Gu, MD

#ImageOfTheWeek by Avishkar Agrawal, Sumit Kumar, and Souvik Sardar from All India Institute of Medical Sciences, New Delhi, India A 28-year-old woman with mitral valve prolapse. What additional high-risk echo finding may be present? ow.ly/V7iS50YJNIU

Structural (eccentric) MR Carpentier Type II 📌 3D ECHO → identifies: •Where MR •Why MR (mechanism) 📌 VOLUMETRY → calculates the “how much” •RegVol MR •RegFraction MR ❌ PISA doesn’t work ❌ #3Dfirst #echofirst @NMerke

This video provides a step-by-step roadmap for healthcare providers to teach and troubleshoot the Goal Directed Valsalva technique and addresses common pitfalls. Watch our Goal Directed Valsalva Education Series, featuring free educational resources! bit.ly/4lR9MmF

@echo_batman Really nice work 👏 already using this in my talks, super helpful perspective on TR👍🏻✨

#EHJCVI 🔍 New insights into PFO risk. Totaro et al. identify “funnel-type” PFO morphology on 3D-TEE as a novel high-risk feature 🧠📊 Read more 👉 doi.org/10.1093/ehjci/…

TAPSE ● Measure of RV longitudinal systolic function (tricuspid annulus motion) ● Method: M-mode in apical 4-chamber at lateral tricuspid annulus. ● Key Cutoff > 17 mm → Normal ≤ 17 mm → RV dysfunction ● Severity 13–17 mm → Mild 10–13 mm → Moderate ≤ 10 mm → Severe 》Clinical pearl ● Always interpret TAPSE with other RV parameters, especially: ▪︎ RV S’ (TDI) ▪︎ FAC (Fractional Area Change) ▪︎ TAPSE/PASP ratio → useful for RV–pulmonary artery coupling

🫀 #CardioNugget: Predicting SAM after MV repair = GEOMETRY 🎯 📉 AML:PML ↓ (big PML) → anterior coaptation 📏 Coaptation-septum distance <2.5 cm → coaptation near LVOT 📐 Narrow aortomitral angle → flow drags AML 📊 Thick septum → LVOT crowding #EchoBoards #CardioTwitter #MedEd #CardioNuggets

@MSBBrandao @mframirezs1973 @jesusgmirelis @EACVIPresident @EHJCVIEiC @denisamuraru @manuelbarreirop @Falmeidasampaio @FGraziani_Grace @Sarah_Moharem @argulian 👉 #echofirst

HFpEF RV dysfunction Stages Staging system for right ventricular (RV) dysfunction in Heart Failure with Preserved Ejection Fraction, based on RV–pulmonary artery (RV-PA) coupling using the TAPSE/PASP ratio and the presence of tricuspid regurgitation (TR). 💡 Clinical Pearls ● TAPSE/PASP ratio is a powerful prognostic marker in HFpEF. ● TR is not just a consequence—it worsens RV failure (vicious cycle). ● Transition from Stage 2 → Stage 3 marks a key turning point (loss of RV adaptation). ● Stage 4 = highest mortality risk. 🧠 One-line Summary 👉 HFpEF RV dysfunction progresses from compensated coupling → TR development → RV-PA uncoupling → end-stage RV failure with TR.

3-D #echofirst assessment of the mitral valve in clinical practice. doi.org/10.1093/ehjimp…

In this #3D TEE mid-esophageal RV in-out view you can better understand the location of different types of VSD in echo #echofirst supracristal VSD lying more cranial than the infracristal. 👉 for more morphological details check this out doi.org/10.1016/j.atho…

Mitral Valve Complex🧐 👉Understanding the mitral complex starts with anatomy: leaflets, annulus, chordae, and papillary muscles function as one unit. 👉Accurate interpretation of mitral valve motion requires integrated assessment of the entire subvalvular and annular apparatus. @AEPCcongenital @iamritu @WGACHDChair @CASivaram1 @alexsfelixecho @echoleolopez @loomba_rohit @alex1708ander @SIwa23288585

How 2D images correlate to 3D images aka CLOCKING - take this #echofirst challenge and put the 🅰️ in the right place on the 3D image (surgeon’s view) * patient with paravalvular leakage (PVL) after MV replacement

Today had the pleasure and honor to present at the #echofirst Master course at Fondazione Policlinico Gemelli Rome organized by @Anto_Lombard and @FGraziani_Grace 👊Introduction to 3D Using #ALAMO

Malignant vs Benign Course of Anomalous Coronary Artery #viralchallenge #Cardiology #lifestyle #medicine

In this patient with HFpEF and high left ventricular filling pressures, shortening of the aortic regurgitation pressure decay time is seen, while aortic regurgitation is mild. Important hemodynamic concept!

#EHJIMP 🫀In >24,000 hypertensive participants from the UK Biobank, CMR-defined LVH phenotypes showed distinct imaging profiles and prognostic trajectories. Eccentric LVH carried the highest risk (↑MACE, markedly ↑HF), while concentric LVH was strongly linked to incident heart failure. Read more 👉doi.org/10.1093/ehjimp… Highlighting the value of CMR phenotyping for risk stratification in hypertension. #CardioImaging #CMR #Hypertension #LVH #HeartFailure #MACE #PrecisionCardiology

#EHJCVI 📢 New #EACVI & @ASE360 Consensus Statement on Strain Echo🚨 Strain has moved from the research arena into everyday #echofirst clinical practice. A practical guide for clinical echocardiographers, with clear supporting evidence for its use ⏭️ doi.org/10.1093/ehjci/…

Bicuspid aortic valve (BAV) morphology and its echocardiographic appearance. The valve is categorized based on: ▪︎ Number of raphes (fusion lines) ▪︎ Which cusps are fused. ✅ Type A (one raphe) ● Type 1A (Raphe LCC/RCC) Fusion between Left coronary cusp (LCC) and Right coronary cusp (RCC) → most common. ● Type 2A (Raphe RCC/NCC) Fusion between Right coronary cusp (RCC) and Non-coronary cusp (NCC). ● Type 3A (Raphe LCC/NCC) Fusion between Left coronary cusp (LCC) and Non-coronary cusp (NCC). 👉 These appear as asymmetric bicuspid valves with a visible raphe. ✅ Type 1B / 2B / 3B (no raphe) True bicuspid valves with: ▪︎ No raphe ▪︎ Two symmetric cusps Subtypes depend on orientation of commissures. 👉 Typically more symmetrical (“fish-mouth” opening). 🔹 Key Clinical Pearls: ■ Most common BAV type: LCC–RCC fusion BAV predisposes to: ▪︎ Aortic stenosis. ▪︎ Aortic regurgitation. ▪︎ Ascending aortopathy. ■ Echo hallmark: ▪︎ Systolic doming. ▪︎ Eccentric closure line in diastole. #cardiology #medicine