Impact of Contrast Echocardiography for Assessment of Left Ventricular Function and Myocardial Perfusion - Essay Example

? Article Critique Table of Contents I. Synthesis 3 II. Analysis 3 A. Information That is Important for Remembering 3 B. Knowledge Gained 4 C. How Knowledge Can Be Applied 4 D. Novel Information That is a Reinforcement of Prior Learning 5 E. Writing- How Poor or Well Done 5 F. Important Values Gained 6 G. Practice Implications, Directions for Future Research Gained from The Piece 6 Works Cited 7 I. Synthesis Advances in MCE, making use of contrast technologies and coupling those with low-power technologies have been shown in the literature to offer dramatic improvements in imaging clarity and precision with regard to imaging left ventricular functions, including perfusion imaging in real time. These have desirable implications for the quality and accuracy of diagnoses of related heart conditions, including the ability of data gathered to be used for quantitative analyses. Advances in MCE likewise lend themselves to being applied in the imaging of other heart conditions, such as induced ischemias (Becher et al. C12-C21). II. Analysis A. Information That is Important for Remembering Technologies tied to the contrast echocardiography have been shown to be of the great benefit to heart disease management, owing to the high resolution and the ability of the images to be analyzed with a great level of precision and the possibility of using the images for quantitative analysis: “[c]ontrast echocardiography offers a comprehensive evaluation of LV function and myocardial perfusion with high spatial and temporal resolution, and has the potential to allow quantification” (Becher et al. C12). Contrast agents use coupled with innovations of low-power imaging breakthroughs are key to this. These characteristics of the technology are especially useful in the definition of borders of left ventricle or LV function in comparison to surrounding heart tissues. These are the improvements over traditional imaging technologies in wide use, such as the analysis of wall motion. These have been demonstrated in at least two studies related to the evaluation of ischemias that are tied to stress (Becher et al. C12-C21). B. Knowledge Gained Contrast agents have been shown to improve imaging quality for LV functions, lending themselves to being used together with breakthroughs in low-power applications/techniques to realize new possibilities that are borne out of better imaging and the imaging that lends itself to being quantified and used for such analysis. Specific characteristics of new technologies state that low-power modes allow for real-time perfusion imaging for the heart muscles, as well as the superior differentiation capabilities when making contrasts between LV and the heart tissues around it (Becher et al. C13-C15): The advent of the new ‘low-power’ imaging techniques is believed to be a breakthrough in the application of automatic contour finding tools, because myocardial tissue signals are almost eliminated whereas intra-cavitary contrast agent still produces a strong signal, resulting in a sharply defined edge between blood and tissue (Becher et al. C14). MCE, or myocardial echocardiography, in these forms, using contrast and low power imaging technologies, is being eyed for wider dispersion and use in other heart-related imaging, such as for those involving ischemias (Becher e al. C13-C21). C. How Knowledge Can Be Applied The defining outstanding characteristics of new MCE breakthroughs, involving contrast techniques as well as low-power techniques, are in the area of enhanced contrasts between LV and heart tissue and enhanced capabilities of the data to be used for quantitative analyses, among others. These lend themselves to being used in a variety of heart disease diagnosis contexts, including in the imaging and diagnoses of ischemias, and other heart conditions: “[o]nce a user-friendly technique for infusion of contrast becomes available, it will be possible to perform myocardial perfusion studies during continuous infusion of contrast” (Becher et al. C20). D. Novel Information That is a Reinforcement of Prior Learning There are higher accuracy scores achieved when MCE was coupled to traditional echocardiography methods in wide use that are stress-based, and the findings from other studies corroborate this. The article asserts that the combination yields the most optimal balance of specificity as well as sensitivity while yielding the highest level of accuracy at about 86 percent in comparison to all other heart imaging techniques in current use. This reinforces prior learning on conventional heart imaging technologies as far as these metrics are concerned. MCE, moreover, turns out to have many overlaps in terms of modalities of stress that can be employed with perfusion imaging that is based on nuclear techniques. Low-power imaging has given rise to the ability of imaging technologies that combine wall motion and perfusion imaging to the benefit of accuracy and specificity of the images obtained: “[w]ith the advent of the low-power imaging technologies, simultaneous acquisition of myocardial perfusion and wall motion became feasible” (Becher et al. C19). E. Writing- How Poor or Well Done The writing is very detailed and reflects rigor both in the conduct of the research and in the collation and analysis of the data. These reflect seriousness and good scholarship. The extensive documentation adds credibility, and so does the precise use of words and the credible treatment of the scientific data. The visuals are well-explained and offer insights into the nature of the advances made in imaging making use of technologies tied to MCE. The writing is excellent overall, with the readability and the organization likewise being excellent. The disciplined thinking of the authors is reflected in the crispness of the article (Becher et al. C12- C21). F. Important Values Gained As a practitioner and student of the discipline, the insights from the article provide me with new ammunition in terms of further areas of research, as well as knowledge about how best to perform imaging making use of the technological advances made in MCE. The techniques and advances outlined give me hope that imaging science will continue to advance and will continue to aid in making diagnoses and treatments more effective moving forward. I can see this helping not just my patients, but my family and community in general. G. Practice Implications, Directions for Future Research Gained from The Piece The article details a way forward for applying the insights gained from advances in MCE to the imaging and diagnoses of heart ischemias that can be induced. The way forward is fuzzy, given that only a few studies have been attempted in this area and there are difficulties relating to the technique. One way forward is to get a hold of those studies that have been done, and then to advance suggestions for research next steps (Becher et al. C20). Works Cited Becher, H. et al. “Diagnostic Impact of Contrast Echocardiography for Assessment of Left Ventricular Function and Myocardial Perfusion in Patients with Coronary Artery Disease”. European Heart Journal Supplements 4 (2002): C12-C21. Web. 28 Oct. 2012. Read More