The latest issue of CASE, ASE’s open access case reports journal, is available and packed with educational material to share with trainees and colleagues. CASE Editor-in-Chief Dr. Vince Sorrell commented, “It seems like every issue of CASE includes at least one report you need to keep handy as an image-reference in your echo reading room. This issue includes a CASE series demonstrating the normal and pathologic variations of caval and coronary sinus venous anomalies. This is an important report that includes outstanding 3D-CCT image correlations.”

This issue also includes another Congenital Heart Disease article (authored by a sonographer), two cases highlighting the value of Multimodality Imaging, two Hemodynamic Corner cases, and two reports on Cardiac Tumors & Pseudotumors. Dr. Sorrell noted, “Most of us have seen patients with severe mitral annular calcification with or without associated echo-free spaces commonly referred to as liquefaction or caseous necrosis. Some of us have also seen the rare pathologic transformation to fistula formation. Fujiwara and coauthors provide us with an excellent surgically correlated case series of these patients with an absolutely striking video taken in the OR that you simply must see to believe!” Dr. Sorrell’s editorial, “Interpreting the Interpretation,” challenges clinical echocardiographers to continually improve their communication of echo findings to non-specialist colleagues to help improve outcomes.

REMINDER: There are still fee waivers available for sonographer lead authors, sponsored by the Sonography Council, waiting to be claimed by you. Submit your case today! Email Debbie Meyer, Director of Publications (JASE, CASE), or Andie Piddington, Deputy Managing Editor (JASE, CASE), with any questions or to request a case-writing mentorship from an ASE sonographer.

ASE is pleased to share the following news release, provided by Ultromics, highlighting the recently published research initiatives funded through the ASE Foundation, with support from the University of Chicago and MedStar Health, and in-kind support from Ultromics. 

Ultromics’ AI technology analyzes echocardiogram images and predicts cardiac-related mortality better than human analysis.

OXFORD, England, 10^th October, 2022

A new study from the World Alliance Societies of Echocardiography (WASE), a major international research initiative led by the American Society of Echocardiography (ASE), says artificial intelligence (AI) is superior to human experts when it comes to predicting cardiac-related death₁, a capability that could revolutionize cardiovascular care.

The AI platform, EchoGo by Ultromics, is FDA-cleared, CE Marked and in-use by a growing number of provider organizations across the US and UK. Ultromics is moving quickly and innovatively to help develop novel approaches to improve heart failure detection. The company recently announced a partnership with The Foundation for the National Institutes of Health (FNIH)₂ that will use their upcoming FDA breakthrough designated product to improve heart failure detection₃, looking specifically at heart failure with preserved ejection (HFpEF).

This latest research from WASE builds on previous work which showed that AI–based analysis could accurately detect outcomes from echocardiographic images₁, including combining myocardial strain biomarkers to improve predictive accuracy, recommended as clinical best practice₄. With this, an interest in the AI’s ability to make outcome predictions was compared with conventional analysis by human experts.

Dr. Federico M. Asch, lead study author and Director of the Cardiovascular and Echo Core Labs at MedStar Health Research Institute, said: “AI derived results outperformed traditional manual analysis in the generation of Left Ventricular Ejection Fraction and Global Longitudinal Strain, as the AI proved to be a significant predictor of outcomes, which traditional reads by expert echocardiographers could not achieve.”

The study looked at 870 patients admitted to 13 hospitals in 9 countries (Asia, Europe, United States, Latin America), who had acute COVID-19 and underwent transthoracic echocardiography.

The research was supported in partnership by MedStar Health, University of Chicago, and Ultromics. Dr. Federico Asch, Director of the Cardiovascular and Echo Core Labs at MedStar Health Research Institute, and Dr. Roberto Lang, Director of the University of Chicago’s Non-invasive Cardiac Imaging Laboratory, served as principal investigators.

Echocardiographic left ventricular ejection fraction (LVEF) and left ventricular longitudinal strain (LVLS) were obtained manually by multiple expert readers and by the automated EchoGo AI platform from Ultromics. The ability of the manual and AI analyses to predict all-cause mortality was compared.

AI-derived LVEF and LVLS were predictors of mortality in univariable and multivariable regression analysis (odds ratio, 0.974 [95% CI, 0.956-0.991; P = .003] for LVEF; odds ratio, 1.060 [95% CI, 1.019-1.105; P = .004] for LVLS), but LVEF and LVLS obtained by manual analysis were not₁.

Direct comparison of the predictive value of AI versus manual measurements of LVEF and LVLS showed that AI was significantly better (P = .005 and P = .003, respectively)₁. In addition, AI-derived LVEF and LVLS had more significant and stronger correlations to other objective biomarkers of acute disease than manual reads. Lastly, , inter-operator agreement for LVEF and GLS was 23% and 44% (respectively) lower for manual measurements than that achieved by the AI₁.

Dr Ross Upton, CEO and Founder of Ultromics, said “Developing precision strategies for cardiovascular disease is more critical than ever, particularly heart failure, where patient cases and costs are expected to double between now and 2030⁵. We built our AI platform to improve the accuracy of heart failure detection and prevent worsening cardiac outcomes.” Upton continued: “The technology was built using deep learning, from 10 years’ worth of echocardiographic images tied to outcomes, to provide precision analysis independent of expert clinicians”.

This study demonstrates the prognostic value of AI for routine primary care and improved accuracy for prediction of cardiovascular disease. Ultromics will continue to explore how AI can contribute to the development of echocardiography and preventative care.

Click here to read the published paper in The Journal of the American Society of Echocardiography (JASE).

Dr. Asch will join Gary Woodward, pHD, Ultromics Chief Technology Officer,  on a webinar on November 3rd, 2022 to discuss these ground-breaking results. Visit www.ultromics.com to register for the online seminar.

About Ultromics:

Ultromics is the leader in artificial intelligence for echocardiography enabling earlier detection and risk stratification of heart failure for better outcomes, lower costs, and improved patient care. All providers, regardless of their care setting, can now make precise, accurate, and timely diagnoses of heart failure with Ultromics’ AI technology. The cloud-based platform, EchoGo, offers a simple, secure and seamless way to augment your existing technology and workflow with fully automated, advanced echo analysis including critical advanced measures recommended by guidelines.. The technology is FDA-cleared and trusted by world-renowned organizations such as Mayo Clinic and the NHS England. Learn more: https://www.ultromics.com

For media inquiries:

Ultromics VP of Marketing – Jeff.Zinger@ultromics.com

1. Asch J, et al, J Am Soc Echocardiogr. 2022;35:1-55

2. https://www.ultromics.com/press-releases/ultromics-joins-fnih-partnership-to-transform-heart-failure-detection

3. EchoGo Heart Failure is pending FDA 510k clearance

4. https://www.onlinejase.com/article/S0894-7317(21)00483-1/fulltext

5. Smiseth, OA, et al. European Heart Journal. 2015;37:1196–1207

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494150/

October is Medical Ultrasound Awareness Month (MUAM)!

During MUAM and in the coming months, ASE will share #ILookLikeASonographer social media posts to celebrate our sonographer members and increase awareness about this important and rewarding profession.

Additionally, and ASEF will shine a spotlight on ultrasound professionals all month long. Submit a photo of a sonographer you with with along with an appreciation message to Mary Carmody. Submissions will be shared on ASEF’s website.

Learn how you can get involved!

Thank you to everyone who uploaded echo images and voted on Connect@ASE during the Image Calendar Competition. Please join ASE in congratulating the following members, whose images have been selected for the 2023 ASE Image Calendar:

• Melynda Ancell, RDCS (AE, PE)
• Bonita Anderson, DMU, (Cardiac), MAppSc (MedU/S), ACS, FASE
• Clara Angulo, ACS, MBA, FASE
• Gerald Jason Ballo, RN, RDCS, RCS, BSE
• Luciano Belem, MD
• Kana Fujikura, MD, PhD, FASE
• John Goodman, RDCS, RVT
• Jason Pereira, MS, RCS, FASE
• Marie Sadler, RDCS
• Madeline Schiminger, MPH, RDCS (AE, PE), FASE
• Nicole Simpkins, BS, RDCS (AE, PE), RCCS, FASE
• Angelica Valentin, RCS
• Megan Yamat, ACS, FASE
• Kathryn Ziegler, BS, RDCS, FASE

To receive your copy of the 2023 Image Calendar, renew your ASE membership by December 31, 2022!

Submit your abstract of original research or clinical cases to be considered for presentation at the premier cardiovascular ultrasound conference of the year, the 34th Annual ASE Scientific Sessions in National Harbor, Maryland, June 23-26, 2023. 

Begin your submission online today! Presenters benefit from dedicated viewing times, a global audience that promotes future collaborative work, eligibility for travel support, publication in JASE, and discounted conference registration rates. Visit the ASE 2023 Call for Science for more information. Submission closes Wednesday, February 8, 2023, 11:59 ET

The October JASE includes, “Simplified Lung Ultrasound Examination and Telehealth Feasibility in Early SARS-CoV-2 Infection,” from Drs. Kimura, Resnikoff, Tran, Bonagiri, and Spierling Bagsic.

Dr. Kimura noted, “Although the nature of SARS-CoV-2 infection seems to be constantly changing, we found that the use of a quick-and-easy ultrasound exam can help identify outpatients with early lung involvement and a worse prognosis, even before detection by skin temperature or pulse oximetry. The simplicity of the exam enabled patients to image themselves from isolation and suggests the feasibility of imaging from home, a school, a pharmacy, or even a drive-through testing site. The COVID-19 pandemic taught us a new pathway to apply ultrasound which may involve a combination of simplified self-imaging, telehealth, and artificial intelligence, that will improve healthcare delivery from within the community on a variety of diseases in the future.”

Another COVID-19 study looks at serial left and right ventricular strain analysis in patients who have recovered from the infection. Additional clinical investigations also look at 3D echocardiography, incremental value of global longitudinal strain to stress echocardiography in outcome assessment, several topics related to tricuspid and mitral regurgitation, left atrial function and outcomes in cryptogenic stroke, transcatheter aortic valve replacement in children, and enhancing quality in pediatric echocardiography.

Two brief research communications round out the issue. The President’s Message from Stephen H. Little, MD, FASE, shares the multi-faceted ways that ASE is a global organization, and why this incredible diversity is so important to the future of advancing cardiovascular ultrasound. The continuing education and meeting calendar outlines a multitude of learning options near and far.

The October 19 deadline to submit papers to be considered for the JASE Echocardiography in Valvular Heart Disease focus issue (published in early 2023) is almost here. Questions? Contact JASE managing editor, Debbie Meyer, at dmeyer@asecho.org

ASE is seeking the best and brightest members to move forward the mission and goals of the Society and the ASE Foundation. Now is your opportunity to become a leader in ASE! The deadline for submission of nominations is November 30, 2022. Ask an active ASE member TODAY to submit your nomination. Please contact Nominations@ASEcho.org with any questions or to submit nominations.

LEARN MORE!

American Society of Echocardiography Invests in Joint Research Initiative to Help Patients Suffering from Wide-Reaching Form of Heart Failure

(DURHAM, NC, Sept. 29, 2022)—The American Society of Echocardiography (ASE) is targeting its research funding over the next five years to help solve some of the mysteries around the early detection of a common form of heart failure. ASE is one of the key partner organizations in a joint research initiative that aims to identify more precise treatment strategies for patients suffering from heart failure with preserved ejection fraction (HFpEF).

The Accelerating Medicines Partnership® Heart Failure (AMP® HF) Program will utilize more than $37 million in funding from private and public collaborators—which includes ASE—to better diagnose and develop treatment options for HFpEF and improve the outlook for millions of patients around the world. The Foundation for the National Institutes of Health (FNIH) and the National Heart Lung and Blood Institute (NHLBI) at the National Institutes of Health (NIH) will facilitate the program over the next five years.

“One of ASE’s current strategic goals is to focus our efforts where they are most needed,” says Stephen H. Little, MD, FASE, FRCPC, FACC, ASE’s 2022-2023 Board of Directors President. “The Society is proud to support research projects like AMP HF because of the great promise the findings can have in advancing the field of cardiovascular ultrasound and improving patient care.”

HFpEF is a common form of heart failure that is difficult to detect. It is often deadly, with a five-year survival rate of just 35-40%. In addition to a high risk for mortality, patients with HFpEF live with declining quality of life and poor capacity to perform tasks of daily living.

The AMP HF Program will advance the understanding of HFpEF using two complementary and integrated research components: analyzing existing HFpEF datasets, sourced from public and private sector funded studies, and initiating a new clinical trial to confirm retrospective findings in an observational cohort with a goal to develop a framework for new precision treatments.

“Echocardiography is a specialty that already plays a significant role in diagnosing heart conditions, and we look forward to continuing to learn how echocardiographic screenings can be used in understanding the many still unanswered questions about HFpEF,” says Judy Hung, MD, FASE, who is a cardiologist with Massachusetts General Hospital and an ASE past president.

“Research shapes the future of medicine, and ASE is honored to be among some of the largest and most innovative biomedical partners contributing to this important initiative,” Dr. Hung added.

ASE’s charitable arm, the ASE Foundation, provides support for initiatives that are not funded by membership dues—such as training scholarships and scientific research. In the last 25 years, the Society and its Foundation have contributed more than $7.3 million to cardiovascular health research.

About American Society of Echocardiography
The American Society of Echocardiography (ASE) is the Society for Cardiovascular Ultrasound Professionals™. ASE is the largest global organization for cardiovascular ultrasound imaging serving physicians, sonographers, nurses, veterinarians, and scientists and as such is the leader and advocate, setting practice standards and guidelines for the field. The Society is committed to advancing cardiovascular ultrasound to improve lives. For more information, visit the ASE website ASEcho.org or social media pages on Facebook, Twitter or LinkedIn.

About the Foundation for the National Institutes of Health: The Foundation for the National Institutes of Health (FNIH) creates and manages alliances with public and private institutions in support of the mission of the NIH. FNIH works with its partners to accelerate biomedical research and strategies against diseases and health concerns in the United States and across the globe. The FNIH organizes and administers research projects; supports education and training of new researchers; organizes educational events and symposia; and administers a series of funds supporting a wide range of health issues—all efforts focused on areas of unmet need, paving the way toward better patient experiences and outcomes. Established by Congress in 1990, the FNIH is a not-for-profit 501(c)(3) charitable organization. For additional information about the FNIH, please visit https://fnih.org.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit https://www.nih.gov/.

The latest issue of CASE, ASE’s open access case reports journal, is available, and is packed with educational material to share with trainees and colleagues, including another fantastic article authored by a sonographer.

Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “The sonographer-led CASE report on the incidental finding of an anonymous coronary artery by Okoli e.t al. was a wonderfully clever update that provided both the sonographer and physician perspectives. When you read the conclusions, you may be struck by the list of items the Medical Doctor has to consider when faced with this diagnosis: Management Dilemmas; Most Desirable imaging options; Most Decisive information to review; Most Dreaded complication risks; Most Definitive treatments; and Most Daunting remaining questions. It was a great reminder that sonographers provide unique perspectives beyond the MD.”

Additionally, this issue includes three cases highlighting the value of Multimodality Imaging in multiple diseases, two additional Congenital Heart Disease cases, and two cases in the Interventional Echocardiography section, including a novel report on echo-guided PIMSRA for residual LVOTO in HCM patients. The editorial from Dr. Sorrell, “Distracted Driving in the Echo Lab,” reflects on the challenges for medical professionals to stay focused amidst our modern daily life full of multi-tasking and disruptions.

We hope this issue of CASE provides new insights and inspires more sonographers to continue authoring and submitting their own case reports. There are still open access fee waivers for sonographers available, sponsored by the Council on Cardiovascular Sonography, waiting to be claimed by you!

Email Debbie Meyer, Director of Publications (JASE, CASE), or Andie Piddington, Deputy Managing Editor (JASE, CASE), with any questions or to request a case-writing mentorship from an ASE sonographer