Echo in the Slopes 2012
For 14 years, the Michigan Society for Echocardiography has held its weekend symposium, Echo in the Slopes, in northern Michigan. That is long enough to have a substantial tradition and the experience makes clear that unusual quirks make each year distinct.
For people in Southeastern Michigan, you might be tempted to say that the meeting got off to a slow start… a sudden snowstorm on February 10th led to a 65 car accident on 1-75 North. Quite a few MSE members were parked on the freeway for two hours before resuming their trip. But, Saturday morning was business as usual and Saturday night it was fun and celebration as usual, with the cocktail reception and Echo Jeopardy. The education program was organized around two themes - - Clinically relevant presentations on day-to-day issues and cases, cases, cases.
The MSE President, Karthik Ananthasubramaniam, MD, grouped the Saturday morning session into four sections: diastology, pericardial disease, guidance for procedures and practical application protocols. Years of teaching echo and work as a sonographer positioned Patricia Bailey to lead off the section on diastology. Diastolic function can be daunting, but Pat boiled it down to a series of straightforward, logical steps. With this background, the topic turned to two vexing but common concerns in the assessment of diastolic function, atrial fibrillation and mitral regurgitation. Craig Alguire, MD of Spectrum Health admitted that atrial fibrillation limits diastolic evaluation but emphasized that clinical context is the key to assess patients. Santamu Biswas, MD, dove into the topic of severe mitral regurgitation, which might seem to defy diastolic evaluation. He focused on active and passive properties of the left ventricle, and the pulmonary vein a wave.
John Schairer, DO now owns the topic of pericardial effusion/tamponade. He stressed that pericardial disease is a continuum, not an end point, and the final diagnosis is at the bedside, not just in the echo lab.
The fields of advanced cardiac imaging and valve interventions are moving forward in a rapid, parallel fashion. Just as well, since these highly technical and complicated valve procedures demand sophisticated and precise imaging support. João Cavalcante, MD, defined multimodality imaging for percutaneous aortic valve interventions, noting that potential complications can be predicted, prevented and assessed. Nathan Kerner, MD, gave a great review of the normal anatomy and function of the mitral valve, and the appropriateness for percutaneous interventions.
One of the features of the Slopes for 2012 was the variety of perspective. There were presentations by sonographers, fellows and clinicians, both young and seasoned. To provide another view, echo protocols were presented from Beaumont, Henry Ford, Grand Rapids and the Cleveland Clinic. In fast-paced summary sessions, Dr. Kerner and Pat Bailey teamed up to report on contrast, Karthik Ananth presented the largest research series on accelerated Dobutamine stress echo, Craig Alguier decoded RV function and João Cavalcante simplified last year’s perspective on strain.
The Sunday sessions could move from the lecture hall directly to the beside. John Gorscan, bright-eyed and bushy-tailed from Echo Jeopardy, led off by making resynchronization therapy understandable. We then took an expansive look at stress echocardiography. Bill Armstrong, MD, highlighted pitfalls and artifacts in CAD; John Schairer homed in on the aortic valve and Guillermo Uriarte scattered pearls about hypertrophic cardiomyopathy.
Nancy Cutler, MD, the lone pediatric cardiologist, taught us how to differentiate the physiological changes of the trained athlete from pathological processes. Karthik Ananth finished our incredible journey by taking us into the structure and function of the left atrium. The morning wrapped up on time and under budget with a flurry of fascinating case presentations.
Echo Jeopardy
The 12th Annual Echo Jeopardy began with a bang! Actually, the table with all of the computers was knocked over about a half hour before show time. Just like the tree falling in the forest with no one around, everything was reassembled in good working order by the time the boisterous MSE crowed filled the room. A veteran of Slopes felt this was best Jeopardy session ever. Certainly, the cases that John Gorscan, MD, selected were the toughest we had ever seen. The caliber of the contestants was unrivaled. Returning champion, João Cavalcante defended against William Armstrong, the all-time champion and newcomer Nathan Kerner, making his first appearance. With a furious comeback, Nate Kerner drew within striking range at the point of Final Jeopardy. The question had to do with the ordinary household item that served as the model for the mechanical sector scan. Dr. Cavalcante’s idea was stimulating and potentially satisfying, but the vibrator was not correct. Dr. Kerner’s idea sucked: the vacuum cleaner was not part of the deal. Bill Armstrong got it right: the electric toothbrush. With a flourish, he returned to the top of the mountain, and was again crowned jeopardy champion!
Business at Hand
It is not that easy to be on the steering committee of the MSE. You have to up for a 7:00 a.m. meeting on Sunday morning. On the other hand, it is not that easy just to be a regular member of the MSE. Kathy Moran was minding her own business at the cocktail reception Saturday night. Before she knew it she was roped into becoming a member of the steering committee, and then named part of the newly formed action team to establish a rejuvenated website for the society. At the morning meeting, David Forst, the perpetual treasurer of the MSE, reported on our financial status, which is good, even with the exorbitant 30th Jubilee last fall. Karthik Ananth led us in a discussion of potential education programs for the year. There were some great ideas and these will be developed by the subcommittee of members over the next few weeks and then publicized on the website. Invited speakers include: Patricia Pellikka, MD, from the Mayo Clinic, Amr Abbas, MD, and Miguel Quinones, MD. The MSE will co-sponsor an imaging conference led by William Beaumont Hospital on September 13-15, 2012. The group decided to make plans to invigorate the website by posting more articles, having case presentations, and downloading all of the ASE guidelines onto the site. Technical hurdles remain and most of the members of this action team are so busy that each needs one extra weekend before they can feel ready to tackle the subject.
About Our Sponsors
The MSE is a highly successful organization and the friendly, congenial atmosphere contributes significantly to growth and stability of this organization. In turn that leads to enthusiastic support by vendors who support us from the fields of echocardiography, imaging and the pharmaceutical trade. Be sure to glance through the photo album that captures pictures of the MSE in education sessions, at social functions, and with the supporting case of our industry vendors.
Thank you to Dr. Felix Rogers for the weekend wrap-up and also to all of you who attended the Echo in the Slopes Weekend Symposium 2012 at Crystal Mountain. Below are the presentations which are available for download.
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