Advances in echocardiography

This study will outline recent advances in echocardiography and their impact in the understanding of cardiac morphology and ventricular function.

Evaluation of morphologic abnormalities in pediatric cardiology has benefited greatly from three-dimensional echocardiography, particularly with the introduction of high-frequency transducers. The size of cardiovascular structures is frequently affected by heart disease, and a systematic approach to adjust measurements for the effects of body size and age has helped to distinguish a normal structure from an abnormal one. Quantification of diastolic and systolic function continues to be a major focus in echocardiography. New modalities such as tissue Doppler imaging and speckle tracking echocardiography have provided new parameters to assess myocardial performance, and these parameters include myocardial velocities, ventricular twist and torsion, strain and strain rate, and mechanical dyssynchrony. Mechanical dyssynchrony analysis has been particularly useful in cardiac resynchronization therapy, a novel treatment for heart failure which shows great promise.

Improved delineation of cardiac morphology has greatly augmented the current understanding of congenital heart diseases, and management strategies have been modified based on three-dimensional echocardiographic findings. The introduction of new parameters to evaluate ventricular function has provided early markers for cardiovascular impairment in several disease states, thereby allowing clinicians to monitor these patients more closely.