Speakers

We're delighted to welcome another stellar round-up of fantastic speakers to this year's conference, and really excited to see them present virtually!

We'll be bringing you more information soon, but we've already confirmed:

Professor Nadia Aissaoui

 Professor of Intensive Care Medicine
Assistance Publique Hopitaux De Paris, France

Nadia is a Professor of Intensive Care Medicine with a background of cardiology in Paris (APHP, Paris University). Having worked in many famous ECMO institutions including La PitiéSalpétrière, Bad Oeynhausen (Germany) and Hershey Medical centre (USA), she published important papers in the field of cardiogenic shock, echocardiography and assist devices.

Mechanical support: ECMO

Echocardiography remains the paramount bedside exam in critically ill patients and particulary in cardiogenic shock patients. 
Thus in patient presenting a refractory CS, an echocardiograph should be ran in order to understand the CS etiology and to settle the indication of Veno-arterial extracorporeal membrane oxygenation (VA ECMO)(recovery expectation, contraindications such as aortic insufficiency). 

At the implantation, echocardiography is the easiest way to control cannula position. After ECMO implantation, daily echocardiography is mandatory to assess loading conditions, diagnose complications and signs of heart recovery. After several days of VA ECMO, echocardiography guides the weaning strategy according to ECMO flow or helps deciding whether VA ECMO can be removed or a new assist device strategy strategy is required.

Echocardiography is an essential tool to manage VA ECMO patients.

 

Mr Waheed Akhtar

Consultant in Echocardiography
United Lincolnshire Hospitals NHS Trust

Echocardiography has been part of Waheed’s life for almost 25 years. He was trained in London and worked with some of the leading experts in echocardiography. He was appointed in 2017/18 as the consultant echocardiographer for the ULH NHS trust part of Lincolnshire Heart Centre. He practices the advancement of echocardiography which includes 3D, DSE, TOE and Contrast.

A practical approach to assess LV systolic function and assessment of LV ejection

Registrar is not like physiologist training in echocardiography, the training has two different methodologies and practicality approach. This may also vary throughout Uk NHS trusts.

The objective of this talk is mainly highlighting the final ST3 stage training in the assessment of LV systolic function and accurate assessment of LV ejection fraction. This will be a simple guide for those trained at this level and the importance of this part of training for the SpR in cardiology. LV systolic function is one of most difficult aspect of echocardiography to master and in my talk I will take the registrar through a journey on achieving this objective.

The talk will refect on the practicality of obtaining the views needed to assess LV systolic function, this will include the quantitative and qualitative approach with simple calculations to achieve LV ejection fraction. This presentation will conclude with some simple regional wall motion assessment and LV function case studies.

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Miss Natasha Anderson

Clinical Modality Lead for Echocardiography
Warrington and Halton Hospitals NHS Foundation Trust

Natasha is a lead Cardiac Physiologist specialising in echocardiography in Northwest England, having completed a Bachelors degree in clinical physiology in London and a research degree in Chester. Natasha is enthusiastic about TOE, 3D and mentoring as well developing physiologist led services.

An unusual shunt – what is it?

Occasionally a routine transthoracic echo is perplexing and all the tools at our disposal need to be exercised. In this case a patient in his seventh decade of life presented with a murmur and the cause of which is not immediately obvious.

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Dr Dan Augustine

Consultant Cardiologist
Royal United Hospitals Bath NHS Foundation Trust

Dan is a Consultant Cardiologist (Echo / CMR) based in Bath and is the current BSE co-chair for Education. He is a co-author of the Oxford handbook of Echocardiography and has specialist interests in sports cardiology and pulmonary hypertension.

Mrs Mellissa Baker

Senior Chief Cardiac Physiologist
East Kent Hospitals University NHS Foundation Trust

Mellissa is a Cardiac Physiologist from Kent who’s enthusiastic about all things echo, with a special interest in physiologist-led valve clinics whilst dabbling in 3D, and is kept going thanks to caffeine and yoga.

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Dr Radwa Bedair

Consultant Cardiologist
University Hospitals Bristol NHS Foundation Trust

Radwa is a consultant cardiologist and specialises in adult congenital heart disease (ACHD). She is a member of the BSE education committee and lead on training in CHD in South-West England.

Tetralogy of fallot: Diagnosis to long term follow up

My presentation will describe the hallmark features of Tetraloigy of Fallot, the most common cyanotic congenital heart condition. I will focus on long term follow up of the adult patient, looking for the known sequalea that can be readily identified and assessed on echocardiography.

Mrs Sadie Bennett

Chief Clinical Scientist
University Hospitals of North Midlands NHS Trust

Sadie is a Highly Specialist Cardiac Physiologist and registered Clinical Scientist. She is a BSE Assessor, BSE council member and current Co-Chair of Accreditation. Sadie has a specialist interest in stress echo, valve surveillance clinics and research with several first author publications.

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Dr Amy Burchell

Consultant Cardiologist
Musgrove Park Hospital

Amy is a Consultant Cardiologist at Musgrove Park Hospital, Taunton, with specialist interests in heart failure, hypertension and complex echocardiography. She developed her clinical and research interests in resistant hypertension at the University of Bristol and the Specialist Hypertension Clinic at the Bristol Heart Institute.

Echocardiography in the assessment of Hypertension

More than 1 in 4 adults in England have hypertension and at least half of all heart attacks and strokes are associated with high blood pressure. In the face of this challenge, what role does echocardiography have to play?

  • Which patients with hypertension should have an echo?
  • What are the key echo parameters in hypertension?
  • Left ventricular hypertrophy – is it hypertensive heart disease?
  • What lies ahead for echo in hypertension?

  • Tune in to find out …

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    Dr Gerry Carr-White

    Consultant Cardiologist
    Guy's and St Thomas' NHS Foundation Trust

    Gerry was the clinical lead for heart failure, and inherited cardiac diseases at St Thomas' Hospital for 14 years and is now the joint medical director of the cardiorespiratory clinical group. He is the vice president for Cardiomyopathy UK and is a professor at King's College London having published over 120 peer-reviewed articles. He is clinical network lead for King’s Health Partners and the South London Cardiac Network.

    Echocardiography in the assessment of myocarditis

    This talk will detail how echocardiography is used in the assessment of myocarditis using illustrative case examples. It will also highlight how echocardiographic images should be interpreted alongside the clinical presentation and allied investigations such as ECG findings and CMR.

    Particular important to diagnose disease processes such as ARVC, sarcoid, Covid, autoimmune disorders and giant cell myocarditis will be discussed.

    Mr Rob Chamberlain

    Advanced Cardiac Scientist in Echocardiography
    Prince Charles Hospital, Australia

    Rob is a UK/Australian trained advanced cardiac scientist practicing adult echocardiography at The Prince Charles Hospital, and is also a higher degree research candidate at Griffith University undertaking a PhD in novel strain imaging in heart transplant.

    Interesting Cases: Not your usual presentation of Takotsubo Cardiomyopathy

    An interesting case surrounding an uncommon presentation of Takotsubo cardiomyopathy and the advanced echocardiographic imaging used.

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    Dr Paul Clift

    Consultant Cardiologist
    University Hospitals Birmingham NHS Foundation Trust

    Paul was appointed consultant cardiologist in the adult congenital heart disease department at Queen Elizabeth Hospital Birmingham in 2005. He has specialist interests in hereditary aortopathy, the single ventricle circulation and pulmonary hypertension related to congenital heart disease. He is clinical researcher and trialist and is current NIHR CRN national speciality lead for Cardiovascular.

    Echo assessment of pulmonary hypertension in patients with CHD

    Congenital heart disease associated pulmonary hypertension is relatively common, occurring in around 5% of adult patients under follow up. BSE guidelines on the diagnosis if pulmonary hypertension are not easy to apply to this population. This talk will focus on some complex lesions and how best to assess whether there is evidence of pulmonary hypertension.

    Dr Claire Colebourn

    Consultant Medical Intensivist
    Oxford University Hospitals NHS Foundation Trust

    Claire is a consultant in intensive care and uses echo in her daily practice both as a trainer and for inpatient and outpatient work. Claire co-wrote the ACCE and Level I accreditations and was Chair of accreditation before taking up the role of society President in October this year. Claire’s interests are training, quality, workforce and professional voice.

    Volume status and why we need echo

    The how and why of assessing volme status in critically ill patients.

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    Professor Mark Dweck

    Professor of Clinical Cardiology and Consultant Cardiologist
    University of Edinburgh and Edinburgh Heart Centre

    Marc’s research program uses multi-modality imaging (echocardiography, CT, CMR, PET) to advance our understanding of cardiovascular disease and to improve patient care. He has published in the leading medical and cardiovascular journals (285 manuscripts, H-index 53) and is an elected Board Member of the European Association of Cardiovascular Imaging. 

    Debate: CTCA vs DSE

    This talk will investigate the data to support coronary CT angiography  in the  investigation of patients presenting with stable chest pain and argue that it deserves its position as the first line imaging technique in the NICE guidelines. 

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    Dr Joerg Ender

    Head of Anesthesiology and Intensive Care Medicine
    Leipzig Heart Centre, Germany

    Jörg has been the Head of Department for Anesthesiology and Intensive Care Medicine, Heart Center, Leipzig since 2005. As of 2020, he has been co-chair of the Scientific Working Group within DGAI, as well as a member of the ERACS advisory board.

    TOE for minimally invasive tricuspid

    Tricuspid Valve Regurgitation (TR) is an undertreated disease. Moderate to severe TR is associated with increased morbidity and mortality. Current transcatheter techniques for tricuspid valve repair are available addressing either the annulus or the leaflets or the coaptation. The most used technique is edge-to edge repair. It can be performed either with TriClip® ( Abbott) or PASCAL® (Edwards Lifesciences) devices . All procedures are TOE-guided in combination with fluoroscopy. 3D TOE is essential in all transcatheter interventions for the Tricuspid Valve. The seven steps for guiding theses procedures:

    1. Evaluation of the tricuspid valve ( confirming preop findings, including anatomy, graduation of TR, consenus on strategy)
    2. Advancing the delivery system
    3. Positioning and orientation of the device in the right atrium
    4. Identification of clasps/grippers
    5. Positioning and Orientation of the device in the right ventricle
    6. Pre-Deployment assessment
    7. Post-deployment assessment

    8. Alignement of the ultrasound beam is difficult for the tricuspid valve compared to mitral valve. Retroflexion and right flexion of the TOE probe in combination with deep oesophageal views help in optimizing visualization of the leaflets. MOE Bicaval, MOE Inflow-outflow views with biplane imaging and/or live 3D as well as TG SAX view are essential.

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    Dr Kate English

    Consultant in Adult Congenital Heart Disease
    Leeds Teaching Hospitals NHS Trust

    Kate is a Consultant in Adult Congenital Cardiology at the Yorkshire Heart Centre in Leeds, a service which covers a population of 5.4 million. The service has a well developed echo team with 8 specialist congenital sonographers providing echo services to congenital heart patients from fetal to adult services.

    Echocardiography in the assessment of constriction

    Left to right shunts are a common finding in congenital heart disease. The impact depends on the site of the shunt.

    This presentation will discuss the echo features of left to right shunts presenting in adulthood.

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    Dr Arsalan Farhangee

    Clinical Fellow in Cardiology
    United Lincolnshire Hospitals NHS Trust

    Arsalan completed cardiology training in 2019 in Romania, and is currently working as a Clinical Fellow at Lincoln County Hospital with special interest in cardiac devices.

    Dr Richard Fisher

    Consultant in Critical Care
    King's College Hospital NHS Foundation Trust

    Richard is a Consultant at King's College Hospital. He undertook a post-CCT fellowship in peri-operative and critical care echocardiography at the Royal Brompton Hospital and holds accreditations in TTE and TOE. He is a member of the BSE’s Education Committee where he is lead for training in level 1 echo.

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    Dr Nick Fletcher

     Consultant in Anaesthesia and Critical Care
    St George's University Hospitals NHS Foundation Trust

    Nick has been a consultant cardiac intensivist and anaesthetist at St Georges University Hospital in London for the last 18 years and is now Chair of Anaesthesia and Critical Care at Cleveland Clinic London. He was the past president of the Association for Cardiothoracic Anaesthesia and Critical Care (ACTACC) and he has been involved with TOE and critical care echocardiography training, accreditation and research in the UK and Europe throughout his career. He was a previous council member of the British Society of Echocardiography between 2013 and 2015 and helped set up the BSE critical care echo accreditation and also the ESICM EDEC accreditation.

    TOE in anaesthetics and ICU

    The utility of TOE has been established for many years in anaesthesia and critical care practice. In addition to cardiologists and Physiologists, Anaesthetists and Critical Care Physicians have developed considerable expertise in its use. In my talk I will present an overview of current clinical practice, raise some relevant questions and discuss how research and practice may evolve in the future.

    Key references:

    Vieillard-Baron A, Millington SJ, Sanfilippo F, Chew M, Diaz-Gomez J, McLean A, Pinsky MR, Pulido J, Mayo P, Fletcher N. A decade of progress in critical care echocardiography: a narrative review. Intensive Care Med 2019;45(6):770-88.

    Barber RL, Fletcher SN. A review of echocardiography in anaesthetic and peri-operative practice. Part 1: impact and utility. Anaesthesia 2014;69(7):764-76.

    Fletcher SN, Grounds RM. Critical care echocardiography: cleared for take up. Br J Anaesth 2012;109(4):490-2.

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    Ms Jan Forster

    Consultant Cardiac Congenital Sonographer
    Leeds Teaching Hospitals NHS Trust

    Jan is a consultant cardiac congenital sonographer at Leeds Teaching Hospitals providing echo provision for the fetus, neonate, child and adults with congenital heart disease. She is the physiologist representative on BCCA council and is leading on the BSE congenital accreditation process. She has been a Fellow of BSE since October 2020.

    Dr Lynsey Forsythe

    Research Associate in Sport and Exercise Cardiology
    University Hospitals Bristol and Weston NHS Foundation Trust

    Lynsey is a cardiac physiologist and has a PhD in sports cardiology. Based at Bristol Royal Hospital for Children, Lynsey is working on a Heart Research UK funded trial in collaboration with Exeter University. The trial involves a physical activity and exercise intervention for young people with congenital heart disease. 

    Dr Arjun Ghosh

    Consultant Cardiologist
    University College London Hospitals NHS Foundation Trust

    Dr Arjun K Ghosh MBBS MSc PhD FHEA FACC FESC FRCP FICOS is the first cardiologist in the UK to be appointed specifically in cardio-oncology and helped establish Cardio-Oncology services at both these hospitals which are now amongst the biggest services worldwide. Arjun leads the cardio-oncology service at UCLH and is joint first author of the first British (BSE-BCOS) cardio-oncology guidelines published earlier this year.

    Introduction to Cardio-Oncology

    Cardio-Oncology is the newest subspecialty in cardiology. It deals with cardiac issues in cancer patients, pre-treatment, during treatment and in the late-effects’ setting. Most cancer treatments (cytotoxics, targeted therapies, immunotherapy, radiotherapy) can cause cardiotoxcity. All parts of the heart can be affected at any stage in the patient journey with heart failure, valve disease, arrhythmias, acute coronary syndromes, myocarditis and pericardial issues all common complications. Arjun’s talk will give a broad overview into this exciting new area in cardiology and briefly touch upon the role of echocardiography in managing cardio-oncology patients.

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    Dr Jaspal Gill

    Cardiology Registrar
    East Kent Hospitals University NHS Foundation Trust

    Jaspal completed medical training at University College London School of Medicine. His junior doctor jobs were in London and his specialist training in Cardiology has brought him to the QEQM Hospital in Margate, Kent.

    When you hear hooves, think Horse, but don’t forget the Zebra

    An elderly gentleman presented was referred to outpatient cardiology with shortness of breath, peripheral oedema, and a raised BNP. Echocardiography revealed normal systolic function but on review of the images, an abnormal appearance of the cardiac apex was identified. Further history revealed systemic symptoms of fatigue, and occasional fever. Peripheral blood test showed an eosinophilia with normal renal function. Cardiac MRI was therefore requested revealing changes typical of Loeffler’s endocarditis and thrombus in the left ventricular apex. The patient was admitted and started on intravenous steroids and anticoagulated. He went on to have an endomyocardial biopsy which confirmed the diagnosis showing eosinophilic infiltration of the myocardium with fibrotic changes. He responded well to intravenous diuretic therapy and prognostic heart failure medications were initiated. This case demonstrates the echocardiographic findings consistent with Loeffler’s endocarditis and the role of echocardiography in its diagnosis.

    Mr Arionilson Gomes

     Lead Cardiac Physiologist and Advanced Echocardiography practitioner
    Brighton and Sussex University Hospitals NHS Trust

    Arionilson is a cardiac physiologist specialising in echocardiography. He is passionate about all the modalities of cardiac ultrasound, but with a special interest in structurall heart disease and intervention.

    Percutaneous device closure: Planning and periprocedural TOE for PFO and ASD closures

    Atrial Septal Defects (ASD) and Patent Foramen Ovale (PFO) are defects of the wall separating the atria, which when present, allow an abnormal communication between the chambers. Symptoms will vary depending on the size of the defect combiner with the haemodynamic impact on the cardiac chambers and increased systemic embolic risk.

    Transcatether closure of ASDs has been a surgical correctieve alternative option since it was first attempted by Mills and King in 1976. Since then, multiple closure devinces and different techiniques and technologies have been used to aid and facilitate the procedure whilist vastly increasing the safety and efficacy. In this time, cardiac imaging has also made immense progress with advent of echocardiography in the 1950s followed by the use on transoesophageal echocardiography (TOE) in the 1970s and 80s.

    Currently TOE imaging offers great technical support during ASD closures by aiding not only with the identification/carachterization of the defects anatomy prior to the procudre, but also aiding with device positioning/deployment during the intervention. Finaly TOE is used for the assessment of a complete seal or need for further devices.

    Mrs Carol Graham

     Cardio-respiratory Service Manager
    Warrington and Halton Hospitals NHS Foundation Trust

    Carol is a Cardio-respiratory service manager with 18 years experience in echocardiography. She continues to maintain a clinical role with special interest in stress echo and cardio-oncology, and holds BSE TTE accreditation whilst currently collecting her log book for BSE SE accreditation.

    Unusual presentation of a right coronary artery to coronary sinus fistula

    A 34 year old normally fit and well female presented feeling unwell for 2 months with night sweats / fever and chest wall pain. Her GP had referred her for a d-dimer which was positive. Physical examination revealed a systolic murmur loudest in the aortic area.

    Working diagnosis on presentation of pulmonary embolism or infective endocarditis.

    The patient underwent an electrocardiogram which was unremarkable, echocardiogram which showed normal LV systolic function, cleft mid inferior and mid inferior septum and abnormal flow in the RCA territory. CT pulmonary angiogram confirmed peripheral subacute / chronic PE. Bubble study was negative for unroofed coronary sinus.

    CT coronary angiogram confirmed RCA to coronary sinus fistula.

    The patient was commenced on antibiotics and anticoagulation.

    Isolated RCA to coronary sinus fistulas are extremely rare, accounting for 7% of all coronary artery fistulas. Most patients present with palpitations, chest pain, syncope and a continuous murmur. Management is often conservative but referral to a specialist cardiologist is important to ensure accurate treatment.

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    Dr Julia Grapsa

     Consultant Cardiologist and Reader in Cardiology
    Guy's and St Thomas' NHS Foundation Trust

    Julia is a consultant cardiologist at Guys and St Thomas NHS Trust. She is also a reader for Kings College and editor in chief for JACC Case Reports. She is also serving as associate editor for JACC, secretary for ESC VHD council and chair of EACVI task force for women in imaging. Julia has served as chair of the young community for multimodality imaging for the European Association of Cardiovascular Imaging and as a member of the European Society of Cardiology (ESC) education committee, leading the ESC clinical case gallery. She was responsible for ESC social media, since its birth and she has been a member of imaging and online education committees of Heart Failure Association.

    TOE in infective endocarditis: Cases that you will never forget

    This lecture will describe an interesting compilation of cases of infective endocarditis and how TOE helped in clarifying the diagnosis.

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    Mrs Samantha Hill

    Clinical Scientist and Echo Service Lead
    North Bristol NHS Trust Southmead Hospital

    Samantha is an experienced HCPC registered Cardiac Clinical Scientist, leading a thriving, BSE accredited echo service, passionate about patient experience and service improvement in the NHS.

    As a STEM ambassador and associate lecturer, she aspires to shape and develop the future workforce in cardiac physiology.

    Mr David Hoare

    Deputy Principal Cardiac Physiologist
    Barts Health NHS Trust

    David is an experienced echocardiographer with over 17 years’ experience working in the profession. He has specific interests in adult congenital heart disease and transoesophageal echocardiography and has been combining these interests for the past few years by working with the structural intervention team at the Barts Heart Centre.

    Transcatheter mitral valve repair: Planning and periprocedural TOE

    The aim of this presentation is to show the steps involved during percutaneous edge-to-edge repair techniques and the central role transoesophageal echocardiography plays in safe and effective procedures. The presentation will also discuss how echocardiography is used in patient selection and follow-up.

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    Dr Tom Ingram

    Consultant Cardiologist
    Shrewsbury and Telford Hospital NHS Trust

    Tom is a Consultant Cardiologist with a special interest in cardiac imaging. He has a keen interest in team working and promoting high quality echocardiography. He co-chairs the BSE departmental accreditation and clinical standards committee along with Sarah Ritzmann.

    An Update on Departmental Accreditation and Clinical Standards

    Sarah and I will provide an update as to how the departmental accreditation process has kept going over the last 18 months. We will be joined by Sam Hill, who runs a department that has recently become accredited, to review her experience of the process. In addition, our new patient representative Zena will give us her insights into how a patient’s perspective can provide valuable feedback during a BSE departmental accreditation visit. Lastly we will discuss how the new BSE Resilience in Leadership program has been able to support our members and the teams they work with.

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    Dr Saleha Kabir

    Physiologist Lead of Paediatrics and Advanced Imaging
    Evelina London Children’s Hospital

    Saleha has over 15 years experience in adult and paediatric echocardiography, holding both BSE and EACVI accreditation. She has a specialist interest in 3D echocardiography and TOE, not only to better describe and display congenital heart lesions prior to intervention but also to enhance echo guidance during interventional procedures.

    The assessment of the atrial septum and role of 3D echocardiography

    This presentation aims to demonstrate how to fully assess the interatrial septum with a view to different transcatheter repair techniques. It will further discuss the importance of the role of 3D echocardiography in assessment prior to, during and after the procedure.

    Dr Hazlyna Kamaruddin

     Consultant Cardiologist
    Sherwood Forest Hospitals NHS Foundation Trust

    Hazlyna is a Consultant Cardiologist and the Clinical Lead in Cardiac Imaging based at King’s Mill Hospital, Mansfield, North Nottinghamshire. She has a specialist interest in Echocardiography and Cardiac Magnetic Resonance Imaging. She has recently been appointed as the Regional ECHO Training Lead for East Midlands North.

    Dr Kalliopi Keramida

    Consultant Cardiologist
    University of Athens, Greece

    Kalliopi, MD, PhD, FESC, FHFA, FICOS: is a Cardiologist Consultant, certified in cardiovascular imaging, heart failure and Cardio-Oncology and member of the Working Group of Cardio-Oncology of the Hellenic Society of Cardiology, of the Cardio-Oncology Council and of the Cardio-Oncology Study Group of HFA.

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    Dr Bonnie Ky

     Associate Professor of Cardio-Oncology, Medicine and Epidemiology
    Hospital of the University of Pennsylvania, USA

    Bonnie is a physician scientist at the University of Pennsylvania and lead a highly active NIH and AHA-funded translational research program in cardio-oncology. Her overarching scientific objectives are to define how we can improve cardiovascular outcomes in cancer patients by determining and modifying individual patient risk through deep phenotyping.

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    Ms Emma Lane

    Chief Physiologist
    Portsmouth Hospitals NHS Trust

    Emma is a Chief Physiologist at Portsmouth Hospitals University Trust, BSE accredited and undergoing BSE stress echo accreditation. She is a hospital mentor and keen developer in all thing focused echo related; actively working on inter-departmental echo relationships, and to date, been key in both ICU and ED echo skills and training for SpRs and ACPs.

    Emma is currently undertaking a part time PhD with University of Portsmouth which focuses on the role advanced echo techniques and biomarkers for detecting heart failure on ICU patient with sepsis and septic shock. This is a NIHR portfolio study and one of the first to look at post discharge data and long-term outcomes in this cohort. She is an honorary senior lecturer at University of Portsmouth, teaching cardiology specific modules on the MSc Clinical Exercise course.

    The ICU scan – right place, right time, right imaging

    Focus echo in both the ED and ICU is becoming more readily available and is making substantial differences in patient care based on its findings. The FICE or FEEL echo pathway involves targeted imaging and modalities in comparison to a BSE data set. But this is usually ideal for answering pertinent questions about a critically ill or peri-arrest patient. This session presents a case whereby focus echo, and collaborative ICU and physiologist/HC scientist scanning, made a lifesaving diagnosis and discusses learning points around focus scanning and the ICU pt.

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    Professor Paul Leeson

    Professor of Cardiovascular Medicine and Consultant Cardiologist
    University of Oxford and Oxford University Hospitals NHS Trust

    Paul is a Professor of Cardiovascular Medicine at the University of Oxford and a Consultant Cardiologist. Following training in Cambridge, London and Oxford, he set up a research programme to improve identification and prevention of heart disease in young people, and has pioneered the translation of AI into echocardiography.

    EVAREST study

    The study of Echocardiography Value and Accuracy at Rest and Stress (EVAREST) began recruiting at a core group of hospitals within the Thames Valley in March 2015. Over the last five years the project has grown and now involves over 30 echocardiography centres across the whole of the UK; becoming one of the largest prospective studies of stress echocardiography practice in the world. Over 10,000 patients have taken part and the project is providing the most accurate data ever available within the NHS on precision, health economics and outcomes, as well as patterns of disease and resource usage, related to stress echocardiography. In the last year EVAREST has joined forces with the British Society of Echocardiography in a formal collaboration (BSE-NSTEP) so that this information can be available to assist development of guidelines and best practice within the society at a national level. The effectiveness of this collaboration was recently demonstrated by the ability, on a rolling monthly basis, to monitor activity, protocols and waiting lists for stress echocardiography practice across the UK in response to waves of COVID-19 infections.

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    Dr Jennifer Liu

    Director of Cardiovascular Laboratories
    Memorial Sloan Kettering Cancer Centre

    Jennifer is the Director of Cardiovascular Laboratories at the Memorial Sloan Kettering Cancer Centre. Her clinical and research interests include developing image-based strategies to optimize CV health in patients with cancer. She is the founder and the course director of the annual MSK-Cardio Oncology symposium educating health care professionals across the globe.

    Role of Strain Imaging in Cardio-Oncology

    Although the spectrum of cardiotoxicity in cancer patients is broad, there is a specific interest in the early detection of cardiomyopathy due to its implication for ongoing cancer treatment and the association with poor prognosis. Echocardiographic derived left ventricular ejection fraction (LVEF) is the most commonly used parameter for identifying LV dysfunction before, during, and after cancer therapy. Although LVEF is a robust diagnostic and prognostic marker in various cardiovascular diseases, it lacks sensitivity to detect subclinical changes in cardiac function caused by early myocyte damage due to cardiotoxic treatment.

    Left ventricular deformation, or strain, which is now feasible by speckle-tracking echocardiography (STE), provides a quantitative measure of cardiac contractile function. Global longitudinal strain (GLS) is the best studied strain parameter with the largest body of literature supporting its diagnostic and prognostic value, and is considered the optimal deformation parameter for the detection of subclinical LV dysfunction. GLS has emerged as an early marker of cardiotoxicity. When reduction in LVEF during chemotherapy is established, it may be too late for treatment to allow complete recovery. The objectives of this presentation are to provide a basic understanding of LV strain measured using speckle tracking echocardiography (STE), review the clinical utility and application of strain imaging in oncology, illustrate cases when strain is helpful, and discuss the logistics of implementing 2D strain in the echo laboratory.

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    Dr Guy Lloyd

    Consultant Cardiologist
    Barts Health NHS Trust

    Guy is a consultant cardiologist with a special interest in valve disease. He practices at Barts and UCLH where he is director of cardiac diagnostics. Guy is a past President of BSE and is currently secretary of the British Cardiovascular Society. He has an active program of research in stress echo, heart valve disease and new approaches to detection.

    Transthoracic microbubble study

    This talk will discuss the indications for microbubble echocardiography, the evidence base underpinning the indications, how to optimise the investigation, how to report and the limits of the test.

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    Dr Anita MacNab

    Consultant Cardiologist
    Manchester University NHS Foundation Trust

    Anita leads the Wythenshawe echo department, serves on the BSE council and leads Stress Accreditation for the BSE. Special interests are stress echocardiography and 3D echo in mitral valve repair and mitraclip. She has also lectured at many national and international conferences, and has ran many stress and TOE courses.

    Stress Echo for Iscaemic Heart Disease

    This is a practical talk on the use of stress echo in the investigation of ischaemic heart disease. Indictions, protocols, advantages/limitations and outcomes of pharmacological vs exercise stress will be covered. Viability assessments will also be shown with illustrative examples.

    Dr Maria Mahmood

     ST3 Cardiology Registrar
    Sandwell and West Birmingham Hospitals NHS Trust

    Maria is a ST3 Cardiology Registrar in the West Midlands Deanery. After completing medical school training at Oxford University, she moved to the West Midlands and completed foundation and core medical training. She is completing her cardiology registrar training in the West Midlands deanery.

    The JRCPTB requirement in specialist training: The echocardiography pathway/syllabus

    This presentation aims to outline the key JRCPTB requirements in specialist training for echocardiography. The aim is to improve understanding and clarify the specific criteria to guide training doctors in how to approach acquiring key competencies.

    Dr Navroz Masani

    Consultant Cardiologist and Associate Medical Director for Clinical Strategy
    Cardiff and Vale University Health Board

    Navrov is a Consultant at cardiologist, specialising in echocardiography, non-invasive cardiology and adult congenital heart disease. He was previously a BSE Council member, Chairman of the BSE Education Committee, Program Director of BSE Conference, and BSE President. He is currently Director of Cardiff Echocardiography Course (see website), Co-Director of the Bristol Adult Congenital Heart Echocardiography Course, and Faculty of Stellenbosch University Echocardiography course (SUNecho).

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    Dr Nicolas Merke

    Head of Echocardiographic Laboratory
    Deutsches Herzzentrum Berlin, Germany

    Nicolas completed medical school in Italy (Ferrara), before undertaking medical training in Germany and completing board exams in internal medicine in 2004, and cardiology in 2009. He has been a consultant physician since 2005 and from 2009 head of echo lab at Sana Klinikum Lichtenberg. Since December 2020, Nicolas has been head of echo lab at DHZB (German Heart Centre Berlin).

    cf- LVAD with an unexpected TAVR follow up and its effect on TR

    The implantation of continuous flow left ventricular assist devices (cfLVADs) is an well established therapeutic option in terminal heart failure. Aortic- and tricuspid regurgitation during LVAD support are known to cause significant morbidity and mortality. Our patient received in 2014 a cf LVAD(HeartWare). Postoperatively there was no significant heart valve disease. After 5 years first aortic regurgitation (AR) and 6 months later also tricuspid regurgitation (TR) was detected. Under medical treatment she was was asymptomatic. With the beginning of 2021 the aortic and tricuspid regurgitation worsened to NYHA class III. Due to progressive signs of heart failure the heart team decided for the implantation of a transcatheter aortic valve replacement (TAVR) with the option of transcatheter edge-to-edge repair (TEER) of the tricuspid valve in a second step. 1 months after TARV the patient underwent transoesophageal echocardiography with an unexpected outcome. The TAVR prothesis was thrombosed and the severity of TR was significantly reduced. Symptoms had improved to NYHA class II.

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    Dr Lynne Millar

    Cardiology Registrar
    Barts Health NHS Trust

    Lynne is a cardiology ST7 in advanced echocardiography and heart failure/inherited cardiac conditions at St. Bartholomew’s Hospital. She has MD (Res) in sport’s cardiology and an interest in heart disease in pregnancy.

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    Professor Mark Monaghan

    Immediate Past Director of Non-Invasive Cardiology
    King's College Hospital NHS Foundation Trust

    Mark is immediate Past Director of Non-Invasive Cardiology at King’s College Hospital, London, UK. He is a past President and current Council Member of the British Society of Echocardiography. He has received a lifetime achievement award from the BSE and the McKenzie Medal (2021) from the British Cardiovascular Society. He is a Fellow of the BSE, Royal College of Physicians, American College of Cardiology and the European Society of Cardiology.

    Professor Monaghan is on the Editorial Board of several Cardiac Imaging Journals, has published extensively in peer reviewed Journals and is the Author, Editor and contributor to multiple books dedicated to Cardiac Imaging.

    Contrast Echocardiography – When and How to optimise

    Contrast echocardiography is now a well established technique for improving left ventricular endocardial definition, detecting intra-cardiac thrombus, helping to diagnosing various heart muscle disorders and evaluating myocardial perfusion. It has become a pivotal adjunct to stress echocardiography, where it is used in the majority of cases.

    Despite the availability of several commercial contrast agents and ultrasound systems with contrast specific imaging software, technical issues with the technique still abound and artefacts are common place. In this presentation, the common errors that can occur whilst performing contrast echo studies will be discussed, together with a demonstration of artefacts and how to avoid them.

    Hints and tips on how to perform a good contrast study will provided along with a demonstration of more advanced techniques such as myocardial perfusion imaging and 3D contrast echo.

    Mr Vitor Morgado-Weaver

    Chief Cardiac Physiologist
    Royal Devon and Exeter NHS Foundation Trust

    Vitor is a Specialist Cardiac Physiologist with interests in Physiologist-Led services and Transoesophageal Echocardiography. Has developed a Physiologist-Led Contrast service and is currently working on setting up a valve surveillance clinic and a Physiologist-Led TOE service.

    Usefulness of 3D-True Vue in the assessment of paravalvular leaks in MVR

    This presentation aims to show the usefulness of using 3D echo techniques to assess replacement mitral valves, particularly the use of True Vue. This case relates to a 61 year old male that initially presented with an ischaemic stroke and was found to have staph infection affecting his mitral valve. On follow-up post MVR he was found to have a paravalvular leak challenging to quantify and a TOE was requested to assess this.

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    Dr Chirojit Mukherjee

     Chairman Department of Anaesthesia and Critical Care
    Helios Heart Surgery Karlsruhe, Germany

    Chirojit studied for his PhD at Leipzig University and his MBA a HHL Leipzig.

    Aortic valve: Repair or replace?

    This talk aims to cover: Valve assessment for repair, Valves replacement: Dos and Don'ts, Patient selection, Complications, and Future directions

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    Professor Denisa Muraru

     Assistant Professor and Cardiologist
    University of Milano-Bicocca, Italy

    Denisa is Vice-President Elect Echocardiography in the EACVI Board 2020-2022, Chair EACVI Research & Innovation Committee, and EuroEcho 2021 Programme co-Chair.

    Her research interests include right heart imaging, valve disease, cardiomyopathies, 3D echo and 2D/3D strain. She co-authored >150 papers (h index 33). She is an Editorial Board member for JASE and EHJCVI, and EHJCVI SoMe Editor.

    She received 22th Feigenbaum Lecturer Award at the 2021 ASE Scientific Sessions.

    3D ventricular assessment

    Quantification of ventricular size and function represents the most frequent indication for an echocardiographic study as it has become essential to reach the diagnosis, address management and predict prognosis in patients with suspected or known cardiac diseases.

    Three-dimensional (3D) echocardiography has proven to be more accurate and reproducible than conventional 2D echocardiography for assessing both the left and right ventricle, and to have incremental value for patient outcome prediction.

    The presentation will summarize the benefits of 3D echocardiography for quantifying the ventricular volumes and ejection fraction, and illustrate how 3D echocardiography can be implemented in the routine to address clinical issues.

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    Professor Petros Nihoyannopoulos

    Professor of Cardiology
    Imperial College London

    Petros was born in Athens, before qualifying from medical school in Strasbourg-France in 1979 (Universite Louis Pasteur). He trained in Cardiology at Hammersmith Hospital (1984-88). In 2006 he was elected Professor of Cardiology at Imperial College London and the Hammersmith Hospital. He has published extensively in most scientific Jornals and has written three books on Cardiac imaging and echocardiography. He served as President of the British Society of Echocardiography (2001-2003), President of the European Association of Echocardiography of the ESC (2006-2008) and was the founder Editor of the European Journal of Echocardiography and the Journal of Echo Research and Practice. He is the founder of a unique Master’s degree on Medical Ultrasound at Imperial College where they attend postgraduate students from all over the world. Professor Nihoyannopoulos is devoted to teaching both, under- and post-graduate medical students and he is an invited lecturer and visiting Professor in several universities around the world.

    Associate Professor Sam Orde

    Director of Intensive Care
    Nepean Hospital, Australia

    Sam is Director of the ICU and echo lab at the Nepean Hospital, Sydney. He trained in the UK at Oxford and GKT, London, and completed his ICU training in Australia. He has completed two echo fellowships, including at the Mayo Clinic, USA. He completed his PhD in assessing use of advanced echo techniques in the critically ill.  He is particularly interested in RV failure and FOAMed in critical care echo. 

    The septic heart

    Septic shock can cause a myriad of acute effects on the heart, which may include: left and right ventricle dysfunction, systolic and diastolic abnormalities, LV dilation, normal or raised left atrial pressure.  Echo is essential to assess these and help provide an individualised approach to treatment.

    A unified, robust diagnostic criteria is still lacking which makes research in this field lack clarity at times.  Much work has been done describing the different cardiac abnormalities seen in patients with septic shock within 24 hours of being admitted to the ICU, however the acute reversible nature is what defines septic cardiomyopathy.  Follow up echo studies on septic patients analysing acute changes in cardiac function are needed; as well as analysis of the possible chronicity of some of the cardiac dysfunction seen. 

    Once firm diagnostic criteria can be agreed on, further studies in this area can hopefully give guidance on how to best treat the septic heart. 

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    Dr David Oxborough

    Reader in Cardiovascular Physiology
    Liverpool John Moores University

    David is a reader in cardiovascular physiology at Liverpool John Moores University and fellow of the British Society of Echocardiography. He has published over 130 peer reviewed papers on quantitative echocardiography and its applications in Clinical and Exercise Cardiology. He has continuously worked in the imaging-based assessment of sudden cardiac death syndromes and pre-participation screening environment and has screened thousands of athletes. He has contributed significantly to our understanding of the Athlete’s Heart and its differentiation from cardiomyopathy.

    BSE athlete's COVID project

    The Covid-19 pandemic has had an unprecedented impact on society. The cardiac manifestations of this disease have been documented in the general population and a recent survey by the European Society of Cardiovascular Imaging demonstrates 70% of hospitalised patients have detrimental cardiac involvement, for which echocardiography is the first-line assessment tool. The virus has also had a significant effect on the athletic population with many professional athletes having contracted the virus and tested positive for Covid-19. Careful consideration has been made for the athletes to ‘return to play’ following the disease utilising echocardiography as an important diagnostic tool to exclude any cardiac involvement. The BSE have published guidelines on the role of echocardiography in pre-participation screening of athletes and it is therefore important to establish the impact of Covid-19 on the athletes heart and whether further recommendations are required. This talk highlights the current evidence base pertaining to Covid-19 on the athletes heart and introduces the methodology for a proposed BSE supported study to specifically identify the cardiac manifestations of Covid-19 on the athletes heart and the role for echocardiography in ‘return to play’ and follow-up.

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    Ms Cheryl Oxley

     Senior Chief Cardiac Physiologist
    University Hospitals of North Midlands NHS Trust

    Dr Maria Paton

    Clinical Academic Fellow
    Leeds Teaching Hospitals NHS Trust and University of Leeds

    Maria is a Cardiac Scientist undertaking a NIHR fellowship at the University of Leeds, investigating the optimal management of patients with heart failure and cardiac devices through tailored therapy riven by advanced imaging assessment. She leads the Heart Failure and Cardiac Device service at Leeds Teaching Hospitals Trust and is co-chair for the Research and Audit committee of the British Society of Echocardiography.

    Research and Audit Subcommittee Update Session: Society Update

    We want to use this opportunity to introduce you to the BSE research and audit subcommittee. We have a team of experienced researchers brought together with the aims of improving understanding and access to research, aligning the BSE with key national research programmes and research bodies, and developing a robust and continuing audit process.

    We welcome the new era of routine research integration alongside the growing body of clinical academics and want to highlight the value and importance of research. During this presentation we will explain some of the projects we have become involved in, the research we have initiated, and our grand plans for the future!

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    Mr Keith Pearce

    Consultant Cardiac Physiologist
    Manchester University NHS Foundation Trust

    Dr Victoria Pettemerides

    Consultant Cardiologist
    Liverpool Heart and Chest Hospital NHS Foundation Trust

    Victoria is a Consultant Cardiologist at Liverpool Heart and Chest Hospital specialising in Echocardiography, Inherited Cardiac Conditions and Sports Cardiology. She completed her training in the North West deanery, and an Advanced Echocardiography fellowship at Wythenshawe Hospital, developing keen interests in stress echocardiography for valve disease and cardiomyopathies.

    Differentiating ARVC from athletes heart

    The physiological remodelling seen in the right ventricle as part of the athlete’s heart may mimic some features of ARVC which is a leading cause of sudden cardiac death in young athletes. It is essential that pathological versus physiological changes are distinguished - an incorrect diagnosis of adaptation may result in a tragic event whilst an incorrect ARVC diagnosis can result in inappropriate exclusion of sporting participation. Echocardiography is just one part of the assessment in such individuals but is often the first line imaging modality. This session will therefore focus on the role of echocardiography in helping to make this important distinction.

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    Dr Mahesh Prabhu

    Consultant in Cardiothoracic Anaesthesia and Intensive Care
    Newcastle upon Tyne Hospitals NHS Foundation Trust

    Mahesh is a Consultant in cardiothoracic anaesthesia and intensive care and cardiothoracic ICU Director at the Freeman Hospital, Newcastle upon Tyne, UK. He is an echo enthusiast and a member of the ACTACC TOE Sub-committee, EACTA TOE Committee, EACTA VAD and Transplant Committee and BSE Accreditation committee. He has been the TOE Lead for ACTACC/BSE TOE accreditation. He is also member of the BSE council. He serves on the editorial board of Annals of Cardiac anaesthesia. His interests include transoesophageal echocardiography, thoracic organ transplantation and teaching.

    Professor Susanna Price

    Consultant Cardiologist and Intensivist
    Royal Brompton and Harefield NHS Foundation Trust

    Susanna is a consultant Cardiologist and Intensivist at Royal Brompton Hospital where she is lead for Peri-procedural Echocardiography and the Cardiogenic Shock Programme. She is an ESC Board Member, Councillor and Chair of the ESC Education Committee, immediate past-President of the ESC-ACVC, and Deputy Editor of the European Heart Journal.

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    Dr Bushra Rana

    Cleveland Clinic London and Imperial College Healthcare NHS Trust
    Consultant Cardiologist

    Bushra is a Consultant Cardiologist with expertise in valvular and structural heart disease as well echocardiography. She works at both Cleveland Clinic London and Imperial College Healthcare NHS Trust. She is Clinical Lead for Cardiac Diagnostics at ICHNT, and co-leads a number of MDT meetings (including endocarditis, mitral/tricuspid MDTs).

    3D Valve Assessment

    Evaluation of valvular heart disease has expanded to include detailed anatomical assessment. This is not only the case for severity quantification using 3D colour formats but also for various interventions including valve repair techniques. The talk will cover essential aspects are an understanding of valve anatomy and their key landmarks along with a systematic protocol to acquire 3D quality data.

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    Mr Filippo Rapetto

    Consultant Congenital Cardiac Surgeon
    University Hospitals Bristol NHS Foundation Trust

    Filippo is a congenital cardiac surgeon with a strong interest in reconstructive valve surgery, including aortic valve surgery in young patients. He also conduct clinical and translational research at Univeristy of Bristol, mainly focusing on novel biomaterials for surgical reconstruction of the right ventricular outflow tract.

    Aortic valve neocuspidization (Ozaki procedure) – Why we do it, what we know and what we hope

    Surgical aortic valve replacement with a mechanical or biological prosthesis and transcatheter aortic valve implantation are currently the routine treatments for aortic valve disease. Prosthetic heart valves carry intrinsic and unavoidable morbidity and mortality, and there is clear evidence of suboptimal long-term results of conventional aortic valve replacement in several patient subgroups, including young adults. The Ross procedure can be an alternative to prosthetic aortic valve replacement/implantation, but it is a significantly more complex procedure and several anatomical and clinical criteria need to be fulfilled for it to be feasible.

    Aortic valve neocuspidization (Ozaki procedure) is an aortic valve replacement with autologous pericardium treated in glutaraldehyde. Each aortic valve cusp is individually sized and reconstructed, avoiding prosthetic material, according to a standardized technique originally developed by Dr Ozaki. The procedure is feasible in virtually all patients with aortic valve disease, including paediatric patients.

    Short- and mid-term results are promising in terms of freedom from aortic regurgitation, freedom from endocarditis and valvar haemodynamics. However, the fate of the autologous pericardium and its late performance are largely unknown at present. If early results are confirmed in the long term, aortic valve neocuspidization could reduce prosthesis-related morbidity and mortality following aortic valve surgery.

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    Mrs Sarah Ritzmann

    Clinical Scientist
    Doncaster and Bassetlaw Hospitals NHS Trust

    Sarah has been an Echocardiographer for 14 years. She studied BSc Clinical Physiology in Leicester (2007) and MSc in Advanced Practice at the University of Leeds in 2014.She is currently co-chair BSE Clinical Standards Committee, responsible for Departmental Accreditation and Echo Quality Accreditation.

    How to Achieve Departmental and Echo Quality Accreditation

    Join us for an overview of the application and accreditation process for both BSE departmental accreditation and the recently launched Echo Quality accreditation. The session will focus on recent changes to the standards for departmental accreditation and evidence for Echo Quality Accreditation and is therefore a must for echocardiographers from both accredited departments, and those aspiring to be.

    Mr Shaun Robinson

    Consultant Clinical Scientist
    North West Anglia NHS Foundation Trust

    Shaun is a consultant clinical scientist with a specialist clinical and research interest in stress echocardiography in valvular heart disease, cardiomyopathies and the athletes heart. He is the current co-chair of the BSE education committee, elected member of BSE council and sits on the editorial board of the journal Echo Research and Practice. Shaun is a regular speaker at regional and national meetings and lead author of the BSE Minimum Dataset and Mitral Valve guidelines.

    Diastolic stress echocardiography

    This presentation will provide an overview of stress echocardiography for the assessment of diastolic function. Resting diastolic function is described with particular emphasis on the spectrum of filling pressures across the different grades of diastolic impairment. The rationale for stress echo assessment of diastolic function is described along with a description of the available modalities, appropriate measures and test interpretation. The presentation concludes with a description of novel techniques and future directions in stress echo.

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    Mr Naveed Saeed

    Consultant Echocardiographer
    Sandwell and West Birmingham Hospitals NHS Trust

    Naveed is a Consultant Echocardiographer and Head of Echo, currently working at Sandwell and West Birmingham Hospitals. He was appointed as Consultant Echocardiographer in 2019, taking lead in complex echocardiography including 3D, TOE, DSE and ESE. He has also successfully set up clinics such as Cardio-Oncology and Physiologist Led Valve Clinic.

    Standardising training protocols and delivery of basic theory and practical

    Registrar training can prove more difficult then Physiologist training for several reasons, none the less, it is important we provide and maintain similar training plans to all staff, proving the importance of standardisation of all registrar training. My talk will demonstrate the importance of tailored outpatient lists as well as the significance of providing the Registrars with all relevant paperwork and manuals to ensure their training needs can be achieved.

    Dr Rebecca Schofield

    Consultant Cardiologist
    North West Anglia NHS Foundation Trust

    Rebecca is a multi-modality cardiac imager and HSST accredited trainer.

    Tako tsubo cardiomyopathy

    An approach to echo assessment, clinical and imaging markers which suggest the condition and how additional modalities can help confirm the diagnosis.

    Professor Roxy Senior

    Consultant Cardiologist and Director of Echocardiography
    Royal Brompton and Harefield NHS Foundation Trust

    Roxy is a professor of cardiology at Imperial College, and has published over 400 papers. He was awarded the Edler Lecture award by University of Lund, Sweden, and awarded hon fellowship of the American Society of Echocardiography. He developed contrast echocardiography for clinical use, is an international leader in stress Echocardiography, and developed the concept of using transvalvular flow rate to define the severity of AS.

    Stress Echo Debate: CCTA vs DSE

    Stress echo is a relatively widely available, low cost and non-ionising radiation free technique for the assessment of coronary artery disease(CAD).The dramatic reduction in the prevalence of CAD and significantly low risk population that presents for the assessment of CAD requires an effective but low risk test for the evaluation of CAD. PROMISE study which is a randomised control trial for the evaluation of functional vs coronary computed tomographic angiography(CCTA) strategies for the assessment of CAD has shown that there was no difference in the medium -term outcome between the 2 strategies. However, CCTA resulted in more coronary angiography and revascularisation and more ionising radiation exposure. This was also shown in a retrospective propensity matched study when stress Echocardiography was compared with CCTA. A longer term study comparing functional vs CCTA+functional testing did show reduction in acute myocardial infarction with the latter strategy but not mortality. This is attributed to the detection of patients with non-obstructive CAD who benefitted from stain therapy. Simultaneous assessment of carotid atherosclerosis and ischemia by SE also showed improved prognostic benefit beyond ischemia. Furthermore, SE can also detect underlying valvular and cardiomyopathic condition which cause chest pain including detection of hibernating myocardium.

    Dr Douglas Shook

     Chief of Cardiac Anaesthesia
    Brigham and Women's Hospital, USA

    Douglas is the Division Chief for Cardiac Anaesthesia at Brigham and Women’s Hospital. He is Chair of the Fellowship Program Directors Council for the Society of Cardiovascular Anaesthesiologists (SCA) and is a Co-Chair of the Education Committee for the American Society of Echocardiography. Previously Douglas served on the Board of Directors for the SCA and Co-Directed SCA Echo Week.

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    Professor John Simpson

    Professor of Paediatric and Fetal Cardiology
    Guy's and St Thomas' NHS Foundation Trust

    John trained at the University of Edinburgh, Evelina London and at the University of California, San Francisco. He has published over 250 papers and textbooks and presented widely, particularly on echocardiographic imaging of congenital heart disease (CHD). He was lead author on the joint USA/European guidelines on 3D echo in CHD. He is Chief Investigator of a BHF transational grant on use of extended reality imaging in CHD, and is president of the British Congenital Cardiac Association.

    Transposition of the great arteries and congenitally corrected transposition of the great arteries: Diagnosis to long term follow up

    Transposition of the great arteries (TGA) and congenitally corrected TGA (CCTGA) may sound similar but are fundamentally different in their anatomy, mode of presentation and consideration for longer term management.

    TGA: There are discordant ventriculo-arterial connections leading to neonatal cyanosis, which is palliated by balloon atrial septostomy to improve mixing and Prostglandin E administration. Definitive treatment is via the arterial switch operation which involves transfer of the coronary arteries to the neo-aorta. Longer term considerations include:

    • The fate of the coronary arteries
    • Dilation of the neo-aorta
    • Branch pulmonary artery stenosis.

    In younger patients, this can be assessed echocardiographically but in older patients multimodality imaging including MRI and CT is vital to plan care. In the UK, this approach has been adopted since the late 1980s which limits information on truly long term prognosis.


    CCTGA: In CCTGA both the atrioventricular connections and the ventriculo-arterial connections are discordant. The delivery of oxygenated blood to the body and deoxygenated blood to the lungs is physiologically correct but the morphological right ventricle (mRV) pumps systemic arterial blood. In most cases there are associated lesions including VSD, pulmonary stenosis and Ebstein anomaly. Conduction disturbances are frequency due to the underlying anatomy.

    In isolation, the treatment options include conservative medical management versus complex surgery to redirect atrial flow and switch the great arteries (“double switch”).

    Longer term considerations include

    • Function / failure of the mRV
    • Tricuspid valve regurgitation
    • Arrhythmias
    • Complications of “double switch” including baffle leaks/stenosis and aortic dilation

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    Dr Anjana Siva

    Consultant Cardiologist and Head of Echocardiography
    Portsmouth Hospitals NHS Trust

    As a head of echo, Anjana is committed to training and developing cardiac physiologists in advanced echocardiography from particular protocols, such as pulmonary hypertension echo to contrast echo, stress echo and TOE. She is also a member of the BSE education committee.

    Dr Rick Steeds

    Consultant Cardiologist
    University Hospitals Birmingham NHS Foundation Trust

    Rick is the Clinical Lead for cardiovascular imaging, incorporating multimodality echocardiography, magnetic resonance and nuclear imaging. He is a past-President of the BSE, having previously been responsible for education with the Society at national level for more than 10 years. He is an Honorary Reader at the Institute of Cardiovascular Sciences, University of Birmingham.

    Echocardiography in the assessment of constriction

    All you ever wanted to know about constriction but were afraid to ask!

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    Professor Martin Stout

    Consultant Cardiac Physiologist and Vice President of the British Society of Echocardiography
    Manchester University NHS Foundation Trust

    Current Vice President of the British Society of Echocardiography, former Education Committee Chair and Vice Chair. A Consultant Physiologist based in Manchester specialising in cardiac imaging for acute medicine. A fellow of both the ESC and BSE. Previously led academic programmes in cardiac science at MSc and PhD level, authored numerous papers in cardiac imaging and invited as faculty to numerous meetings nationally and internationally. 

    Dr Shivasankar Murugan Sukumar

    ST4 Cardiology Registrar
    United Lincolnshire Hospitals NHS Trust

    Shivasankar graduated as a doctor from India and moved to the UK for his foundation years in medicine. After completing his core medical training in the east of England, he worked as a Cardiology Fellow at the Bart's Heart Centre, before moving to the east midlands to start his cardiology training post.

    The registrar journey at ST3

    This talk is my personal journey as an ST3 Cardiology Registrar starting in echocardiography and what worked, and what didn't. As I continue on my journey towards a BSE accreditation it feels exciting and scary at the same time, particularly trying to meet the numbers in the logbook while at the same time shuffling other areas of cardiology and general medicine on calls. I am sure everyone who has been on this journey could relate to it and I hope those starting might find it useful.

    Dr Madhav Swaminathan

    Professor of Anesthesiology and Vice Chair for Faculty Affairs
    Duke University, USA

    Madhav is a tenured Professor of Anesthesiology and the Vice-Chair for Faculty Affairs at Duke University, USA. His research interests include perioperative echocardiography and acute kidney injury. He most recently served the American Society of Echocardiography as its 30th President from 2019 to 2020.

    Perioperative diastolic dysfunction

    Diastolic dysfunction remains an important determinant of hemodynamic performance in patients undergoing cardiac surgery. The hemodynamic perturbations typical of the perioperative period reflect rapid fluctuations in preload, afterload and contractility, all of which are influenced by and in turn influence left ventricular diastolic function. Critical in the management of these patients is an appreciation of the proper left ventricular filling pressures for ensuring adequate cardiac output. The echocardiographic parameters for determining diastolic dysfunction and filling pressures are primarily based on spectral Doppler assessment of transmitral flow, pulmonary vein flow and tissue Doppler velocities. An algorithmic approach to both estimation of filling pressures and hemodynamic management based on echocardiographic parameters is important. Establishing the nature and severity of diastolic dysfunction will help define postoperative surveillance for ensuring optimal outcomes after cardiac surgery.

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    Dr Paaladinesh Thavendiranathan

    Cardiologist and Associate Professor of Medicine
    Peter Munk Cardiac Centre, University of Toronto

    Dinesh is a cardiologist at the Toronto General Hospital, University of Toronto, as well as an associate professor of medicine and a clinician scientist. His clinical practice involves work with cardiac MRI, CT, and echocardiography. He is the Director of the Ted Rogers Program in Cardiotoxicity Prevention. His research focus is in the use of advanced cardiac imaging techniques for detection and management of cardiomyopathy. He is also an international expert in the field of Cardio-oncology and holds a Canada Research Chair in the field.

    SUCCOUR Trial: Relevance to Clinical Practice

    The SUCCOUR trial is the first imaging based randomized controlled trial in the field of cardiooncology. The study compared two echocardiography imaging strategies to identify early cardiac injury, initiate cardioprotective therapy, and prevent the decrement in LVEF and development of CTRCD in high risk patients receiving anthracycline based cancer therapy. The two strategies compared were GLS based initiation of cardioprotective therapy versus LVEF based monitoring (Standard of care). The 1 year results of the SUCCOUR study and its relevance to clinical practice will be discussed.

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    Dr Israel Valverde

    Head of Paediatric Cardiology
    Hospital Virgen del Rocio, Spain

    Israel has clinical expertise is in advanced 3D imaging, including echocardiography, MRI and CT. His translational research focused on adaptation of novel cardiac MRI technology and pioneering the translation of 3D printed models to improve patient care of children and adults with heart diseases. He is an honorary senior lecturer at King's College London, UK.

    Multimodality imaging fusion for 3D printed models and virtual reality

    A combination of multimodal imaging including MRI, echocardiography and CT is the key for advanced surgical and interventional planning based on 3D printing, Virtual Reality and Augmented Reality.

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    Miss Kelly Victor

    Head of Echocardiography
    Cleveland Clinic London

    Kelly is a clinical scientist with accreditation in TTE and TOE. She is the lead for echocardiography at Cleveland Clinic London. Her interests lie in valve disease and structural valve intervention. She has completed a doctorate thesis in mitral regurgitation in heart failure. Kelly is currently communications committee chair at the BSE.

    Communications

    This session will provide a brief overview of the activity of the communications committee over the last 12 months. It will outline our 2020-2021 achievements and the important role communications played during the COVID-19 pandemic. With a focus on delivering on our annual objectives, this session will describe our focus and delivery strategy in relation to he BSE National Workforce Survey, the development and accessibility of useful and applicable Membership Resources, and the creation and roll out of a BSE Writing Club. Kelly Victor will be welcoming Dr Emma Rees to this session so that we can find out more about the BSE Writing Club, set to start at the end of 2021, on which Dr Rees will be leading. We will be discussing the structure, what’s in it for members, what’s the purpose, who’s eligible, as well as opportunities for how you might like to get involved. We look forward to welcoming you to this session.

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    Professor Antoine Vieillard-Baron

    Head of Intensive Care Unit
    Assistance Publique Hopitaux De Paris, France

    Antoine is well known for his research on cardiopulmonary interactions, ARDS, and mechanical ventilation. He has been a pioneer in using transesophageal echocardiography to elucidate the pathophysiology of adverse effects of ventilatory support on hemodynamic function. In addition, he has defined the utility of transesophageal echocardiography (TEE) as a primary clinical tool for hemodynamic monitoring of the critically ill patient.

    Mr Joseph Walukiewicz

    Chief Cardiac Physiologist
    United Lincolnshire Hospitals NHS Trust

    Joseph is a Physiologist with a passion for Physiologist led bubble contrast clinics and interests in Cardio-oncology, Stress Echocardiography and Echo in the Cath Lab. He currently help to deliver the Echo training for Physiologists and Cardiology Registrars at Lincoln County Hospital.

    Basics of Echocardiography and Doppler: Optimization and calculations

    Image optimization and the accurate utilisation of Doppler are crucial components of performing an Echocardiogram. During Registrar Echo training, to an extent these can be overlooked as the desire for understanding the anatomy in context of Echocardiographic views, and interpretation of findings for clinical use, may be the prime focus of the Registrar learning Echo. Here, he will outline the importance of optimization, demonstrate the components of optimization and propose a straightforward method of optimizing (with reference to basic calculations) in an attempt to demystify optimization and encourage the Registrar to engage with optimization and enjoy doing so during their Echo training.

    Dr Jess Webster

    Consultant in Cardiac Anaesthesia and Intensive Care
    University Hospitals Bristol NHS Foundation Trust

    Jess specialises in cardiac anaesthesia, cardiac ICU and procedural TOE at the Bristol Heart Institute having trained in units such as Harefield, the Royal Brompton and Barts Heart Centre. She has a particular interest in adult congenital heart patients for cardiac and non-cardiac surgery.

    Windmills in theatre

    This presentation looks into patients who need aortic valve replacement and takes an overview of their current options. We go on to discuss a novel approach which could give patients more choice

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    Ms Cathy West

    Principal Echocardiographer
    Royal Brompton and Harefield NHS Foundation Trust

    Cathy is passionate about teaching, and has spent the last 10 years specialising in echo in adult patients with congenital heart disease.

    Segmental approach to congenital echocardiography

    If you have been trained in adult echo and find congenital heart disease a bit baffling, this is the session for you! I’ll explain why congenital echo starts at the subcostal window, how to approach hearts which aren’t in the right place and explain some key concepts used in congenital scanning.

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    Dr Carol Whelan

    Consultant Cardiologist and Honorary Associate Professor
    Royal Free London NHS Foundation Trust

    Carol was appointed as Consultant Cardiologist with an interest in imaging, heart failure and, in particular, cardiac amyloidosis, in October 2009 at the Royal Free London NHS Foundation Trust. She was appointed as Honorary Senior Lecturer in 2010 at UCL in recognition for her work at the National Amyloidosis Centre. In July 2020, she was conferred the title of Honorary Associate Professor. She became the hospital clinical lead for Heart Failure in 2011 and is now the Trust lead.

    In November 2019, Carol was appointed as councillor on the board of the British Society for Heart Failure. She wrote the chapter on cardiac amyloidosis in the latest Oxford Textbook of Heart Failure and has published widely on this subject.

    As a clinical expert, she recently assisted the NICE committee in their evaluation of two novel treatments, inotersen and patisiran, for hereditary transthyretin amyloidosis. These have both been approved.

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    Dr James Willis

    Senior Clinical Scientist
    Royal United Hospitals Bath NHS Foundation Trust

    James is a clinical scientist with an interest in both echocardiography and research working at the Royal United Hospital in Bath.

    Physiologist and scientist-led clinics: Set-up to current UK practice

    This presentation will look at what is required to set-up a physiologist or scientist led service. What is the current practice within the UK and based on initial data from the BSE NSTEP study, discuss the different models being employed within the study cohort.

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    Dr Susan Wright

     Consultant Anaesthetist
    St George's University Hospitals NHS Foundation Trust

    Sue Wright FRCA FFICM was an early adopter of intraoperative TOE in the UK. She has since led the development of an echo simulator and has played an active role in echo education throughout her career as a cardiac anaesthetist.

    TOE for TAVI

    This presentation will cover the use of TOE during transcatheter aortic valve implantation, with a focus on procedure guidance, the assessment of implanted TAVI valves and the identification of complications of the procedure.