Speakers

Matthew graduated from University College Dublin in 2009 and completed subspecialty training in Northwestern Memorial Hospital, Chicago. He currently works in St Vincent’s Hospital in the areas of advanced cardiovascular imaging and heart failure, and is the cardiology lead for integrated care in the south Dublin region.

Echocardiography and the British Society of Echocardiography have been part of Mark's professional life for over 25 years. Having completed his cardiology specialist training in the West Midlands, he was appointed as consultant cardiologist and head of echocardiography at the Royal Cornwall NHS Trust in February 2003. In January 2008 he moved to Cambridge University NHS Foundation Trust as consultant cardiologist and head of echocardiography. Throughout his various clinical roles echocardiography has been a constant and he have always tried to bring my enthusiasm for the technique to those around him. It has been a great honour to be involved in the organisation of BSE + ICE 2023 and he looks forward to continuing to work with the team; bringing the joy of echocardiography to an ever increasing audience.

For over 20 years Noel has practiced as a Cardiac Physiologist specialising in echo. As an experienced Cardiac Physiologist, and Healthcare Manager, he’s had the privilege of leading teams in delivering echo services. Driven by the aim of providing excellence in healthcare, his goals have included inspiring leadership and innovation.

Assessment of ventricular function (left and right) in atrial fibrillation

Atrial fibrillation (AF) is a common arrhythmia, with echo ventricular functional assessment being an important diagnostic tool in the diagnosis and treatment of heart failure. However, the beat-to-beat variation, which is the signature of atrial AF, can be detrimental to the reliability and reproducibility of the echo assessment of systolic and diastolic ventricular function. Owing to this variability, in clinical practice the standard protocol for obtaining an accurate assessment of ventricular function involves averaging a random number of consecutive cardiac cycles. In addition to being cumbersome, this process is suboptimal, because the averaged value is variable and dependent on a selected window of cardiac cycles. Ventricular function during AF varies depending on the preceding cardiac cycle lengths. Using an index-beat approach, whereby measurements are taken after two cycles with similar R-R interval, may improve the echocardiographic reproducibility in patients with AF. Loss of atrial contraction, variable cycle length and the frequent occurrence of atrial dilatation limit the usefulness of conventional indices in the assessment of diastolic assessment. However, several echocardiographic variables can indicate increased filling pressures in the presence of AF. E/e′ is still a valid measurement in patients with AF.

Roger graduated from Trinity College, Dublin, finalised his Higher Specialist Training, and completed an Advanced Cardiac Imaging Fellowship in the Cleveland Clinic, Ohio. Since 2020 he specialises in multimodality cardiac imaging in the Mater Private Hospital, Dublin, with a keen interest in structural heart disease, including periprocedural transoesophageal echocardiography.

Patricia is the NI Lead Clinician for Heart Failure as well as a consultant cardiologist in the Southern Trust. 

She did her HF and echo training in Brigham and Women’s Hospital/Harvard Medical School, and her past publications focused on echocardiographic changes in HF and her previous roles involved establishing formal cardio-oncology services. 

Cardio-oncology care according to guidelines

Update on ESC and BSE guidelines in cardio-oncology care, role of echocardiography and biomarkers for follow up of patients in cardio-oncology. Case study example

Natasha has been working as a Cardiac Physiologist for over 20 years and is currently working in Kerry. She is a BSE adult accredited echocardiographer and a BSE Regional Representative. She enjoys both scanning and teaching and assisting her colleagues through the accreditation process. When she’s not working, she can be found hiking and cycling around the country.

Cocaine Induced Cardiomyopathy

Cocaine is one of the most widely consumed recreational drugs in the world with estimated global users of around 18 million. Cardiac complications remain the most frequently attributed causes of cocaine related death. Chest pain is the most common presenting complaint of cocaine users to ED. Cocaine exerts effects on endothelial cells by release of endothelial cells by release of endothelin-1 (vasoconstriction) and inhibiting production of nitric oxide (vasodilator), stimulation of the cardiovascular system increasing heart rate and blood pressure, blocking peripheral norepinephrine transport. Cardiovascular disease associated with cocaine use include myocardial infarction, arrhythmias, congestive heart failure, aortic dissection, endocarditis, and cardiomyopathy. This case study presents a 25-year-old male with history of cocaine use, presenting to ED in May 2022 with a 2/52 history of shortness of breath, increasing in severity. Presenting the Initial transthoracic echo study, patient’s , subsequent care pathway and the most recent transthoracic echo performed in January 2023.

Lynn currently works as the Lead Physiologist in Echocardiography at the Belfast Trust. She recently gained STP equivalence as a Clinical Scientist. Her main areas of interest include diastolic function and physiologist led surveillance clinics, which include valve surveillance and screening for inherited cardiac conditions.

Lynsey is a cardiac physiologist and echocardiographer with a PhD in sports cardiology. She is currently working as a research associate in sport and exercise cardiology at Bristol Royal Hospital for Children. Her current research involves physical activity and exercise intervention for young people with congenital heart disease.

Andrew is a cardiologist at the Ulster Hospital with a subspeciality in cardiac imaging and clinical informatics. He is the deputy CCIO for his trust and leads the implementation of the ‘Encompass’ Electronic Medical Record system for cardiology in Northern Ireland powered by EPIC.

The introduction of the ENCOMPASS - Electronic Medical Record System to NI

In October 2023 a single electronic medical record system for Northern Ireland called ENCOMPASS goes live in the South Eastern Trust. This is then rolled out across NI with a new trust every 6 months and will be complete by 2025. This will be provided by EPIC, which is the brand leader in USA and widely used across many UK trusts.  In conjunction with this a new NI single echo archive storage system will become operational from Sectra called NIPACS+. This will allow for standardised reporting and database analysis of all patients undergoing cardiac investigations across all NI hospitals. It will link with the new national Children’s Hospital which is currently under construction in Dublin. They have also contracted to use EPIC from 2025. This will allow data sharing of cardiology tests across both NI and in the Dublin region for CHI Children’s services. It will allow patients with complex congenital heart disease to have simpler transfer of their records across Ireland.

Paul is a Clinical Lecturer on ATU Sligo’s Clinical Measurement Physiology Programmes. He is a Cardiac Physiologist of over 22 years’ experience and has European accreditation in the areas of Adult Echocardiography and Cardiac Devices. He also has an MSc in Leadership from the Royal College of Surgeons Ireland.

Assessment of valve lesion severity (especially AS and MR) in atrial fibrillation

This talk will review the guidelines on assessment of severity of valve regurgitation and stenosis. How the assessment is confounded by the presence of atrial fibrillation will be discussed along with how atrial fibrillation is an important prognostic indicator in the management of valve disease.

David is a Professor of Echocardiography and Cardiovascular Physiology at Liverpool John Moores University. He is an accredited Clinical Cardiac Physiologist with over 25 years of experience in primary, secondary and tertiary healthcare settings. He is currently the co-chair for the Education Committee and the joint lead for the Research and Audit Committee of the British Society of Echocardiography (BSE) and has been awarded a fellowship from the society. He has been the lead and co-author on 20 plus BSE published professional guidelines which are used by echocardiographers across the UK and worldwide. He has published over 140 peer reviewed papers on quantitative echocardiography and its applications in clinical and exercise cardiology.

Strain Imaging – How to do the perfect scan

Global longitudinal strain (GLS) is fast becoming a routine technique in the assessment of left ventricular function however there are many nuances that should be considered. This talk highlights the imperfect nature of strain imaging and the potential pitfalls that can occur. The structure of the presentation addresses issues related to acquisition of images, offline analysis and interpretation and is supported by image examples and theoretical underpinning. We also introduce the technical requirements for left atrial and right ventricular automated strain imaging in tandem with their gradual introduction into our technological armamentarium.

Sandeep is a Senior Cardiac Physiologist with 13 years of experience in Adult and Paediatric Echocardiography and the cath lab. He has a degree in Cardiac Care Technology and worked in Kuwait and the UK before coming to Ireland.

Marfan's Syndrome and Surgery

Patient presentation - Audible clicking from chest, palpitations worst left lateral decubitus position. Previous Surgeries- Spine correction for Scoliosis and Aortic root replacement. Echo findings - Eccentric AR jet, holodiastolic flow reversal, preserved EF and LV dimensions. Quantitation not possible due to moderate MR due to MVP, MRI not possible due to spinal hardware. Subsequent findings revealed large left apical pneumothorax for which drainage was recommended. TOE to clarify mechanism of AR and serial follow up were recommended.

Liam is a Consultant Cardiologist with an interest in echocardiography. He has been a member of the BSE for over 10 years and has contributed in a number of ways, including writing practice guidelines. He has recently become the co-chair of the Education Committee.

Beatriz is a Cardiac Physiologist with a BSc Hons in Clinical Physiology, and an accredited member of the British Society of Echocardiography. She started her echocardiography training at St Bartholomew’s Hospital. She has worked at Royal Papworth Hospital, and is currently working at Cambridge University Hospital where she continues to develop her career experience. Beatriz is very passionate about echo training and education, having most recently volunteered for four weeks in Arusha, Tanzania at the Mt Meru hospital. Here she helped develop an echocardiography service and run clinics daily. She also has a strong will to explore opportunities to further help in deprived countries.

Strain in Valve disease

With the progressive ageing of the population the incidence of degenerative diseases is growing, in particular valve heart disease, representing an important public health problem with high morbidity and mortality. The European Society of Cardiology proposed decision making guidelines for intervention in valvular heart disease (VHD) which are based on severity of the pathology, hemodynamic consequences in left ventricular and right ventricular structure and function, symptomology and pulmonary circulation. However parameters of ventricular function such as ejection fraction EF often become abnormal when the pathophysiological process is advanced and therefore harm can be caused to these patients, if intervention is proposed too late. Thus, optimal clinical risk assessment and timing of intervention are crucial to avoid adverse clinical outcomes. Assessment of left ventricular function (LV) is commonly performed based on LVEF, however recently there is growing evidence of the clinical importance and value of strain echocardiography as a powerful and superior technique to assess subtle cardiac dysfunction, as it correlates with the amount of myocardial fibrosis detected. It has been proven that the amount of fibrosis present in valve heart disease (VHD) has important prognostic implications. Moreover, echocardiography strain imaging can detect LV systolic dysfunction before LVEF reduces, leading to better surgical outcomes. Hence, provoking a debate on whether patients should be sent to surgery on an early stage, before symptoms onset, by incorporating alternative methods of advanced myocardial deformation techniques such as strain imaging into the clinical practice of these patients.

Grace is a Senior Physiologist based at Midlands Regional Hospital Portlaoise, Ireland. She’s been fortunate enough to work in several busy hospitals in Ireland, UK and Canada. She got involved in the BSE Regional Representative network to try to provide the same help and invaluable support she received from colleagues along the way. She is involved echo training in Ireland and she also assists in the logbook assessment station ahead of the practical assessments for BSE accreditation.