Author + information
- Thomas H. Marwick, MBBS, PhD, FRACP, FESC, FACC⁎ ()
- ↵⁎University of Queensland, Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, QLD4102, Australia
We appreciate the interest and commentary of Dr. Galderisi concerning my report (1). His suggestions may help with the avoidance of artifact, but they may not be sufficient to make this technique a standard clinical tool. Narrow sector imaging certainly permits acquisition at a high frame rate, while maintaining a high number of Doppler beams across the image (and therefore spatial resolution). Unfortunately, this does not remove the problem of signal noise, and the narrow sector prevents visualization of the contralateral wall, which is vital during stress echocardiography or other regional analyses for comparing the timing and magnitude of contraction. Similarly, the use of blood-flow Doppler to position timing markers is a worthwhile step to optimize timing, but may be misleading if the heart rate changes, and this approach reduces feasibility by requiring another step during the acquisition. Dr. Galderisi’s suggestions to improve the reliability of strain-rate imaging reinforce our belief that the critical component in the current iteration of this technique is a thoughtful physician or sonographer to acquire and process the images. Although this can be expected in the research laboratory, the availability of such a person with the time to do this is less certain in a busy clinical laboratory.
- American College of Cardiology Foundation