[How to use echocardiography in clinical practice in cardiology]

Echography is an essential diagnostic tool in cardiology. Recent advancements have further increased the potential of echography. 3D echo assessment of LA and LV volumes and LV mass index LA volume index and LV end systolic volumes are easily obtained with 3D echo, and are useful for risk stratification among patients with heart failure. LV mass index, which is also measured with 3D echo, reflects time-integral exposure of the heart to risk factors, such as hypertension, DM, CKD and so on. Increased LV mass index is associated with a higher risk of cardiovascular events. Quantitative evaluation of regional myocardial function with automated functional imaging (AFI) AFI is based on the speckle tracking method and quantitates wall motion abnormality. AFI provides a strain map of the left ventricle in a color-coded bull's eye image. Assessment of endothelial function with flow-mediated dilation (FMD) FMD reflects endothelial function to produce nitric oxide in response to an increase in blood flow. Decreased FMD, which implies endothelial dysfunction, is an initial step in atherosclerosis. FMD-guided therapy may be a new trend in the prevention of atherosclerosis.