Recent advances in non-invasive cardiology
http://www.100md.com
《英国医生杂志》
Article does not mention echocardiography
EDITOR—The recent review of advances in non-invasive cardiology by Prasad et al does not discuss echocardiography except briefly as an electronic addendum.1 A striking omission is three dimensional echocardiography, which has advantages over two dimensional echocardiography in assessing left ventricular volumes and synchrony and for congenital disease and mitral valve disease.2 Miniaturisation of machines now allows studies to be conducted anywhere,3 so that echocardiography is increasingly being adopted by non-cardiologists. Stress echocardiography has repeatedly been validated for the prediction of coronary stenoses and for stratifying risk and is gaining in use (cardiac workforce requirements in the UK, www.BCS.com).4 A fuller account of advances in echocardiography is available.5
Credit: BULLETTE AND THEROUX/SPL
No competition should occur between different imaging modalities, and the most appropriate option should be used for any particular clinical indication. Echocardiography will always remain essential for the investigation of acutely ill patients since it is portable. Most district hospitals perform 3000-5000 studies each year, and national workforce planning indicates the need for 11-15 echocardiography consultants per million population compared with 2.9 per million for nuclear medicine and 1 per million for magnetic resonance (cardiac workforce requirements in the UK, www.BCS.com).
We are concerned that this article could lead health service managers to eschew the relatively inexpensive, effective, safe and widely available echocardiographic techniques for the apparently more alluring, more expensive techniques of magnetic resonance and cardiac computed tomography. All have developing roles either in clinical practice or research, and it is important that they are viewed in proper perspective.
John Chambers, president
jboydchambers@aol.com, British Society of Echocardiography, London SW1P 1SB
Kevin Fox, president-elect
British Society of Echocardiography, London SW1P 1SB
Alan Fraser, president
European Association of Echocardiography, The European Heart House, 2035 Route des Colles, Les Templiers—BP 179, 06903 Sophia-Antipolis Cedex, France
Competing interests: None declared.
Details of the five other authors are on bmj.com
References
Prasad SK, Assomull RG, Pennell DJ. Recent developments in non-invasive cardiology. BMJ 2004;329: 1386-9. (11 December.)
Mor-Avi V, Sugeng L, Weinert L, MacEneney P, Caiana EG, Koch R, et al. Fast measurement of left ventricular mass with real-time three-dimensional echocardiography: comparison with magnetic resonance imaging. Circulation 2004;110: 1814-8.
Roelandt JRTC. Ultrasound stethoscopy: a renaissance of the physical examination? Heart 2003;89: 971-4.
BSE procedure guidelines for the clinical application of stress echocardiography. Heart 2004;90(suppl VI): 23-30.
Weyman AE. The year in echocardiography. J Am Coll Cardiol 2004;43: 140-8.
EDITOR—The recent review of advances in non-invasive cardiology by Prasad et al does not discuss echocardiography except briefly as an electronic addendum.1 A striking omission is three dimensional echocardiography, which has advantages over two dimensional echocardiography in assessing left ventricular volumes and synchrony and for congenital disease and mitral valve disease.2 Miniaturisation of machines now allows studies to be conducted anywhere,3 so that echocardiography is increasingly being adopted by non-cardiologists. Stress echocardiography has repeatedly been validated for the prediction of coronary stenoses and for stratifying risk and is gaining in use (cardiac workforce requirements in the UK, www.BCS.com).4 A fuller account of advances in echocardiography is available.5
Credit: BULLETTE AND THEROUX/SPL
No competition should occur between different imaging modalities, and the most appropriate option should be used for any particular clinical indication. Echocardiography will always remain essential for the investigation of acutely ill patients since it is portable. Most district hospitals perform 3000-5000 studies each year, and national workforce planning indicates the need for 11-15 echocardiography consultants per million population compared with 2.9 per million for nuclear medicine and 1 per million for magnetic resonance (cardiac workforce requirements in the UK, www.BCS.com).
We are concerned that this article could lead health service managers to eschew the relatively inexpensive, effective, safe and widely available echocardiographic techniques for the apparently more alluring, more expensive techniques of magnetic resonance and cardiac computed tomography. All have developing roles either in clinical practice or research, and it is important that they are viewed in proper perspective.
John Chambers, president
jboydchambers@aol.com, British Society of Echocardiography, London SW1P 1SB
Kevin Fox, president-elect
British Society of Echocardiography, London SW1P 1SB
Alan Fraser, president
European Association of Echocardiography, The European Heart House, 2035 Route des Colles, Les Templiers—BP 179, 06903 Sophia-Antipolis Cedex, France
Competing interests: None declared.
Details of the five other authors are on bmj.com
References
Prasad SK, Assomull RG, Pennell DJ. Recent developments in non-invasive cardiology. BMJ 2004;329: 1386-9. (11 December.)
Mor-Avi V, Sugeng L, Weinert L, MacEneney P, Caiana EG, Koch R, et al. Fast measurement of left ventricular mass with real-time three-dimensional echocardiography: comparison with magnetic resonance imaging. Circulation 2004;110: 1814-8.
Roelandt JRTC. Ultrasound stethoscopy: a renaissance of the physical examination? Heart 2003;89: 971-4.
BSE procedure guidelines for the clinical application of stress echocardiography. Heart 2004;90(suppl VI): 23-30.
Weyman AE. The year in echocardiography. J Am Coll Cardiol 2004;43: 140-8.