Echocardiography is hardly new. It’s been pulling yeoman’s duty since it was invented in 1953; even digital echocardiography, developed over a decade ago, is sprouting grey hairs. And that’s exactly what makes it so much fun to argue that digital echo has progressed more since its inception than any other cardiac modality. Recent innovations such as real-time 3D, contrast echo, endocardial border detection and tissue harmonic imaging are powering echo to the head of its diagnostic class.

The short story is this: Digital echo is quickly becoming accepted as the superior method of viewing stress and resting cardiac images side by side. It provides unmatched quantitative information about regional heart function. Its ability to display multiple images rapidly makes it easier for doctors to assess serial studies of coronary artery disease and subtle wall motion abnormalities or changes in ventricular function that occur in myocardial infarction. Even patients like it. They now can see a condition while it is explained to them, which lowers their anxiety level and mitigates the panic factor.

And yes, we’re talking about a lot of patients. The American Heart Association (Dallas) believes 12 million Americans have coronary artery disease, the leading cause of death in the U.S. Industry sources say that in 2001, approximately 18 million echo exams were performed in the U.S.; 2.5 million of those were stress tests, the most common method for determining whether a patient requires angiography. Eleven million were performed to evaluate left ventricular [LV] function, and about 15 million were part of transthoracic procedures.

The fully digital echo lab is the exception today, but experts predict that soon it will be the norm. Send all thank-you notes to video, whose shortcomings are quickly relegating it to technology history. The speed of digital transmission and display simply cannot be duplicated in video’s analog format. Can you say “typewriter”?

Speed, volume, powerful vision
Sheer volume and demand for faster image turnaround are fueling digital echocardiography’s not-so-distant ubiquity, aided by advances in ultrasound image management and clarity. The huge electronic files and slow transmission that plagued its progress are suddenly relics of the past.

The total image-management package for echo is a recent — and pivotal — innovation. One such solution, Image Arena, comes from TomTec Imaging Systems GmbH (Atlanta). The cardiology version supports DICOM, non-DICOM, AVI, BMP, 2D, 3D, 4D, M-mode, Doppler, and ASE wall-motion scoring. Image Arena acquires, stores and retrieves ultrasound images from most vendors’ systems and displays up to nine images at once. Camtronics (Milwaukee) markets a system called Vericis that combines dedicated workstations and telecom capability with client/server, archive and database technologies. It allows physicians immediate access to all multimode cardiac records of a patient. Heartlab, Inc. (Westerly, R.I.) sells a similar solution called Encompass that utilizes large-scale DVDs for long-term archiving, which the company says is 10 times faster than competing technologies.

Please refer to the July 2002 issue for the complete story. For information on article reprints, contact Martin St. Denis