The Echocardiography laboratory can rely on the professional skills of a team of 25 highly specialised echocardiographers, 6 of whom work full-time in the laboratory and 19 of whom are also employed in healthcare activities in the Institute's other Units.
The activities of the Echocardiography laboratory, which has been operative since the Institute was founded, have increased exponentially in recent years, for both inpatients and outpatients (overall, more than 25,000 examinations were performed in 2015). The laboratory has 28 latest-generation echocardiographic devices, 8 of which are equipped with three-dimensional technology, and ensures different types of examinations (thoracic, transoesophageal, echocardiograms during exercise and pharmacologically induced stress).
For several years, there has been an on-call service to support the activities of the Emergency Room, Coronary Unit, Haemodynamics Suite, Post-operative Intensive Care and Cardiac Surgery Unit.
The research activity of the Cardiac Imaging Area is deeply integrated with the daily clinical work and includes echocardiography, computed tomography and magnetic resonance.
Regarding recent research projects, the main efforts of the Imaging Area as a whole are focused on:
- new methods in transthoracic and transesophageal 3D-echocardiography demonstrating advantages of 3D vs 2D-echocardiography in the evaluation of right ventricular function, mitral valve prolapse, intraoperative monitoring of cardiac surgery, left atrial function;
- feasibility and accuracy of non-invasive evaluation of coronary arteries, stents and bypass grafting through cardiac computed tomography;
- new technical advances in radiation dose reduction in cardiac computed tomography maintaining a high accuracy in native and stented coronary arteries evaluation;
- cardiac CT and prognosis;
- new bioengineering approaches to cardiac imaging computation, mainly in the field of 3D-echocardiography;
- collaboration with other Units within the framework of a disease-specific multidisciplinary team in the evaluation of patients undergoing electrophysiological approaches, cardiac failure therapies, PCI procedures, cardiac surgery (including percutaneous/transapical aortic valve implantation, mitral clip, left atrial appendage closure).
A recent field of scientific interest is the new real-time 3D-echocardiographic imaging. In particular, our attention is focused on the quantification of novel 3D left ventricular shape indices, able to overcome the limitations relevant to prior 2D indices, to better follow ventricular remodelling after surgery and to study the coupling between left ventricular function and morphology.
Recently, MRI has been integrated in our area and, even though the Unit start-up allowed us only a 2 year experience (with more than 1000 cases per year), has allowed new approaches such as the analysis of the tricuspid valve by an innovative method of acquisition and reconstruction of images of the tricuspid annulus and right ventricle. Interestingly, tricuspid annulus is relatively easily evaluated through this novel MRI method and an accurate dynamic reconstruction has been shown to be feasible.
All the Institute’s doctors with echocardiographic skills collaborate with the Department of Cardiology of the University of Milan and with the School of Specialisation in Cardiology of the University of Milan. The laboratory receives post-graduate trainees specialising in cardiology in rotation every three months, and provides the logistics and tutors necessary for the preparation of theses for both undergraduates and graduates specialising in cardiology. The clinical echocardiographers also teach in the Specialisation school.
For several years now, the Institute’s echocardiographers and students of the Specialisation School meet every Thursday. During this meeting several clinical cases are presented and echocardiographic material and imaging techniques of particular diagnostic, methodological or scientific interest are discussed.
Finally, the laboratory regularly welcomes doctors from various Italian and foreign institutes who visit the Centre for educational purposes.
National and international scientific activities
The laboratory’s doctors participate in congresses and course held by the Italian Society of Echocardiography and the European Association of Cardiovascular Imaging of the European Society of Cardiology. They give speeches both at Italian and international imaging society congresses, participate in educational courses provided by these societies and collaborate in the production of numerous international guidelines.