President's messagehappy new year, 2004!

Abstract

It is hard to believe that it is now 2004. It seems like just a year ago that we were celebrating the millennium—the New Year of 2000. I can remember watching television in the early morning darkness in the Eastern United States, and seeing the beginnings of the celebration of the millennium coming to me from Sydney, Australia.The new year is a time for both reflection and renewal. In the United States, New Year's Eve is a big celebration and a time to make those famous New Year's resolutions—many of which I am afraid we do not keep. The American Society of Echocardiography had a super year in 2003, and 2004 is going to be a banner year. And so, as we begin 2004, there are some New Year's resolutions that I would like you to think about and keep throughout the year.Think contrastI want each of you, in echocardiography labs throughout this country and abroad, to think about using contrast agents more often. This is a message that I constantly stress to the excellent staff in our own lab. I am always asking them why they do not use contrast more often. Why would I say that, especially since I pride myself on being an excellent echocardiographer (after all, I've been doing this for 29 years, so I ought to be) and because we have such outstanding sonographers? I say that because I know that the use of contrast agents makes me a better echocardiographer. It clearly improves the diagnostic capabilities of our ultrasound exams, and it improves not only the accuracy, but also the yield. By using contrast in both transthoracic and stress echocardiographs, you obtain a better depiction of regional and global ventricular function, especially in those difficult patients. You also obtain very important information about the apex of the left and right ventricle. I know from our own practice that we could easily use contrast in at least 20% of our daily studies and still be underutilizing it. It is revealing to me to realize that in 2002, only 1.1 % of all echocardiographic studies performed in the United States used contrast. This is clearly an underapplication, because 98.9 % of the studies were not crystal clear. Again, I emphasize that I believe in contrast echocardiography because it gives us a more accurate evaluation of global and regional function, which allows us to better serve our referral physicians and our patients.The future of contrast is very bright. Perfusion imaging with contrast agents continues to make great strides. Also, Steve Feinstein, one of the pioneers of contrast, has pointed out the dramatic role that contrast will play in vascular ultrasound, specifically, carotid vascular ultrasound. We have been using it ourselves during our duplex carotid exams and have been impressed with the fact that contrast duplex carotid ultrasound better allows us to delineate intimal medial thickness (IMT), as well as plaque morphology. Also important is the fact that it allows us to detect the activity of the vasa vasorum, blood vessels on the adventitial level that feed plaques. It is my assertion that contrast, when used with duplex imaging, may allow us to detect plaque activity and vulnerable plaques.So, as 2004 commences, make a pledge in your lab to THINK CONTRAST—USE CONTRAST. It will make you a better echocardiographer.Think education—2004 annual scientific sessions!It's hard for me to believe that fewer than 20% of our 8600 members have been to the outstanding Annual Scientific Sessions held each spring. The ASE 2004 Scientific Sessions will take place this June, from the 26th to the 30th, in San Diego, California. John Gorcsan, III, MD, is the chairman of the 2004 Annual Scientific Sessions. All of you know that John, the host of Echo Jeopardy, is an outstanding and innovative educator and echocardiographer. Under his leadership, the Program Committee has developed this year's Annual Scientific Sessions to be the best ever, from its educational activities to its location in San Diego, California, a wonderful place to visit. The title and focus of this year's meeting is based on a simple fact: “Echo is at the Heart of Clinical Cardiology.” The meeting will use a disease-based approach to show how echocardiography plays a central role in cardiovascular care, highlighting such things as its role in heart failure, atrial fibrillation, and valvular heart disease, just to name a few. The Intraoperative Symposium, on Saturday, June 26, will highlight the latest advances in the use of echocardiography for surgical care of mitral valve disease. Special symposia will be held on Sunday, June 27, that will highlight many of the new advances in the field of echocardiography. During the meeting, from June 28 through 30, there are invited lecturers, keynote symposia, case studies, abstract presentations, and great manufacturer exhibits. This will provide educational opportunities for everyone, whatever their level of experience. San Diego is a great spot to visit at the end of June, and the Convention Center, with its outstanding location, is close to many of the historic areas of San Diego. Think about how you will have the total experience, including both education and fun.The ASE Scientific Sessions are the best educational activities I have ever attended. Therefore, I want each of you to pledge to treat yourself, or members of your lab or staff, to attending this event. You are not only going to learn a lot, but you are going to have a lot of fun.Think communication and act on itEchocardiography in the year 2004 spans the gamut from hand-held to 3-dimensional echocardiography. There have been tremendous advances in the image quality of echocardiography and also in areas such as tissue Doppler, vascular ultrasound, and contrast ultrasound. We know what a critical role echocardiography plays in the day-to-day management of patients. Currently, it seems like cardiologists, especially those in academic cardiology, are enamored with MRI and CT. Although both are exciting, dynamic technologies that offer tremendous potential in the diagnosis and management of patients, echocardiography is the heart of clinical cardiology. I say this by the nature of the role it plays in inpatient and outpatient management, as well as the management of those in critical care areas, such as operating rooms, ICUs, and cath labs. So it behooves all of us to communicate with our referral physicians and our colleagues. By communicating, I mean show them what you do—show them the outstanding images, so that they will understand the power of echocardiography. One of the best places to start is with a digital review station. As I have said to many, if somebody came in and said that they were going to take away our digital lab system, I would probably want to “do them in” because it means that much to our practice. Digital lab systems are a great place for people to review studies and certainly are an outstanding way to show your referral physicians and colleagues the impact that echocardiography has in diagnosis and management.Think about your personal well-beingThe fourth resolution that I want you to make involves 4 things: 1.I want each of you to make sure that you tell those around you how much you appreciate all the hard work they do. This is true not only for our sonographers, who help us so much on a day-to-day basis, but also for your colleagues, nurses, and even your office personnel. The practice of medicine today is very complex and often overwhelming. You must remember that the busy echocardiographic practices of today are a team effort. Therefore, continually thank and tell all those around you how much you appreciate them; it makes the struggles of medicine so much easier to withstand.2.I want each of you to take care of yourself by exercising for 30 minutes, ideally on a daily basis (I do try to run every morning). We, meaning the collective United States and the world in general, are expanding, specifically in regard to our waistlines. Exercise is a great way to help control our weight, relieve stress, and to do good things for our arteries. So try to exercise daily.3.Watch your weight—and I don't mean watch it increase. If, beginning at age 20, you had gained an extra pound a year, by age 50 you'd be 30 pounds overweight. There are a host of diets on which you could place yourself (including the outstanding diet written by one of our members, Dr Art Agatston), but the key component is to try to discipline yourself. Eat healthier by including more fruits, vegetables, and complex carbohydrates and staying away from those fast food meals with saturated fats and a lot of empty calories.4.And the final way I want you to take care of yourself is to try to find something funny to laugh at each day. Laughter is the best medicine. It's good for your body, good for your soul, and may actually be great for your immune system.I wish each of you a Happy New Year and the best in 2004. I know that this year will be spectacular for the field of echocardiography and the American Society of Echocardiography. It is hard to believe that it is now 2004. It seems like just a year ago that we were celebrating the millennium—the New Year of 2000. I can remember watching television in the early morning darkness in the Eastern United States, and seeing the beginnings of the celebration of the millennium coming to me from Sydney, Australia. The new year is a time for both reflection and renewal. In the United States, New Year's Eve is a big celebration and a time to make those famous New Year's resolutions—many of which I am afraid we do not keep. The American Society of Echocardiography had a super year in 2003, and 2004 is going to be a banner year. And so, as we begin 2004, there are some New Year's resolutions that I would like you to think about and keep throughout the year. Think contrastI want each of you, in echocardiography labs throughout this country and abroad, to think about using contrast agents more often. This is a message that I constantly stress to the excellent staff in our own lab. I am always asking them why they do not use contrast more often. Why would I say that, especially since I pride myself on being an excellent echocardiographer (after all, I've been doing this for 29 years, so I ought to be) and because we have such outstanding sonographers? I say that because I know that the use of contrast agents makes me a better echocardiographer. It clearly improves the diagnostic capabilities of our ultrasound exams, and it improves not only the accuracy, but also the yield. By using contrast in both transthoracic and stress echocardiographs, you obtain a better depiction of regional and global ventricular function, especially in those difficult patients. You also obtain very important information about the apex of the left and right ventricle. I know from our own practice that we could easily use contrast in at least 20% of our daily studies and still be underutilizing it. It is revealing to me to realize that in 2002, only 1.1 % of all echocardiographic studies performed in the United States used contrast. This is clearly an underapplication, because 98.9 % of the studies were not crystal clear. Again, I emphasize that I believe in contrast echocardiography because it gives us a more accurate evaluation of global and regional function, which allows us to better serve our referral physicians and our patients.The future of contrast is very bright. Perfusion imaging with contrast agents continues to make great strides. Also, Steve Feinstein, one of the pioneers of contrast, has pointed out the dramatic role that contrast will play in vascular ultrasound, specifically, carotid vascular ultrasound. We have been using it ourselves during our duplex carotid exams and have been impressed with the fact that contrast duplex carotid ultrasound better allows us to delineate intimal medial thickness (IMT), as well as plaque morphology. Also important is the fact that it allows us to detect the activity of the vasa vasorum, blood vessels on the adventitial level that feed plaques. It is my assertion that contrast, when used with duplex imaging, may allow us to detect plaque activity and vulnerable plaques.So, as 2004 commences, make a pledge in your lab to THINK CONTRAST—USE CONTRAST. It will make you a better echocardiographer. I want each of you, in echocardiography labs throughout this country and abroad, to think about using contrast agents more often. This is a message that I constantly stress to the excellent staff in our own lab. I am always asking them why they do not use contrast more often. Why would I say that, especially since I pride myself on being an excellent echocardiographer (after all, I've been doing this for 29 years, so I ought to be) and because we have such outstanding sonographers? I say that because I know that the use of contrast agents makes me a better echocardiographer. It clearly improves the diagnostic capabilities of our ultrasound exams, and it improves not only the accuracy, but also the yield. By using contrast in both transthoracic and stress echocardiographs, you obtain a better depiction of regional and global ventricular function, especially in those difficult patients. You also obtain very important information about the apex of the left and right ventricle. I know from our own practice that we could easily use contrast in at least 20% of our daily studies and still be underutilizing it. It is revealing to me to realize that in 2002, only 1.1 % of all echocardiographic studies performed in the United States used contrast. This is clearly an underapplication, because 98.9 % of the studies were not crystal clear. Again, I emphasize that I believe in contrast echocardiography because it gives us a more accurate evaluation of global and regional function, which allows us to better serve our referral physicians and our patients. The future of contrast is very bright. Perfusion imaging with contrast agents continues to make great strides. Also, Steve Feinstein, one of the pioneers of contrast, has pointed out the dramatic role that contrast will play in vascular ultrasound, specifically, carotid vascular ultrasound. We have been using it ourselves during our duplex carotid exams and have been impressed with the fact that contrast duplex carotid ultrasound better allows us to delineate intimal medial thickness (IMT), as well as plaque morphology. Also important is the fact that it allows us to detect the activity of the vasa vasorum, blood vessels on the adventitial level that feed plaques. It is my assertion that contrast, when used with duplex imaging, may allow us to detect plaque activity and vulnerable plaques. So, as 2004 commences, make a pledge in your lab to THINK CONTRAST—USE CONTRAST. It will make you a better echocardiographer. Think education—2004 annual scientific sessions!It's hard for me to believe that fewer than 20% of our 8600 members have been to the outstanding Annual Scientific Sessions held each spring. The ASE 2004 Scientific Sessions will take place this June, from the 26th to the 30th, in San Diego, California. John Gorcsan, III, MD, is the chairman of the 2004 Annual Scientific Sessions. All of you know that John, the host of Echo Jeopardy, is an outstanding and innovative educator and echocardiographer. Under his leadership, the Program Committee has developed this year's Annual Scientific Sessions to be the best ever, from its educational activities to its location in San Diego, California, a wonderful place to visit. The title and focus of this year's meeting is based on a simple fact: “Echo is at the Heart of Clinical Cardiology.” The meeting will use a disease-based approach to show how echocardiography plays a central role in cardiovascular care, highlighting such things as its role in heart failure, atrial fibrillation, and valvular heart disease, just to name a few. The Intraoperative Symposium, on Saturday, June 26, will highlight the latest advances in the use of echocardiography for surgical care of mitral valve disease. Special symposia will be held on Sunday, June 27, that will highlight many of the new advances in the field of echocardiography. During the meeting, from June 28 through 30, there are invited lecturers, keynote symposia, case studies, abstract presentations, and great manufacturer exhibits. This will provide educational opportunities for everyone, whatever their level of experience. San Diego is a great spot to visit at the end of June, and the Convention Center, with its outstanding location, is close to many of the historic areas of San Diego. Think about how you will have the total experience, including both education and fun.The ASE Scientific Sessions are the best educational activities I have ever attended. Therefore, I want each of you to pledge to treat yourself, or members of your lab or staff, to attending this event. You are not only going to learn a lot, but you are going to have a lot of fun. It's hard for me to believe that fewer than 20% of our 8600 members have been to the outstanding Annual Scientific Sessions held each spring. The ASE 2004 Scientific Sessions will take place this June, from the 26th to the 30th, in San Diego, California. John Gorcsan, III, MD, is the chairman of the 2004 Annual Scientific Sessions. All of you know that John, the host of Echo Jeopardy, is an outstanding and innovative educator and echocardiographer. Under his leadership, the Program Committee has developed this year's Annual Scientific Sessions to be the best ever, from its educational activities to its location in San Diego, California, a wonderful place to visit. The title and focus of this year's meeting is based on a simple fact: “Echo is at the Heart of Clinical Cardiology.” The meeting will use a disease-based approach to show how echocardiography plays a central role in cardiovascular care, highlighting such things as its role in heart failure, atrial fibrillation, and valvular heart disease, just to name a few. The Intraoperative Symposium, on Saturday, June 26, will highlight the latest advances in the use of echocardiography for surgical care of mitral valve disease. Special symposia will be held on Sunday, June 27, that will highlight many of the new advances in the field of echocardiography. During the meeting, from June 28 through 30, there are invited lecturers, keynote symposia, case studies, abstract presentations, and great manufacturer exhibits. This will provide educational opportunities for everyone, whatever their level of experience. San Diego is a great spot to visit at the end of June, and the Convention Center, with its outstanding location, is close to many of the historic areas of San Diego. Think about how you will have the total experience, including both education and fun. The ASE Scientific Sessions are the best educational activities I have ever attended. Therefore, I want each of you to pledge to treat yourself, or members of your lab or staff, to attending this event. You are not only going to learn a lot, but you are going to have a lot of fun. Think communication and act on itEchocardiography in the year 2004 spans the gamut from hand-held to 3-dimensional echocardiography. There have been tremendous advances in the image quality of echocardiography and also in areas such as tissue Doppler, vascular ultrasound, and contrast ultrasound. We know what a critical role echocardiography plays in the day-to-day management of patients. Currently, it seems like cardiologists, especially those in academic cardiology, are enamored with MRI and CT. Although both are exciting, dynamic technologies that offer tremendous potential in the diagnosis and management of patients, echocardiography is the heart of clinical cardiology. I say this by the nature of the role it plays in inpatient and outpatient management, as well as the management of those in critical care areas, such as operating rooms, ICUs, and cath labs. So it behooves all of us to communicate with our referral physicians and our colleagues. By communicating, I mean show them what you do—show them the outstanding images, so that they will understand the power of echocardiography. One of the best places to start is with a digital review station. As I have said to many, if somebody came in and said that they were going to take away our digital lab system, I would probably want to “do them in” because it means that much to our practice. Digital lab systems are a great place for people to review studies and certainly are an outstanding way to show your referral physicians and colleagues the impact that echocardiography has in diagnosis and management. Echocardiography in the year 2004 spans the gamut from hand-held to 3-dimensional echocardiography. There have been tremendous advances in the image quality of echocardiography and also in areas such as tissue Doppler, vascular ultrasound, and contrast ultrasound. We know what a critical role echocardiography plays in the day-to-day management of patients. Currently, it seems like cardiologists, especially those in academic cardiology, are enamored with MRI and CT. Although both are exciting, dynamic technologies that offer tremendous potential in the diagnosis and management of patients, echocardiography is the heart of clinical cardiology. I say this by the nature of the role it plays in inpatient and outpatient management, as well as the management of those in critical care areas, such as operating rooms, ICUs, and cath labs. So it behooves all of us to communicate with our referral physicians and our colleagues. By communicating, I mean show them what you do—show them the outstanding images, so that they will understand the power of echocardiography. One of the best places to start is with a digital review station. As I have said to many, if somebody came in and said that they were going to take away our digital lab system, I would probably want to “do them in” because it means that much to our practice. Digital lab systems are a great place for people to review studies and certainly are an outstanding way to show your referral physicians and colleagues the impact that echocardiography has in diagnosis and management. Think about your personal well-beingThe fourth resolution that I want you to make involves 4 things: 1.I want each of you to make sure that you tell those around you how much you appreciate all the hard work they do. This is true not only for our sonographers, who help us so much on a day-to-day basis, but also for your colleagues, nurses, and even your office personnel. The practice of medicine today is very complex and often overwhelming. You must remember that the busy echocardiographic practices of today are a team effort. Therefore, continually thank and tell all those around you how much you appreciate them; it makes the struggles of medicine so much easier to withstand.2.I want each of you to take care of yourself by exercising for 30 minutes, ideally on a daily basis (I do try to run every morning). We, meaning the collective United States and the world in general, are expanding, specifically in regard to our waistlines. Exercise is a great way to help control our weight, relieve stress, and to do good things for our arteries. So try to exercise daily.3.Watch your weight—and I don't mean watch it increase. If, beginning at age 20, you had gained an extra pound a year, by age 50 you'd be 30 pounds overweight. There are a host of diets on which you could place yourself (including the outstanding diet written by one of our members, Dr Art Agatston), but the key component is to try to discipline yourself. Eat healthier by including more fruits, vegetables, and complex carbohydrates and staying away from those fast food meals with saturated fats and a lot of empty calories.4.And the final way I want you to take care of yourself is to try to find something funny to laugh at each day. Laughter is the best medicine. It's good for your body, good for your soul, and may actually be great for your immune system.I wish each of you a Happy New Year and the best in 2004. I know that this year will be spectacular for the field of echocardiography and the American Society of Echocardiography. The fourth resolution that I want you to make involves 4 things: 1.I want each of you to make sure that you tell those around you how much you appreciate all the hard work they do. This is true not only for our sonographers, who help us so much on a day-to-day basis, but also for your colleagues, nurses, and even your office personnel. The practice of medicine today is very complex and often overwhelming. You must remember that the busy echocardiographic practices of today are a team effort. Therefore, continually thank and tell all those around you how much you appreciate them; it makes the struggles of medicine so much easier to withstand.2.I want each of you to take care of yourself by exercising for 30 minutes, ideally on a daily basis (I do try to run every morning). We, meaning the collective United States and the world in general, are expanding, specifically in regard to our waistlines. Exercise is a great way to help control our weight, relieve stress, and to do good things for our arteries. So try to exercise daily.3.Watch your weight—and I don't mean watch it increase. If, beginning at age 20, you had gained an extra pound a year, by age 50 you'd be 30 pounds overweight. There are a host of diets on which you could place yourself (including the outstanding diet written by one of our members, Dr Art Agatston), but the key component is to try to discipline yourself. Eat healthier by including more fruits, vegetables, and complex carbohydrates and staying away from those fast food meals with saturated fats and a lot of empty calories.4.And the final way I want you to take care of yourself is to try to find something funny to laugh at each day. Laughter is the best medicine. It's good for your body, good for your soul, and may actually be great for your immune system. I wish each of you a Happy New Year and the best in 2004. I know that this year will be spectacular for the field of echocardiography and the American Society of Echocardiography.