Cardiologist @ dhzc.charite.de, #echofirst #volumetrics #EchoMath #3D
Germany @dhzcharite
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@DHZB_Akademie "3D Advanced Echocardiography Workshop" (happening January 22- 24, 2027) makes it clear why this is way "more than just 3D."
The program bridges advanced imaging with intensive clinical realities”specifically targeting ICU management, complex valvular heart disease, mechanical circulatory support (MCS), and heart failure.
Perfect for clinicians who want practical utility, not just pretty 3D pictures.
Yes, it’s a 3D workshop but we are taking it straight to the ICU
At the #echofirst Workshop , we aren't just looking at static valves. We’re tackling the tough cases:
Echo in ICU: Deep dives into ECMO hemodynamics and using echo to guide acute fluid management.
Critical Decision Making: Using acute heart failure echo to trigger therapy (from diuretics to MCS).
Live Knobology: Real-time mastering of GE & Philips systems.
Register & view the full program: backend.dhzb-akademie.de/app…
Just take a look at this GOAT line up 🔝
@alex1708ander @alexsfelixecho @dr_benoy_n_shah @iceman_ex @echo_batman @FGraziani_Grace @VictoriaDe32503 @Ph_Bertrand @StellEkaterina @echo_stepbystep @fiore_corrado @LunaGargani @ArgaizR @papadocardio @eromerodorta @mauripieroni72 @KemalogluOz @JanKnierim @echotainment @DonalErwan @FH_Verbrugge
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Look 👀 at this #echofirst resolution in 3D (14 FPS)
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#echofirst 3D VCA in a nutshell
Dear #echofirst friends, preparing a talk for our colleagues on CD images quality and measurements as 3D VCA
The literature shows as severity cut off 0,4 qcm up to max 0,6 qcm, but there is Dietl & Avenatti with 0,9 up to 1,0 qcm
How should we explain this?
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Nicolas Merke retweeted
We published a comparison of studies available back in 2023 (supplementary table)
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Nicolas Merke retweeted
Nice discussion. Timing of VCA measurements was a key aspect in our experience, not (equally) defined in all studies you mentioned. VCA max may overestimate severity and a higher threshold may be needed as compared to VCAmean or VCAmid pubmed.ncbi.nlm.nih.gov/3620…
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Dear #echofirst friends, preparing a talk for our colleagues on CD images quality and measurements as 3D VCA
The literature shows as severity cut off 0,4 qcm up to max 0,6 qcm, but there is Dietl & Avenatti with 0,9 up to 1,0 qcm
How should we explain this?
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👉Dietl et al., Cardiovascular Ultrasound 2018: 3D vena contracta area after MitraClip© procedure: precise quantification of residual mitral regurgitation and identification of prognostic information.
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What #echofirst settings we need to use in 2D color doppler and 3D color doppler for our semiquantitative and quantitative evaluation in regurgitant lesion
- vena contracta
- 3D VCA
- PISA EROA
We will look into it
👉 backend.dhzb-akademie.de/app…
👉 dhzb-akademie.de/course/3d-w…
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Nicolas Merke retweeted
In AR think beyond LVEF - think LVOT SV 🆚 RVOT SV🫀#volumetrics #echomath
In AR, LVOT SV > RVOT SV
RegVol AR = LVOT SV - RVOT SV
RegFr AR = RegVol AR / LVOT SV
📌 if no MR, LV SV ~ LVOT SV
📌 if no TR, RV SV ~ RVOT SV
#echofirst @NMerke
Aortic regurgitation: why can EF be misleading?
In severe aortic regurgitation, the LV ejects blood in two directions: forward into the aorta and backward into the LV.
That changes how we interpret stroke volume and EF.
⬜ Acute severe AR: Total stroke volume rises, but forward stroke volume falls. LVEDP rises sharply.
🟧 Chronic compensated AR: LV dilates and develops eccentric hypertrophy. EDV increases, allowing both total and forward stroke volume to rise while filling pressure remains relatively normal.
🟩 Chronic decompensated AR: LV contractile function deteriorates. ESV rises, EF falls, forward stroke volume falls, and LV filling pressure rises again.
🟥 After valve replacement: EF may initially fall because the low-resistance regurgitant pathway has been eliminated. This does not necessarily mean the LV has worsened. Forward stroke volume improves, and EF can recover with remodeling.
Key point: In severe AR, a normal or high EF does not necessarily mean normal LV function. The LV is ejecting blood both forward and back into the ventricle.
#Cardiology
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Great pleasure and honor to be first speaker at the #echofirst course treating the vast field of interventional echocardiography My topic is kinda gatekeeper for what coming in terms of therapy “What is severe MR” machine settings are crucial
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Nicolas Merke retweeted
Perfect overview. We have to know what we do when we are turning knops. 3D VCA highly depends on gain, voxle size and smoothing, frame rate etc. It's crucial to internal validate our result eg with volumetry. And in the end: anatomy, hemodynamics and cardiomechanics must align.
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#echofirst 3D compilation of tricuspid valve more to see and do at #3DEchoBerlin
👉 backend.dhzb-akademie.de/app…
👉 dhzb-akademie.de/course/3d-w…
Just take a look at this GOAT line up 🔝
@alex1708ander @alexsfelixecho @dr_benoy_n_shah
@iceman_ex @echo_batman @FGraziani_Grace @VictoriaDe32503 @Ph_Bertrand
@StellEkaterina @echo_stepbystep
@fiore_corrado @LunaGargani
@ArgaizR @papadocardio @eromerodorta
@mauripieroni72 @LHoyesWouter
@JanKnierim @echotainment
@DonalErwan @FH_Verbrugge
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We all struggle to understand severity quantification of regurgitation by #echofirst If our KOL present cases on the big stage they show severe Regurgitation showing VC width or 3DVCA usually without showing the needed machine settings We need to understand how to do #EACVI26
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This is one important piece of the complex puzzle of severity quantification.
Often we see people showing only vena contracta and their description that MR Jet is broad across the commissure to convince the audience that MR is severe!
There is need to demonstrate big LV volume and small LVOT SV as well as hemodynamic changes as elevated E wave, sPAP and dilated LV & LA
let’s wait for #EACVI26 if our #echofirst faculty shows the whole picture
Volumetric approach in MR 🎯
This represents a much-needed change in approach 🌟 (🆚 PISA)
Step 1 - calculate LV SV = total stroke volume
Step 2 - calculate LVOT SV = forward volume
Step 3 - calculate RegVol MR = LV SV - LVOT AV
Step 4 - calculate RF MR = RegVol MR/LV SV
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Nicolas Merke retweeted
Volumetric approach in MR 🎯
This represents a much-needed change in approach 🌟 (🆚 PISA)
Step 1 - calculate LV SV = total stroke volume
Step 2 - calculate LVOT SV = forward volume
Step 3 - calculate RegVol MR = LV SV - LVOT AV
Step 4 - calculate RF MR = RegVol MR/LV SV
🫀 MITRAL REGURGITATION: EROA BY STROKE VOLUME METHOD
📚 Echo Quantification – Step by Step
One useful quantitative method for assessing mitral regurgitation (MR) is the stroke volume method.
🔹 STEP 1 — Calculate LVOT Stroke Volume
Thread 👇
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Nicolas Merke retweeted
When evidence shapes guidelines and guidelines shape practice, one question deserves attention: Do trial results 🗣️entirely for themselves — or should we also ask about investigators’ relationships with the device manufacturer? Transparency is not distrust. It is part of science.
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