The latest issue of CASE is now available with intriguing reports, including “Exaggerated Pressure Recovery during Pregnancy: A Multimodal Approach to Assessment of Prosthetic Aortic Stenosis Severity.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Connor et al. reported serial Doppler echocardiography on a complex young, pregnant woman with Turner syndrome, prior aortic valve and ascending aortic surgery. They compare findings to both baseline and an earlier uncomplicated pregnancy, including mean and peak CWD gradients, indexed effective orifice areas (note: indexing is important, given the history of Turner and suspected short stature), invasive hemodynamics, and a dynamic cardiac CT of the prosthetic AVR for correlation. The major discrepancies between echo and cath stimulated the authors to write this report which provides readers with a fabulous discussion regarding the many factors that contributed. These differences were the results of her progressing pregnancy, previous valve and aortic surgery, and important impact of pressure recovery phenomenon. If you enjoy cardiovascular physiology and the many factors that alter echo hemodynamics, be sure to read all about it.”

Panidapu et. al add to this Hemodynamic Corner category with their report on how coexistent severe tricuspid regurgitation can lead to underestimating the severity of mitral stenosis. Two reports in the Cardiac Tumors and Pseudotumors category uphold the importance of echo through the discovery of a large right atrial thrombus and pulmonary embolism in a 22-month-old girl, and a case of synchronous cardiac diffuse B-cell lymphoma, treated successfully by chemotherapy after early rapid diagnosis with echocardiography. Coronary Artery Disease rounds out this issue, reporting on the methods of echocardiographic detection of a partially obscured ventricular septal defect in a patient with a post-infarction ventricular septal rupture.

In the spirit of Thanksgiving, be sure to read Dr. Sorrell’s editorial as he expresses gratitude for all that the field of echocardiography bestows upon its patients and practitioners.

SUBMIT your case report to us! Whether it will be your first time submitting a case or your 50^th, we are here to make it a great experience. Email us with questions or submit your report today!

The November issue of JASE includes a state-of-the-art review titled, “Advances in the Assessment of Patients With Tricuspid Regurgitation: A State-of-the-Art Review on the Echocardiographic Evaluation Before and After Tricuspid Valve Interventions.” Lead author Luigi Badano, MD, PhD, FASE, remarks, “The tricuspid valve (TV) is not merely the right counterpart of the mitral valve. It has a distinct anatomy, featuring three leaflets as opposed to two, and a more pliable annulus. Additionally, it functions in a unique hemodynamic environment, working in a volume pump rather than a pressure pump. Therefore, it requires a specialized approach and different threshold values for evaluating its severity before and after valve repair interventions. Conventional parameters used to evaluate right ventricular geometry and function may be misleading in patients with moderate to severe tricuspid regurgitation. Three-dimensional echocardiography has significantly enhanced our understanding of tricuspid valve anatomy, the pathophysiology of tricuspid regurgitation, and the assessment of right ventricular geometry and function.”

This issue’s original investigations incorporate many topics including stress echocardiography in low gradient aortic stenosis, diastolic function and prognosis in heart failure, myocardial shear wave analysis in children, and perinatal cardiac function in congenital heart disease. Additionally, there are five brief research communications and three editorial comments. These reports cover diagnosing severe mitral stenosis, applying appropriate use criteria for echo in an underserved population, effectiveness of negative pressure booths in mitigating airborne infection risk during TEE, prognostic value of echo parameters of the subpulmonary LV in adults with a systemic RV, and shear wave elastography in children with a Fontan circulation. Rounding out this issue are two letters to the editor—one addresses how guidelines reinforce treatment disparities for patients with aortic stenosis and the other describes the importance of a complete hemodynamic assessment of the aortic valve.

This month’s President’s Message highlights the important work of ASE’s advocacy team as they navigate challenges and opportunities within the fluctuating economic realm of cardiovascular ultrasound.

Tune into our Author Spotlight page for interviews between JASE Editor-in-Chief Patricia Pellikka, MD, FASE, and authors of recently published papers. November’s interview features Nils Sofus Borg Mogensen, MD, discussing his paper, “Dobutamine Stress Echocardiography in Low-Gradient Aortic Stenosis.”

Please see the November ASE Education Calendar for a listing of educational opportunities far and wide.

The latest issue of CASE is now available with intriguing reports, including “Epicardial Lead Pacer Wire Migration Causing Endocarditis in an Orthotopic Heart Transplant Patient.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “These authors, through a carefully investigated clinical care approach, used TTE, TEE, and CT imaging to find the source of infection in a young man post-orthotopic transplant (OHT). What they found will likely surprise you – as it did me. After OHT, placement of a temporary epicardial pacing wire (TEPW) is routine; occasionally the TEPW is left in place, and the wires are cut in challenging cases where removal is considered too difficult. For such patients, the need for further monitoring and understanding of this approach to care is described. These authors demonstrate a case of TEPW migration that resulted in persistent bacteremia and endocarditis, and remind us that OHT recipients whose TEPWs are not entirely removed warrant recognition of this possibility and the importance of imaging surveillance.”

In addition to this Infections in the Heart case, Rare but Deadly Findings offers readers two impactful reports. The first depicts a patient with an iatrogenic complication that required urgent thoracic surgery to avoid a deadly outcome. Maturi et al. then present a case of chest stab wounds penetrating multiple cardiac structures, illustrating how echocardiographic imaging (with Doppler) can correlate with surgical findings. Echo Innovation rounds out this issue with two reports that will benefit your echo knowledge. Koratala et al. provide insight on venous Doppler patterns that can assist with volume assessment and guidance on ultrafiltration in dialysis patients. Wen et al. demonstrate in-situ TEE during screening for direct-current cardioversion and describe their approach to incorporating these echocardiographic findings into their anticoagulation strategies.

Be sure to check out Dr. Sorrell’s editorial as he explores spectral Doppler and related phenomena in honor of our even spookier specters appearing later this month.

SUBMIT your case report to us! Whether it will be your first time submitting a case or your 50^th, we are here to make it a great experience. Email us with questions or submit your report today!

Read the October CASE.

Important Update: Cancellation of the 12th Annual Echo Florida Course Due to Hurricane Milton

Due to the projected impact of Hurricane Milton, ASE has made the difficult decision to cancel the 12th Annual Echo Florida course. The course directors and ASE staff are actively exploring all possible options to ensure this valuable educational content remains accessible to you. We will provide additional details as soon as possible. ASE staff will be processing refunds of all registration fees over the next several days. Your refund should show on your account within 5-7 business days. Attendees must cancel your hotel reservations. We are not able to cancel hotel reservation on your behalf. If you wish to keep your reservation, please work with Disney directly. They will honor the conference rate.

Thank you for your understanding and continued support. Our thoughts are with all those who are in the pathway of this storm.

Questions? Email: Registrar@ASEcho.org 

The October issue of JASE includes, “Sonothrombolysis Before and After Percutaneous Coronary Intervention Provides the Largest Myocardial Salvage in ST Segment Elevation Myocardial Infarction.” Lead author Prajith Jeyaprakash, MD, remarks, “We are excited to share the results of our REDUCE pilot trial, which found that sonothrombolysis delivered pre- and post-pPCI may salvage up to 30% more myocardium than pPCI in STEMI. This data helps to provide a mechanistic understanding of the specific benefits of pre-pPCI sonothrombolysis delivery. It has also provided valuable insights for our multicenter RCT which will be powered for infarct size as its primary endpoint.”

This issue’s clinical investigations incorporate many topics including echocardiographic predictors of outcome in heart failure, ventricular strain in cardiomyopathy, postprandial and exercise echo in HCM, and sonothrombolysis in myocardial infarction. Two editorial comments accompany these clinical investigations as well as four brief research communications with reports on right atrial and ventricular strain in patients with carcinoid heart disease, perivascular amyloid deposition, indexing of aortic dimensions in overweight and obese patients, and the learning curve for left atrial strain analysis. An In Memoriam for Arthur E. Weyman, MD, FASE, shares the story of his life and many contributions to the field as one of echocardiography’s greats. Also included in this issue is a letter to the editor on considerations while screening for polyethylene glycol hypersensitivity in patients receiving ultrasound enhancing agents. To conclude, there is the annual photo spread from this year’s Scientific Sessions in Portland.

This month’s President’s Message details the goals of current ASE President Theordore Abraham, MD, FASE, for his 2025 term. As ASE celebrates its 50^th anniversary next year, there are many plans in motion to propel the Society into another 50 years of exemplary contributions to the field of cardiovascular ultrasound.

Stay tuned for our October Author Spotlight for an interview between JASE Editor-in-Chief Patricia Pellikka, MD, FASE, and Mark Sherrid, MD, FASE.

Please see the October ASE Education Calendar for a listing of educational opportunities far and wide.