.
This highly successful meeting of the MSE can be attributed to the skillful work of our planning committee and dedicated efforts of the MSE President, Michael Gallagher, M.D. and our secretary, Susan Kobylarek, RDCS. Alice Betz was the behind the scenes wizard who pulled everything together with charm and grace.
The MSE thanks Dr. Felix Rogers for this wonderful meeting wrap-up.