ASE’s Comprehensive Echocardiography

Written and endorsed by world experts from the American Society of Echocardiography (ASE), this unique multimedia resource uses text, case studies, and online components to cover the latest uses of echocardiography, including the most recent 2D and 3D advances. Unlike other existing textbooks in echocardiography, including the predecessor of this volume, entitled Dynamic Echocardiography , this 2nd edition, with its new title, covers a full range of topics, reflected in its 200 chapters that include essential material in a succinct format. Dr. Roberto M. Lang and his expert colleagues provide everything you need to assess cardiac anatomy and function and obtain clinically useful, noninvasive information for more accurate diagnosis and evaluation of heart disease. "I am also very proud that this textbook illustrates what is great about the ASE. We are a society with more than 16,000 members worldwide, dedicated to quality in cardiovascular ultrasound and education, both of which are prominently demonstrated throughout this textbook. ASE is also a village made up of many different people from many different backgrounds, all united and energized about the value of cardiovascular ultrasound in caring for people worldwide." Foreword by : Neil J. Weissman, American Society of Echocardiography, July 2015 Take advantage of an outstanding online library of slides and videos of case presentations that correspond to crisp, full-color images, allowing you to view dynamic echocardiographic clips of various cardiac pathologies. Tap into the knowledge and skills of a team of experts from the ASE, led by world-renowned authorities in echocardiography. Access the fully searchable text online at expertconsult.com, along with additional cases, images, and an extensive library of cine images. Get fully up to date with the latest echo practice guidelines and advanced technologies, including 3D echocardiography and myocardial strain. Gain a better understanding of the latest methods to assess cardiac chamber size and function, valvular stenosis/regurgitation, cardiomyopathies, coronary artery disease, complications of myocardial infarction, and much more – all in a practical, well-illustrated brief yet comprehensive format extensively supported by multimedia material. Stay up to date with hot topics in this rapidly evolving field: interventional/intraoperative echocardiography, transesophageal echocardiography, cardiac resynchronization therapy, and more. Set the pace with enhanced technologies and guidelines Title Page I Physics and Instrumentation General Principles of Echocardiography Transducer Instrument Artifacts Safety Reference Three-Dimensional Echocardiography Comparison between 2DE and 3DE ultrasound transducers 3D Echocardiography physics Image acquisition and display Doppler Principles Color doppler displays Spectral doppler displays Aliasing References Tissue Doppler Imaging and Speckle Tracking Echocardiography Principles of tissue doppler imaging Strain rate, strain, and displacement Speckle tracking echocardiography Evaluations of LV mechanics by TDI and STE References Tissue Harmonic Imaging Advantages of tissue harmonic imaging Disadvantages of tissue harmonic imaging Key application principles for tissue harmonic imaging Conclusions References II Transthoracic Echocardiography Transthoracic Echocardiography: Nomenclature and Standard Views Parasternal window Long Axis: Left Ventricle Long Axis: Right Ventricular Inflow and Outflow Short Axis Right Parasternal Window Apical window Four-Chamber View Two-Chamber View Three-Chamber (Long-Axis) View Subcostal window Suprasternal notch window References Technical Quality Optimizing 2D images Optimizing spectral doppler traces Optimizing color doppler images Summary References Transthoracic Echocardiography Tomographic Views Parasternal window: long-axis, right ventricular inflow and outflow, and short-axis views Transthoracic apical window Subcostal window Transthoracic suprasternal window Off-axis views References M-Mode Echocardiography Left ventricle Mitral valve Normal Motion Mitral Stenosis Mitral Valve Prolapse Systolic Anterior Motion of the Anterior Mitral Leaflet The Mitral Valve in Aortic Insufficiency The Mitral Valve in Left Ventricular Dysfunction Color M-Mode Aortic valve Normal Motion The Aortic Valve in Hypertrophic Obstructive Cardiomyopathy Premature Aortic Valve Opening Pulmonic valve Normal Motion Severe Pulmonary Hypertension Pericardial disease Cardiac tamponade Constrictive pericarditis References Doppler Echocardiography: Normal Antegrade Flow Patterns Basic concepts Technical considerations for optimal doppler recordings Individual flow profiles LV Outflow RV Outflow LV Inflow RV Inflow Pulmonary Venous Flow Hepatic Vein Flow Descending Thoracic Aortic Flow References III Transesophageal Echocardiography Protocol, Probe Insertion and Manipulation, Risks and Complications Protocol Topical anesthesia Sedation Probe insertion Probe manipulation General Points in Probe Manipulation Risks and complications References Transesophageal Echocardiography: Tomographic View Midesophageal five-chamber view Midesophageal four-chamber view Midesophageal mitral commissural view Midesophageal two-chamber view Midesophageal long-axis view Midesophageal AV LAX view Midesophageal ascending aorta LAX view Midesophageal ascending aorta short-axis view Midesophageal right pulmonary vein view Midesophageal AV SAX view Midesophageal right ventricle inflow-outflow view Midesophageal modified bicaval TV view Midesophageal bicaval view Midesophageal right and left pulmonary veins view Midesophageal left atrial appendage view Transgastric basal SAX view Transgastric midpapillary SAX view Transgastric apical SAX view Transgastric RV basal view Transgastric RV inflow-outflow view Deep transgastric five-chamber view Transgastric two-chamber view Transgastric right ventricle inflow view Transgastric long-axis view Descending aorta SAX and LAX views Upper esophageal aortic arch long-axis view Upper esophageal aortic arch short-axis view References Applications of Transesophageal Echocardiography Valvular heart disease Aortic Valve Disease Mitral Valve Disease Tricuspid and Pulmonic Valve Disease Prosthetic Valve Disease Interventional imaging Atrial Fibrillation Ablation and Left Atrial Appendage Closure Patent Foramen Ovale or Atrial/Ventricular Septal Defect Closure Transcatheter Aortic and Mitral Valve Interventions Intraoperative imaging Valvular and Aortic Surgery and Congenital Heart Disease Repair Cardiac thrombus and embolus evaluation Precardioversion in Atrial Fibrillation and Cardiac Source of Emboli Endocarditis and cardiac mass investigation Aortic evaluation Critically ill patients Summary References Pitfalls and Artifacts in Transesophageal Echocardiography Tee pitfalls Crista Terminalis Eustachian Valve and Chiari Network Lipomatous Hypertrophy of the Atrial Septum Coumadin Ridge Moderator Band Lambl Excrescences Prosthetic Valve Structures Pericardial Fat Pleural Effusion Hiatal Hernia Tee artifacts Low Imaging Quality Acoustic Shadowing Side Lobe and Beam Width Artifacts Reverberation Artifacts concerning spectral and color flow doppler echocardiography Aliasing Acoustic Shadowing Beam Angle and Width Artifacts Mirroring Color Flow Reverberation and Gain-Related Anomalies Conclusions References IV Intracardiac Echocardiography Applications of Intracardiac Echocardiography Device closure of interatrial communications Electrophysiologic ablation procedures Transcatheter aortic valve replacement Rare and investigational applications Summary References Limitations of Intracardiac Echocardiography Technical limitations Operator-dependent limitations Cost-benefit ratio Current limitations of three-dimensional intracardiac echocardiography References V Intravascular Ultrasound Intravascular Ultrasound: Instrumentation and Technique Intravascular ultrasound imaging technology Performance of the IVUS procedure Modalities of IVUS imaging Conclusions References Intravascular Ultrasound: Applications and Limitations Current applications Types of IVUS Imaging and Basics of Image Interpretation IVUS for Assessment of Lesion Severity IVUS for Assessment of Plaque Characteristics Pre- and Post-PCI Assessment Using IVUS Limitations Conclusions References V I Hand-Held Echocardiography Hand-Carried Cardiac Ultrasound: Background, Instrumentation, and Technique Background Instrumentation Technique References Applications Limitations References VII Contrast Echocardiography Contrast Echocardiography: Introduction References Ultrasound Contrast Agents Ultrasound contrast agent composition Technical considerations and responsibilities Role of the physician Role of the sonographer or nurse Safety of ultrasound contrast agents References Physical Properties of Microbubble Ultrasound Contrast Agents Microbubble contrast agents Contrast-specific imaging techniques Clinical perspective References Applications of Ultrasound Contrast Agents Clinical applications Assessment of Cardiac Function Delineation of Intracardiac Pathology Summary References Stress Echocardiography and Contrast Contrast stress echocardiography: methodology and interpretation Methodology Interpretation Contrast left ventricular opacification stress echocardiography Diagnostic Efficacy Prognostic Role Cost-Effectiveness Contrast off-label use for myocardial perfusion stress echocardiography Diagnostic Efficacy Prognostic Role Conclusion References Contrast-Enhanced Carotid Imaging Clinical applications of carotid ultrasound Methodology of contrast-enhanced carotid ultrasound Detection of plaques Improvement of the Doppler signal Assessment of plaque vulnerability Limitations of contrast-enhanced carotid ultrasound Future perspectives Conclusions References VIII Left Ventricular Systolic Function Introduction Indications for systolic function evaluation Limitations of ejection fraction Choice for assessment tool of lv systolic function in multimodality ERA Conclusions References Left Ventricular Systolic Function: Basic Principles Functional anatomy of the left ventricle Left ventricular volume and its dynamic geometry Cardiac cycle Determinants of LV performance Response to exercise References Global Left Ventricular Systolic Function Echocardiographic methods used to assess lv global systolic function M-Mode Echocardiography Two-Dimensional Echocardiography Three-Dimensional Echocardiography Doppler Echocardiography Tissue Doppler Imaging Speckle Tracking Echocardiography Global LV systolic functional parameters Fractional Shortening and Ejection Fraction Ejection Acceleration Time Myocardial Performance Index Strain and Strain Rate Limitations and technical considerations Conclusion and recommendations References Regional Left Ventricular Systolic Function LV myocardial segmentation Methods for assessment of regional lv systolic function Visual Assessment of Regional LV Systolic Function Assessment of the Myocardial Contractile Function by Speckle Tracking Echocardiography Other Techniques Correlation with coronary blood supply Correlation with extent of infarction Nonischemic causes of regional LV systolic dysfunction References Assessment of Left Ventricular Dyssynchrony Electrical dispersion and mechanical dyssynchrony Echocardiographic approaches to assess mechanical dyssynchrony Interventricular mechanical delay Tissue doppler imaging Speckle tracking strain Dyssynchrony in patients with widened QRS complex for prognosis Dyssynchrony as a marker for arrhythmias Mechanical dyssynchrony in myocardial disease with narrow QRS complex Mapping latest mechanical activation for left ventricular lead placement Three-dimensional speckle tracking imaging References IX Right Heart Right Ventricular Anatomy Coronary flow to the right ventricle Echocardiographic assessment of right ventricular anatomy Reference values for right ventricular structure References The Physiologic Basis of Right Ventricular Echocardiography Structure and anatomy of the right ventricle Ejection and function of the right ventricle Right ventricular hemodynamics RV Preload RV Contractility RV Afterload Coronary blood flow of the right ventricle Interventricular dependence RV diastolic function Rhythm disturbances originating from the RV Newer imaging modalities to image RV Conclusion References Assessment of Right Ventricular Systolic and Diastolic Function Introduction Anatomy and physiology Quantitative evaluation by echocardiography Right Ventricular Size Two-Dimensional Measurements Volume of the Right Ventricle Right ventricular systolic function Fractional Area Change Tricuspid Annular Plane Systolic Excursion and Velocity Right Ventricular Index of Myocardial Performance Three-dimensional right ventricular ejection fraction Right ventricular strain Right ventricular diastolic function Transtricuspid Flow Hepatic Vein Flow Tissue Doppler Echocardiography and Strain Lateral Tricuspid Annulus Velocities Tricuspid E/e Ratio Grading Diastolic Function Clinical impact of right ventricular size and function: prognosis Summary and recommendations References Right Ventricular Hemodynamics Flow Pressure Resistance Pulmonary artery catheter in a box Right Atrial Pressure Secondary Indices of Right Atrial Pressure Right Ventricular Systolic Pressure Pulmonary Artery Pressure (Fig.35.2, A, B) Pulmonary Vascular Resistance Summary References The Right Atrium Introduction Anatomy Anatomic Landmarks Physiology Echocardiographic views Anatomic variants Right atrial size measurement Right Atrial Dimensions and Volume Measurement by Two-Dimensional Echocardiography Right Atrial Volume Assessment Based on Three-Dimensional Echocardiography Clinical Implications of Right Atrial Enlargement Right atrium pressure and performance Assessment of Right Atrial Pressure by Two-Dimensional Echocardiography Conclusion References Pulmonary Embolism Introduction Diagnosis Transthoracic echocardiography Transesophageal echocardiography Prognosis Summary References X Diastolic Function Physiology of Diastole LV relaxation LV stiffness Ventricular arterial coupling Diagnosis of diastolic heart failure References Methods of Assessment Invasive assessment of diastolic function Noninvasive assessment of diastolic function: echocardiography References Echo Doppler Parameters of Diastolic Function Doppler mitral flow velocity patterns Valsalva maneuver Pulmonary venous flow Systolic/Diastolic ratio Reverse Flow at Atrial Contraction Velocity Color M-mode flow propagation velocity Tissue doppler annular velocity Myocardial performance index Integration of doppler echocardiography parameters Conclusion References Estimation of Left Ventricular Filling Pressures Difficult cases References Clinical Recommendations for Echocardiography Laboratories for Assessment of Left Ventricular Diastolic Function Estimation of left ventricular filling pressures in patients with depressed ejection fraction Estimation of left ventricular filling pressures in patients with normal ejection fraction Grading of left ventricular diastolic function Estimation of left ventricular filling pressures in patients with atrial fibrillation Estimation of left ventricular filling pressures in patients with mitral regurgitation Prognostic power of the american society of echocardiography/european association of echocardiography diastolic function grade References Newer Methods to Assess Diastolic Function Myocardial muscle mechanics Three-dimensional strain Fluid mechanics Conclusion References Causes of Diastolic Dysfunction Definition Prevalence of diastolic dysfunction in common comorbid conditions Hypertension Coronary Artery Disease Diabetes Mellitus Obesity Hypertrophic cardiomyopathy Diastolic dysfunction in restrictive cardiomyopathy Amyloidosis Hemosiderosis Cardiac Sarcoidosis Hypereosinophilic Syndrome Systemic Sclerosis Impact on survival Mechanistic considerations Transition from diastolic dysfunction to overt heart failure References XI Left Atrium Assessment of Left Atrial Size Left atrial remodeling: an echocardiographic diagnosis Definition of left atrial remodeling Diastolic dysfunction and left atrial size Left atrial enlargement for outcome prediction and prognostication Echocardiographic methods of left atrial size assessment Pitfalls of left atrial volume measurement Newer modalities of echocardiographic left atrial volume assessment Reverse remodeling of LA Future directions References Assessment of Left Atrial Function Left atrial function Volumetric methods Spectral doppler Tissue doppler imaging Deformation analysis (strain and strain rate imaging) Challenges to measurement of left atrial function References XII Ischemic Heart Disease Introduction to Ischemic Heart Disease References Ischemic Heart Disease: Basic Principles Acute effects of myocardial ischemia Echocardiographic detection of myocardial ischemia and infarction Patterns of ischemia based on coronary artery involvement False indications of ischemia on echocardiography References Acute Chest Pain Syndromes: Differential Diagnosis Left ventricle Left Ventricular Function and Acute Coronary Syndrome Left Ventricular Function and Cardiomyopathies Right ventricle Aorta Pericardium References Echocardiography in Acute Myocardial Infarction Left ventricular thrombosis Postinfarction ventricular septal rupture Left ventricular free wall rupture Acute mitral regurgitation and papillary muscle rupture Left ventricular outflow tract obstruction Right ventricular infarction References Echocardiography in Stable Coronary Artery Disease Diagnosis Stress echocardiography Image interpretation Prognostic value of stress echocardiography Mechanisms of reversibility Role of dobutamine stress echocardiography in viability assessment Importance of viability Conclusion References Old Myocardial Infarction Chronic remodeling LV Size and Function Other Manifestations of Remodeling Risk Factors for Chronic Remodeling Treatment and Prevention of Adverse Remodeling Early Detection of Adverse Remodeling Viability Ischemic MR References End-Stage Cardiomyopathy due to Coronary Artery Disease Etiology of ventricular dysfunction Characterization of left ventricular size and function Right ventricle Diastolic function Mitral regurgitation Left ventricular aneurysm Serial evaluation References Coronary Artery Anomalies Classification of coronary artery anomalies Multimodality imaging for the identification of coronary artery anomalies Imaging protocol for transthoracic echocardiography Incidence of coronary anomalies diagnosed by echocardiography Perioperative transesophageal echocardiography Conclusion References XIII Stress Echocardiography Stress Echocardiography: Introduction References Effects of Exercise, Pharmacological Stress, and Pacing on the Cardiovascular System Hemodynamic effects Mechanisms of ischemia Left ventricular response to stress Comparisons of stressors Hypertensive response to stress Parameters to assess for noncoronary indications Mitral Regurgitation Aortic Stenosis Diastolic Dysfunction Conclusions References Diagnostic Criteria and Accuracy Diagnostic criteria Semiquantification of Left Ventricular Wall Motion Using Wall Motion Score Index Wall Motion Abnormalities at Low Heart Rates Left Atrial Size Right Ventricular Function Transient Ischemic Dilatation Diagnostic accuracy References Stress Echocardiography Methodology Exercise echocardiography Exercise protocols Treadmill Bicycle Ergometry Pharmacologic stress protocols Dobutamine Vasodilator Stress Echocardiography Other modalities Handgrip Diastolic Stress Test References Stress Echocardiography: Image Acquisition Acknowledgment References Prognosis Risk stratification and prognosis with extent and severity of wall motion abnormalities Single vessel and multivessel coronary artery disease Prediction of myocardial infarction versus cardiac death Functional parameters, including heart rate reserve, important in prognosis Heart rate when wall motion abnormality occurs Prognostic value of stress echocardiography versus stress electrocardiography Duration of regional wall motion abnormalities Role of right ventricular wall motion Transient ischemic left ventricular cavity dilatation Left atrial size Warranty time of a normal stress echocardiogram References Viability Dobutamine stress echocardiography Rationale Protocol Prognostic value Comparison with other modalities Thallium scintigraphy Fluorodeoxyglucose F 18 Positron Emission Tomography Magnetic Resonance Imaging Reasons for discordant findings between various modalities to assess viability Future advances Nitroglycerin-Enhanced Dobutamine Stress Echocardiography Enoximone Stress Echocardiography Strain Rate Measurement Myocardial Contrast Echocardiography Conclusions References Contrast-Enhanced Stress Echocardiography Ultrasound contrast applications for stress echocardiography Approaches to optimize contrast use during stress echocardiography Physiologic basis for examining myocardial perfusion with ultrasound contrast agents Technical considerations and components Role of physician Role of sonographer and nurse Advantages and disadvantages of using RTPE instead of other imaging techniques Acquisition of RTPE images Specific stress protocols Exercise Stress RTPE Acquisition Analysis of Images Dobutamine stress real-time perfusion echocardiography and left ventricular opacification protocols Acquisition Analysis of Images Vasodilator stress myocardial perfusion imaging Acquisition Analysis Pitfalls and clinical tips for all RTPE stress acquisitions References Three-Dimensional Stress Echocardiography Introduction Modes of 3D stress echocardiography Real-Time Imaging Real-Time 3D Full Volume Data Acquisition Temporal resolution 3D volume data acquisition LV segment visualization Left ventricular contrast opacification Workflow and display Analysis Other methods of 3D stress analysis and display Conclusion References Stress Echocardiography for Valve Disease: Aortic Regurgitation and Mitral Stenosis Introduction Stress echocardiography protocol Aortic regurgitation Indications Prognostic value of left ventricular contractile reserve Mitral stenosis Indications Prognostic value of changes in transmitral pressure gradient and systolic pulmonary artery pressure Impact on clinical decision making References Appropriate Use Criteria for Stress Echocardiography What are appropriate use criteria for stress echocardiography? Is the current clinical practice of stress echocardiography appropriate? Do the appropriate use criteria for stress echocardiography stratify diagnosis and prognosis? References Comparison with Other Techniques Exercise electrocardiography stress testing and stress echocardiography Nuclear stress testing Cardiac magnetic resonance perfusion imaging Coronary computed tomography angiography Advantage of stress echocardiography over other imaging techniques References XIV Cardiomyopathies Introduction to Cardiomyopathies Definition of cardiomyopathy Role for echocardiography References Pathophysiology and Variants of Hypertrophic Cardiomyopathy Anatomic variants Pathophysiology Diastolic Dysfunction Myocardial Ischemia Autonomic Dysfunction Physiologic variants Nonobstructive Hypertrophic Cardiomyopathy Hypertrophic Cardiomyopathy with Left Ventricular Outflow Tract Obstruction Mid-Ventricular Obstruction in Hypertrophic Cardiomyopathy Apical Hypertrophic Cardiomyopathy References Hypertrophic Cardiomyopathy: Pathophysiology, Functional Features, and Treatment of Outflow Tract Obstruction Pathophysiology of left ventricular outflow tract obstruction Mechanisms of mitral regurgitation Functional features of obstructive hypertrophic cardiomyopathy Echocardiographic and doppler assessment of obstructive hypertrophic cardiomyopathy Treatment strategies for obstructive hypertrophic cardiomyopathy References Differential of Hypertrophic Cardiomyopathy versus Secondary Conditions That Mimic Hypertrophic Cardiomyopathy Hypertensive heart disease Athletes ́ hearts Infiltrative disorders of the myocardium Cardiac Amyloidosis Cardiac Sarcoidosis Isolated left ventricular noncompaction cardiomyopathy Storage diseases Lysosomal Storage Disorders Anderson-Fabry disease Danon Disease Glycogen Storage Diseases Syndromic hypertrophic cardiomyopathy RASopathies: Noonan Syndrome and LEOPARD Syndrome Friedreich Ataxia References Echocardiographic Features of Hypertrophic Cardiomyopathy: Mechanism of Systolic Anterior Motion The left ventricle Pathophysiologic classification Obstructive Hypertrophic Cardiomyopathy Nonobstructive Hypertrophic Cardiomyopathy Echocardiographic Features of Obstructive Hypertrophic Cardiomyopathy with Left Ventricular Outflow Obstruction The Mitral Leaflets The Mitral Annulus Mechanisms of Systolic Anterior Motion Doppler Assessment of Left Ventricular Outflow Obstruction Role of Intraoperative Echocardiography to Guide Surgical Myectomy Echocardiographic Features of Obstructive Hypertrophic with Mid-Ventricular Obstruction Nonobstructive Hypertrophic Cardiomyopathy Prognostic Implications of Echocardiographic Findings Doppler Assessment of Diastolic Function The right ventricle Conclusion References Hypertrophic Cardiomyopathy: Assessment of Therapy Treatment and assessment of obstructive hypertrophic cardiomyopathy Pharmacologic therapy Surgical myectomy Alcohol septal ablation Dual-chamber pacing References Hypertrophic Cardiomyopathy: Screening of Relatives Genetics of hypertrophic cardiomyopathy Genetic testing in hypertrophic cardiomyopathy Recommendations for clinical screening Clinical and Electrocardiographic Assessment Echocardiographic Assessment Assessment by Cardiac Magnetic Resonance Imaging Findings in hypertrophic cardiomyopathy gene carriers Echocardiographic Studies Other Morphologic Abnormalities in Hypertrophic Cardiomyopathy Gene Carriers References Apical Hypertrophic Cardiomyopathy Morphology and Echocardiographic Features Subtypes Apical Aneurysms References Echocardiography in Athletic Preparticipation Screening Sports medicine physicians The athletic heart Transthoracic echocardiography Benefits of echocardiographic preparticipation screening Chapter application Conclusions References Dilated Cardiomyopathy: Etiology, Diagnostic Criteria, and Echocardiographic Features Etiology Echocardiographic assessment of dilated cardiomyopathy Morphological Assessment Assessment of Chamber Dimensions and Function Secondary Findings References Imaging in Familial Dilated Cardiomyopathy Etiology Epidemiology Case reports XIV Cardiomyopathies Imaging in Familial Dilated Cardiomyopathy Value of imaging in familial dilated cardiomyopathy References Echocardiographic Predictors of Outcome in Patients with Dilated Cardiomyopathy Left ventricular dimensions and ejection fraction Left ventricular diastolic dysfunction Left atrial size Other variables: myocardial viability, ischemia, and dyssynchrony References Right Ventricle in Dilated Cardiomyopathy Pathophysiology of right ventricular dysfunction Echocardiographic methods for evaluating right ventricular size and function Studies evaluating right ventricular function Fractional Area Change Right Ventricular Index of Myocardial Performance Tricuspid Annular Plane Systolic Excursion Doppler S Two-Dimensional Strain Imaging Multiple Parameters Pulmonary hemodynamics Conclusion and Recommendations References Restrictive Cardiomyopathy: Classification References Cardiac Amyloidosis: Echocardiographic Features Pathology Classification Diagnostic imaging modalities for the evaluation of cardiac amyloidosis Echocardiography Doppler Echocardiography Prognosis Treatment References Hereditary and Acquired Infiltrative Cardiomyopathy Clinical spectrum Diagnosis Echocardiography Speckle Tracking Cardiac Magnetic Resonance Endomyocardial Biopsy Infiltrative cardiomyopathy with thick walls Fabry Disease Danon Disease Oxalosis Mucopolysaccharidoses Glycogen Storage Disease Infiltrative cardiomyopathy with the dilated phenotype Hemochromatosis Conclusions References Endomyocardial Fibrosis Etiology Epidemiology Pathophysiology Physical examination Diagnostic testing References Restriction versus Constriction Etiology and physiopathology Constrictive Pericarditis Restrictive Cardiomyopathy Echocardiography Other investigations References Echocardiography in Arrhythmogenic Right Ventricular Cardiomyopathy Echocardiographic findings in arrhythmogenic right ventricular cardiomyopathy Right Ventricular Structure Right Ventricular Function Newer Echocardiographic Techniques in Arrhythmogenic Right Ventricular Cardiomyopathy Echocardiography versus other modalities for arrhythmogenic right ventricular cardiomyopathy Summary References Echocardiographic Analysis of Left Ventricular Noncompaction Echocardiographic features Available diagnostic criteria Echocardiography tricks and tips References Takotsubo-like Transient Left Ventricular Dysfunction: Takotsubo Cardiomyopathy References A Systematic Echocardiographic Approach to Left Ventricular Assist Device Therapy Echocardiographic analysis The left ventricular assist device Post-Left Ventricular Assist Device Implantation Evaluation Left ventricular assist device malfunction considerations Postoperative Troubleshooting Summary References Posttransplantation Echocardiographic Evaluation Screening Recipient Evaluation Donor Evaluation Perioperative monitoring Ventricular Structure and Function Valve Function Pericardial Effusion Posttransplantation surveillance Early Surveillance Late Surveillance References Familial Cardiomyopathies Friedreich ataxia Cardiac Manifestations Imaging Management Myotonic dystrophy Cardiac Manifestations Imaging Management Duchenne muscular dystrophy Cardiac Manifestations Imaging Management Summary References Echocardiography in Cor Pulmonale and/or Pulmonary Heart Disease Structural abnormalities in pulmonary arterial hypertension Doppler findings in pulmonary arterial hypertension Echocardiographic findings and prognosis in cor pulmonale Echocardiography to predict and monitor response to therapy in pulmonary arterial hypertension Summary References Echocardiographic Evaluation of Functional Tricuspid Regurgitation Pathophysiology of secondary tricuspid regurgitation Tricuspid annulus dilation and dysfunction Right ventricular remodeling and tricuspid valve tethering Pulmonary hypertension Natural history of secondary tricuspid regurgitation Management References Echocardiographic Evaluation of the Right Heart: Limitations and Technical Considerations Limitations Technical considerations Summary References XV Aortic Stenosis Aortic Stenosis Morphology Congenital aortic stenosis Bicuspid Aortic Valve Natural History of Bicuspid Aortic Valves Echocardiographic Features of Bicuspid Aortic Valves Coarctation Infective Endocarditis Aortic Complications Surveillance (Serial Assessment of Patients with Bicuspid Aortic Valve) Family Screening of Patients with BAV Unicuspid Aortic Valve Quadricuspid Aortic Valve Calcific (degenerative) aortic stenosis Rheumatic aortic stenosis References Quantification of Aortic Stenosis Severity Normal aortic valve Two-Dimensional Echocardiography M-Mode Echocardiography Quantitative diagnosis of aortic stenosis Quantitative doppler assessment of severity of aortic stenosis Transaortic Velocities Pressure Gradients Aortic Valve Area by Continuity Equation Limitations and pitfalls in the echo-doppler quantitation of aortic stenosis Planimetry of aortic valve orifice Three-dimensional assessment of the aortic valve area Other methods of measuring aortic stenosis severity Serial evaluation of aortic stenosis Physiologic consequences of aortic stenosis Left Ventricular Systolic Dysfunction Left Ventricular Diastolic Dysfunction Pulmonary Hypertension Aortic valve sclerosis References Asymptomatic Aortic Stenosis Arguments for surgery in asymptomatic aortic stenosis Risk of Sudden Cardiac Death Risk of Irreversible Myocardial Damage Surgical Considerations Duration of the Asymptomatic Phase Studies Reporting Better Outcome with Early Surgery in Asymptomatic Severe Aortic Stenosis Predictors of outcome and risk stratification in asymptomatic severe aortic stenosis Echocardiography at rest Exercise testing Incremental value of exercise hemodynamics assessed by doppler echocardiography Biomarkers Summary References Risk Stratification—Timing of Surgery Risk stratif Written and endorsed by world experts from the American Society of Echocardiography (ASE), this **unique multimedia resource uses text, case studies, and online components** to cover the latest uses of echocardiography, including **the most recent 2D and 3D advances.** Unlike other existing textbooks in echocardiography, including the predecessor of this volume, entitled __Dynamic Echocardiography__, this 2nd edition, with its new title, covers a full range of topics, reflected in its 200 chapters that include essential material in a succinct format. Dr. Roberto M. Lang and his expert colleagues provide everything you need to assess cardiac anatomy and function and obtain clinically useful, noninvasive information for more accurate diagnosis and evaluation of heart disease. __"I am also very proud that this textbook illustrates what is great about the ASE. We are a society with more than 16,000 members worldwide, dedicated to quality in cardiovascular ultrasound and education, both of which are prominently demonstrated throughout this textbook. ASE is also a village made up of many different people from many different backgrounds, all united and energized about the value of cardiovascular ultrasound in caring for people worldwide."__ **Foreword by**__:__ Neil J. Weissman, American Society of Echocardiography, July 2015 *** Get fully up to date**with the latest echo practice guidelines and advanced technologies, including 3D echocardiography and myocardial strain. * Gain a better understanding of the latest methods to assess cardiac chamber size and function, valvular stenosis/regurgitation, cardiomyopathies, coronary artery disease, complications of myocardial infarction, and much more – all in a practical, well-illustrated brief yet comprehensive format extensively supported by multimedia material. * Stay up to date with hot topics in this rapidly evolving field: interventional/intraoperative echocardiography, transesophageal echocardiography, cardiac resynchronization therapy, and more.