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Expert CONSULT Don’t Forget Your Online Access to Elsevier | ExpertConsult.com Enhanced eBooks for medical professionals Compatible with PC, Mac®, most mobile devices, and eReaders, Expert Consult allows you to browse, search, and interact with this title – online and offl ine. Redeem your PIN at expertconsult.com today! PIN REDEMPTION INSTRUCTIONS Start using these innovative features today: (cid:129) Seamless, real-time integration between devices 1. Login or Sign Up at ExpertConsult.com 2. Scratch off your PIN code below (cid:129) Straightforward navigation and search 3. Enter PIN into the “Redeem a Book Code” box (cid:129) Notes and highlights sharing with other users 4. Click “Redeem” through social media 5. Go to “My Library” (cid:129) Enhanced images with annotations, labels, and hot spots for zooming on specifi c details * (cid:129) Live streaming video and animations * (cid:129) Self-assessment tools such as questions embedded within the text and multiple-format quizzes * * some features vary by title Use of the current edition of the electronic version of this book (eBook) is subject to the terms of the nontransferable, limited license granted on ExpertConsult.com. Access to the eBook is limited to the fi rst individual who redeems the PIN, located on the inside cover of this book, at ExpertConsult.com and may not be transferred to another party by resale, lending, or other means. For technical assistance: Email: [email protected]; Call: within the US and Canada: 800-401-9962; outside the US and Canada: +1-314-447-8200 ’ ASE s Comprehensive Echocardiography ’ ASE s Comprehensive Echocardiography ROBERTO M. LANG, MD, FASE, FACC, FAHA, FESC, FRCP ProfessorofMedicine Director,NoninvasiveCardiacImagingLaboratories UniversityofChicagoMedicalCenter Chicago,Illinois STEVEN A. GOLDSTEIN, MD, FACC Director,NoninvasiveCardiologyLab WashingtonHospitalCenter Washington,DistrictofColumbia ITZHAK KRONZON, MD, FASE, FACC, FAHA, FESC, FACP ProfessorofMedicine DepartmentofCardiology HofstraUniversitySchoolofMedicine,andLIJ/NorthShoreLenoxHillHospital, NewYork,NewYork BIJOY K. KHANDHERIA, MD, FASE, FACC, FESC, FACP Director,EchocardiographyServices AuroraHealthCare AuroraMedicalGroup AuroraSt.LukeMedicalCenter Director,EchocardiographyCenterforResearchandInnovation AuroraResearchInstitute Co-Director,AuroraCenterforCardio-Oncology ClinicalAdjunctProfessorofMedicine UniversityofWisconsinSchoolofMedicine Milwaukee,Wisconsin VICTOR MOR-AVI, PhD, FASE Professor,DirectorofCardiacImagingResearch UniversityofChicagoMedicalCenter Chicago,Illinois 1600JohnF.KennedyBlvd. Ste1800 Philadelphia,PA19103-2899 ASE’SCOMPREHENSIVEECHOCARDIOGRAPHY, SECONDEDITION ISBN:978-0-323-26011-4 Copyright©2016,2011bySaunders,animprintofElsevierInc. Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,electronicor mechanical,includingphotocopying,recording,oranyinformationstorageandretrievalsystem,without permissioninwritingfromthepublisher.Detailsonhowtoseekpermission,furtherinformationaboutthe Publisher’spermissionspoliciesandourarrangementswithorganizationssuchastheCopyrightClearance CenterandtheCopyrightLicensingAgency,canbefoundatourwebsite:www.elsevier.com/permissions. ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher(other thanasmaybenotedherein). Notices Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchandexperiencebroaden ourunderstanding,changesinresearchmethods,professionalpractices,ormedicaltreatmentmaybecome necessary. Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluatingand usinganyinformation,methods,compounds,orexperimentsdescribedherein.Inusingsuchinformationor methodstheyshouldbemindfuloftheirownsafetyandthesafetyofothers,includingpartiesforwhomthey haveaprofessionalresponsibility. Withrespecttoanydrugorpharmaceuticalproductsidentified,readersareadvisedtocheckthemostcurrent informationprovided(i)onproceduresfeaturedor(ii)bythemanufacturerofeachproducttobeadministered, toverifytherecommendeddoseorformula,themethodanddurationofadministration,andcontraindications. Itistheresponsibilityofpractitioners,relyingontheirownexperienceandknowledgeoftheirpatients,to makediagnoses,todeterminedosagesandthebesttreatmentforeachindividualpatient,andtotakeall appropriatesafetyprecautions. Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditors,assumeany liabilityforanyinjuryand/ordamagetopersonsorpropertyasamatterofproductsliability,negligenceor otherwise,orfromanyuseoroperationofanymethods,products,instructions,orideascontainedinthe materialherein. LibraryofCongressCataloging-in-PublicationData Dynamicechocardiography ASE’scomprehensiveechocardiography/[editedby]RobertoM.Lang,StevenA.Goldstein,Itzhak Kronzon,BijoyK.Khandheria,VictorMor-Avi.–Secondedition. p.;cm. AmericanSocietyofEchocardiographycomprehensiveechocardiography Comprehensiveechocardiography PrecededbyDynamicechocardiography/AmericanSocietyofEchocardiography;[editedby] RobertoM.Lang...[etal.]c2011. Includesbibliographicalreferencesandindex. ISBN978-0-323-26011-4(hardcover:alk.paper) I.Lang,RobertoM.,editorII.Goldstein,StevenA.,M.D.,editorIII.Kronzon,Itzhak,editor.IV.Khandheria, Bijoy,editor.V.Mor-Avi,Victor,editor.VI.AmericanSocietyofEchocardiography,issuingbody.VII.Title. VIII.Title:AmericanSocietyofEchocardiographycomprehensiveechocardiography.IX.Title: Comprehensiveechocardiography. [DNLM:1.Echocardiography–methods.2.CardiovascularDiseases–ultrasonography.WG141.5.E2] RC683.5.U5 616.1’207543–dc23 2014043847 SeniorContentStrategist:DoloresMeloni ContentDevelopmentManager:MargaretNelson PublishingServicesManager:PatriciaTannian ProjectManager:KateMannix DesignDirection:BrianSalisbury PrintedinChina Lastdigitistheprintnumber:9 8 7 6 5 4 3 2 1 Contributors AmrE.Abbas,MD,FACC,FSCAI,FASE YoramAgmon,MD LuigiP.Badano,MD,PhD,FESC,FACC BeaumontHealth Director,EchocardiographyLaboratoryand Professor RoyalOak,Michigan HeartValvesClinic DepartmentofCardiac,Thoracic,and DepartmentofCardiology VascularSciences RambamHealthCareCampus; UniversityofPadua SaharS.Abdelmoneim,MD,MSc, AssociateClinicalProfessor Padua,Italy MS,FESC BruceRappaportFacultyofMedicine AssistantProfessorofMedicine Technion–IsraelInstituteofTechnology RevathiBalakrishnan,MD ResearchAssociateofCardiovascular Haifa,Israel CardiologyFellow Diseases LeonH.CharneyDivisionofCardiology MayoClinic MohamedAhmed,MD NewYorkUniversityLangoneMedical Rochester,Minnesota DepartmentofMedicine Center DivisionofCardiovascularMedicine NewYork,NewYork UniversityofMassachusetts TheodoreAbraham,MD MedicalSchool SourinBanerji,MD AssociateProfessor UmassMemorialHealthcare HeartFailureandTransplantFellow DepartmentofCardiology Worcester,Massachusetts UniversityofPennsylvaniaPerelman TheJohnsHopkinsUniversitySchool SchoolofMedicine CarlosAlviar,MD ofMedicine Philadelphia,Pennsylvania CardiologyFellow Baltimore,Maryland LeonH.CharneyDivisionofCardiology SripalBangalore,MD,MHA NewYorkUniversityLangoneMedical AssociateProfessorofMedicine Center HarryAcquatella,MD,FASE DivisionofCardiology NewYork,NewYork Director DirectorofResearch EchocardiographyLaboratory BonitaAnderson,DMU(Cardiac), CardiacCatheterizationLaboratory DepartmentofMedicine MApplSc(MedUltrasound) Director CentroMedico SeniorLecturer CardiovascularOutcomesGroup Caracas,Venezuela MedicalRadiationSciences NewYorkUniversitySchoolofMedicine QueenslandUniversityofTechnology NewYork,NewYork Brisbane,Queensland,Australia DavidB.Adams,RCS,RDCS,FASE ManishBansal,MD CardiacSonographer EdgarArgulian,MD,MPH AssistantProfessorofPediatrics CardiacDiagnosticClinic MountSinaiSt.Luke’sHospital DepartmentofPediatricCardiology DukeUniversityMedicalCenter MountSinaiHealthSystem TexasChildren’sHospital/BaylorCollege Durham,NorthCarolina NewYork,NewYork ofMedicine Houston,Texas FedericoM.Asch,MD,FACC,FASE AssociateDirector KarimaAddentia,MD ThomasBartel,MD CardiovascularCoreLaboratories SectionofCardiology HeartandVascularInstitute MedStarHealthResearchInstituteat DepartmentofMedicine ClevelandClinic WashingtonHospitalCenter; UniversityofChicago AbuDhabi,UnitedArabEmirates AssistantProfessorofMedicine Chicago,Illinois GeorgetownUniversity RebeccaLynnBaumann,MD Washington,DC Fellow JonathanAfilalo,MD,MSc GerardP.Aurigemma,MD,FASE DepartmentofCardiology DivisionsofCardiologyandClinical DivisionofCardiovascularMedicine UMassMemorialMedicalCenter Epidemiology DepartmentofMedicine Worcester,Massachusetts JewishGeneralHospital UniversityofMassachusettsMedical McGillUniversity School HelmutBaumgartner,MD Montreal,Quebec,Canada UmassMemorialHealthcare Director DivisionofAdultCongenitalandValvular Worcester,Massachusetts HeartDisease VikramAgarwal,MD,MPH KellyAxsom,MD DepartmentofCardiovascularMedicine DepartmentofMedicine Fellow UniversityHospitalMuenster; DivisionofCardiology CardiovascularDiseases ProfessorofCardiology/AdultCongenital MountSinaiSt.Luke’sandRoosevelt LeonH.CharneyDivisionofCardiology HeartDisease Hospitals NewYorkUniversityLangoneMedical MedicalFaculty MountSinaiHealthNetwork Center UniversityofMuenster NewYork,NewYork NewYork,NewYork Muenster,Germany v vi Contributors RoyBeigel,MD DarrylJ.Burstow,MBBS,FRACP BlaiColl,MD TheHeartInstitute AssociateProfessor DepartmentofInternalMedicine CedarsSinaiMedicalCenter DepartmentofMedicine SectionofCardiology LosAngeles,California; UniversityofQueensland; RushUniversityMedicalCenter TheLevievHeartCenter SeniorStaffCardiologist Chicago,Illinois ShebaMedicalCenteratTelHashomer DepartmentofCardiology SacklerSchoolofMedicine ThePrinceCharlesHospital VivianW.Cui,MD TelAvivUniversity Brisbane,Queensland,Australia ResearchandEducationSonographer TelAviv,Israel DepartmentofPediatric Echocardiography BenjaminByrdIII,MD AdvocateChildren’sHospital J.ToddBelcik,RCS,RDCS Professor OakLawn,Illinois SeniorResearchAssociate/Research DepartmentofMedicine Sonographer VanderbiltUniversitySchoolofMedicine MaurizioCusma-Picconne,MD,PhD KnightCardiovascularInstitute Nashville,Tennessee CardiologyInstitution OregonHealth&ScienceUniversity DepartmentofClinicalandExperimental Portland,Oregon ScipioneCarerj,MD Medicine CardiologyInstitution UniversityofMessina MarekBelohlavek,MD,PhD DepartmentofClinicalandExperimental Messina,Italy ProfessorofMedicineand Medicine AbdellazizDahou,MD,MSc Bioengineering UniversityofMessina ProfessorofMedicine Director Messina,Italy DepartmentofMedicine TranslationalUltrasoundResearch QuebecHeartandLungInstitute Laboratory JohnD.Carroll,MD Quebec,Quebec,Canada DepartmentofInternalMedicine Director DivisionofCardiology CardiacandVascularCenter JacobP.Dal-Bianco,MD MayoClinic Director DepartmentofCardiology Scottsdale,Arizona InterventionalCardiology MassachusettsGeneralHospital DivisionofCardiology Boston,Massachusetts RicardoBenenstein,MD UniversityofColoradoDenver DanielA.Daneshvar,MD AssistantProfessorofMedicine Aurora,Colorado CardiologyFellow LeonH.CharneyDivisionofCardiology NorthShoreLIJ/LenoxHillHospital NewYorkUniversityLangoneMedical ScottChadderdon,MD NewYork,NewYork Center OregonHealth&ScienceUniversity NewYork,NewYork Portland,Oregon MelissaA.Daubert,MD AssistantProfessorofMedicine EricBerkowitz,MD HariP.Chaliki,MD DukeUniversityMedicalCenter DepartmentofCardiovascularDisease AssociateProfessorofMedicine Durham,NorthCarolina LenoxHillHospital DivisionofCardiovascularMedicine RavinDavidoff,MBBCh NewYork,NewYork MayoClinic ChiefMedicalOfficer Scottsdale,Arizona SectionofCardiovascularMedicine NicoleM.Bhave,MD BostonUniversitySchoolofMedicine DepartmentofInternalMedicine Kwan-LeungChan,MD,FRCPC,FAHA, BostonMedicalCenter DivisionofCardiovascularMedicine FACC Boston,Massachusetts UniversityofMichiganMedicalCenter UniversityofOttawaHeartInstitute AnnArbor,Michigan Ottawa,Ontario,Canada JeanneM.DeCara,MD AssociateProfessorofMedicine SectionofCardiology AngeloBiviano,MD FarooqA.Chaudhry,MD,FACP,FACC, UniversityofChicagoMedicine CenterforInterventionalVascularTherapy FASE,FAHA Chicago,Illinois ColumbiaUniversityMedicalCenter Director NewYork,NewYork EchocardiographyLaboratory AntoniaDelgado-Montero,MD DepartmentofMedicine DepartmentofCardiology NimrodBlank,MD DivisionofCardiology UniversityofPittsburgh DivisionofCardiology IcahnSchoolofMedicineatMount Pittsburgh,Pennsylvania JewishGeneralHospital SinaiHospital Montreal,Quebec,Canada NewYork,NewYork LisaDellefave-Castillo,MS,CGC GeneticCounselor DepartmentofMedicine GeoffChidsey,MD RobertO.Bonow,MD,MS TheUniversityofChicago AssistantProfessor MaxandLillyGoldbergDistinguished Chicago,Illinois DepartmentofCardiology ProfessorofCardiology VanderbiltUniversityMedicalCenter Director AnkitA.Desai,MD Nashville,Tennessee CenterforCardiovascularInnovation AssistantProfessorofMedicine DivisionofCardiology DivisionofCardiology NorthwesternUniversityFeinbergSchool SofiaChurzidse,MD SarverHeartCenter ofMedicine UniversityClinicEssen UniversityofArizona Chicago,Illinois Essen,Germany Tucson,Arizona Contributors vii KavitA.DeSouza,MD ArturoA.Evangelista,MD StevenA.Goldstein,MD,FACC InterventionalCardiology Professor Director ColumbiaUniversityDivisionof CardiacImagingDepartment NoninvasiveCardiologyLab Cardiology HospitalUniversitariValld’Hebron WashingtonHospitalCenter MountSinaiMedicalCenter Barcelona,Spain Washington,DC MiamiBeach,Florida StevenB.Feinstein,MD JohnGorcsanIII,MD BryanDoherty,MD DepartmentofInternalMedicine ProfessorofMedicine CardiologyFellow SectionofCardiology DepartmentofCardiology NS/LIJLenoxHillHospital RushUniversityMedicalCenter UniversityofPittsburgh NewYork,NewYork Chicago,Illinois Pittsburgh,Pennsylvania RobertDonnino,MD BeatrizFerreira,MD,PhD RiccardoGorla,MD AssistantProfessorofMedicine DepartmentofCardiology DepartmentofCardiology DepartmentsofRadiologyandMedicine MaputoHeartInstitute WestGermanHeartCentre NewYorkUniversityLangoneMedical Maputo,Mozambique Essen,Germany Center DepartmentofVeteransAffairs ElyseFoster,MD JuliaGrapsa,MD,PhD DepartmentofCardiology NewYorkHarborHealthcareSystem ProfessorofMedicine HammersmithHospital NewYork,NewYork AraxeVilenskyEndowedChair Cardiology ImperialCollegeofLondon London,UnitedKingdom PamelaS.Douglas,MD,MACC, UniversityofCalifornia FASE,FAHA SanFrancisco,California ErinS.Grawe,MD UrsulaGellerProfessorofResearchin AssistantProfessorofClinical CardiovascularDisease BenjaminH.Freed,MD Anesthesia DukeUniversitySchoolofMedicine; AssistantProfessorofMedicine DepartmentofAnesthesiology Director NorthwesternMemorialHospital UniversityofCincinnatiMedicalCenter ImagingProgram FeinbergSchoolofMedicine Cincinnati,Ohio DukeClinicalResearchInstitute Chicago,Illinois Durham,NorthCarolina ChristianeGruner,MD JuliusM.Gardin,MD,MBA DepartmentofCardiology DavidM.Dudzinski,MD,JD,FAHA ProfessorandChair UniversityHeartCenter FellowinEchocardiography DepartmentofMedicine UniversityHospital CardiacUltrasoundLaboratoryand HackensackUniversityMedicalCenter Zurich,Switzerland CriticalCareDepartment Hackensack,NewJersey; MassachusettsGeneralHospital Professor PoojaGupta,MD,FAAP,FACC,FASE Boston,Massachusetts DepartmentofMedicine AssistantProfessorofPediatrics RutgersNewJerseyMedicalSchool WayneStateUniversitySchoolof RalucaDulgheru,MD Newark,NewJersey Medicine; GIGACardiovascularSciences Director DepartmentofCardiology EdwardA.Gill,MD MichiganAdultCongenitalHeartCenter HeartValveClinicUniversityofLie´ge ProfessorofMedicine Children’sHospitalofMichigan UniversityHospitalSartTilman AdjunctProfessorofRadiology Detroit,Michigan Lie´ge,Belgium DepartmentsofMedicineandCardiology UniversityofWashington; SwaminathaGurudevan,MD JeanG.Dumesnil,MD,FRCPC,FACC, DirectorofEchocardiography SeniorClinicalCardiologist FASE(Hon:) HarborviewMedicalCenter DepartmentofCardiology ProfessorofMedicine Seattle,Washington HealthcarePartnersMedicalGroup DepartmentofMedicine Pasadena,California QuebecHeartandLungInstitute LindaGillam,MD,MPH Quebec,Quebec,Canada Chair RebeccaT.Hahn,MD,FACC,FASE DepartmentofCardiovascularMedicine ColumbiaCollegeofPhysiciansand UriElkayam,MD MorristownMedicalCenter Surgeons DivisionofCardiology Morristown,NewJersey ColumbiaUniversityMedicalCenter UniversityofSouthernCalifornia NewYork,NewYork LosAngeles,California StevenGiovannone,MD CardiologyFellow YuchiHan,MD,MMSc RaimundErbel,MD,FASE,FAHA,FACC, LeonH.CharneyDivisionofCardiology AssistantProfessor FESC NewYorkUniversityLangoneMedical CardiovascularDivision Professor Center DepartmentofMedicine DepartmentofCardiology NewYork,NewYork UniversityofPennsylvania UniversityClinicEssen Philadelphia,Pennsylvania Essen,Germany MarkGoldberger,MD DivisionofCardiology JenniferL.Hellawell,MD FrancineErenberg,MD DepartmentofMedicine Fellow DepartmentofPediatricCardiology ColumbiaUniversityCollegeofPhysicians CardiovascularMedicine ClevelandClinic andSurgeons BostonMedicalCenter Cleveland,Ohio NewYork,NewYork Boston,Massachusetts viii Contributors SamuelD.Hillier,MBChB,MA,FRACP Co-Director,AuroraCenterfor PayalKohli,MD DepartmentofEchocardiography Cardio-Oncology DivisionofCardiology ThePrinceCharlesHospital; ClinicalAdjunctProfessorofMedicine DepartmentofMedicine SchoolofMedicine UniversityofWisconsinSchoolofMedicine UniversityofCalifornia UniversityofQueensland Milwaukee,Wisconsin SanFrancisco,California Brisbane,Queensland,Australia GeneH.Kim,MD ClaudiaE.Korcarz,DVM,RDCS,FASE BrianD.Hoit,MD,FACC,FASE AssistantProfessorofMedicine SeniorScientist Professor AdvancedHeartFailureandCardiac DepartmentofMedicine DepartmentofMedicine,Physiologyand Transplantation CardiovascularMedicineDivision Biophysics InstituteofCardiovascularResearch UniversityofWisconsinSchoolof CaseWesternReserveUniversity; DepartmentofMedicine MedicineandPublicHealth DirectorofEchocardiography UniversityofChicago Madison,Wisconsin HarringtonHeart&VascularCenter Chicago,Illinois UniversityHospitalCaseMedicalCenter MichaelS.Kim,MD SmadarKort,MD,FACC,FASE,FAHA Cleveland,Ohio AssistantProfessorofMedicine ProfessorofMedicine CardiologyDirector DirectorofCardiovascularImaging RichardHumes,MD,FAAP,FACC, StructuralHeartDiseaseProgram Director,ValveCenter FASE SectionofInterventionalCardiology StonyBrookUniversityMedicine ProfessorofPediatrics UniversityofColoradoDenver StonyBrook,NewYork WayneStateUniversitySchoolofMedicine; AnschutzMedicalCampus Chief,DivisionofCardiology Aurora,Colorado WojciechKosmala,MD,PhD Children’sHospitalofMichigan Professor Detroit,Michigan BruceJ.Kimura,MD,FACC DepartmentofCardiology MedicalDirector WroclawMedicalUniversity VikrantJagadeesan,MD CardiovascularUltrasoundLaboratory Wroclaw,Poland DepartmentofMedicine ScrippsMercyHospital; SectionofCardiology AssociateClinicalProfessor KonstantinosKoulogiannis,MD UniversityofChicago DepartmentofCardiology AssociateDirector Chicago,Illinois UniversityofCalifornia CardiovascularCoreLab SanDiego,California DepartmentofCardiovascularMedicine SoniaJain,MD,MBBS MorristownMedicalCenter Fellow MaryEttaKing,MD GagnonCardiovascularInstitute CardiovascularDisease AssociateProfessorofPediatrics Morristown,NewJersey MayoClinic HarvardMedicalSchool; Rochester,Minnesota StaffEchocardiographer CardiacUltrasoundLaboratory IliasKoutsogeorgis,MD AlexanderJanosi,MD MassachusettsGeneralHospital DepartmentofCardiology DepartmentofCardiology Boston,Massachusetts HammersmithHospital ImperialCollegeofLondon West-GermanHeartandVascularCenter DmitryKireyev,MD London,UnitedKingdom UniversityofDuisburg-Essen ClinicalandResearchFellowinMedicine Essen,Germany CardiacUltrasoundLaboratory FrederickW.Kremkau,PhD,FACR, PeterA.Kahn,BA CardiologyDivision FAIUM MS-2AlbertEinsteinCollegeofMedicine DepartmentofMedicine ProfessorofRadiologicSciences YeshivaUniversity MassachusettsGeneralHospital CenterforAppliedLearning NewYork,NewYork; Boston,Massachusetts WakeForestUniversitySchoolof BloombergSchoolofPublicHealth Medicine JamesN.Kirkpatrick,MD JohnsHopkinsUniversity Winston-Salem,NorthCarolina AssistantProfessor Baltimore,Maryland CardiovascularMedicineDivision EricV.Krieger,MD DepartmentofMedicine SanjivKaul,MD,FASE,FACC DepartmentofMedicalEthicsandHealth AssistantProfessor ProfessorandDivisionHead Policy DepartmentsofMedicineandCardiology CardiovascularMedicine UniversityofPennsylvania UniversityofWashington; OregonHealth&ScienceUniversity Philadelphia,Pennsylvania DirectorofEchocardiography Portland,Oregon AdjunctProfessorofRadiology AllanL.Klein,MD,FRCP(C),FACC, DepartmentsofMedicineandCardiology BijoyK.Khandheria,MD,FASE,FACC, FAHA,FASE HarborviewMedicalCenter FESC,FACP ProfessorofMedicine Seattle,Washington Director ClevelandClinicLernerCollegeof EchocardiographyServices Medicine ItzhakKronzon,MD,FASE,FACC, AuroraHealthCare CaseWesternReserveUniversity; FAHA,FESC,FACP AuroraMedicalGroup DirectorofPericardialCenter ProfessorofMedicine Aurora/St.LukeMedicalCenter; CardiovascularMedicine DepartmentofCardiology Director,EchocardiographyCenterfor HeartandVascularInstitute HofstraUniversitySchoolofMedicine, ResearchandInnovation ClevelandClinic andLIJ/NorthShoreLenoxHill,Hospital AuroraResearchInstitute; Cleveland,Ohio NewYork,NewYork Contributors ix RichardT.Kutnick,MD,FASE SteveW.Leung,MD,FACC, JudyR.Mangion,MD AttendingPhysician FRCPC,FASE DivisionofCardiovascularMedicine NS/LIJLenoxHillHospital AssistantProfessorofMedicine BrighamandWomen’sHospital NewYork,NewYork DivisionsofCardiovascularMedicineand HarvardMedicalSchool Radiology Boston,Massachussetts WymanLai,MD,MPH,FACC,FASE UniversityofKentucky ProfessorofPediatricsatCUMC Lexington,Kentucky DivisionofPediatricCardiology SunilV.Mankad,MD,FASE ColumbiaUniversityMedicalCenter AssociateProfessorofMedicine NewYork,NewYork FlorentLeVen,MD DepartmentofCardiovascularDiseases DepartmentofCardiology MayoClinic StephaneLambert,MD,FRCPC BrestUniversityHospital Rochester,Minnesota AssistantProfessor Brest,France; Professor DivisionofCardiacAnesthesiology DepartmentofMedicine DimitriosMaragiannis,MD UniversityofOttawaHeartInstitute LavalUniversity ConsultantCardiologist Ottawa,Ontario,Canada Quebec,Quebec,Canada DepartmentofCardiology 401GeneralArmyHospital PatrizioLancellotti,MD,PhD Athens,Greece; Professor RobertA.Levine,MD PostdoctoralAssociate GIGACardiovascularSciences ProfessorofMedicine DepartmentofCardiology DepartmentofCardiology CardiacUltrasoundLaboratory HoustonMethodistHospital HeartValveClinic MassachusettsGeneralHospital Houston,Texas UniversityofLie`geHospital HarvardMedicalSchool UniversityHospitalSartTilman Boston,Massachusetts; Lie`ge,Belgium FellowinHypertrophicCardiomyopathy LeoMarcoff,MD andEchocardiography AssistantClinicalProfessorof RobertoM.Lang,MD,FASE,FACC, TorontoGeneralHospital Medicine FAHA,FESC,FRCP Toronto,Ontario,Canada DepartmentofMedicine ProfessorofMedicine DivisionofCardiology Director ColumbiaUniversity NoninvasiveCardiacImaging QinLi,MD NewYork,NewYork Laboratories FellowinHypertrophicCardiomyopathy UniversityofChicagoMedicalCenter andEchocardiography Chicago,Illinois TorontoGeneralHospital RandolphP.Martin,MD Toronto,Ontario,Canada Chief AlexPui-WaiLee,MBChB,FHKCP, StructuralandValvularHeartDisease FHKAM CenterofExcellence FabioLima,MPH AssistantProfessor PhysicianPrincipalAdvisor StonyBrookMedicine DivisionofCardiology MarcusHeartValveCenter StonyBrook,NewYork DepartmentofMedicineand PiedmontHeartInstitute; Therapeutics EmeritusProfessorofMedicine FacultyofMedicine JonathanR.Lindner,MD EmoryUniversitySchoolofMedicine TheChineseUniversityofHongKong ProfessorofMedicine Atlanta,Georgia HongKong,China DepartmentofCardiology OregonHealth&ScienceUniversity MingSumLee,MD,PhD Portland,Oregon ThomasH.Marwick,MD,PhD,MPH DepartmentofCardiology MenziesResearchInstitute KaiserFoundationHospital Hobart,Tasmania,Australia LeoLopez,MD,FACC,FAAP,FASE LosAngeles,California MedicalDirectorofNoninvasiveCardiac StamatiosLerakis,MD Imaging PierreMassabuau,MD DepartmentofMedicine MiamiChildren’sHospital CardiologyDepartment DivisionofCardiology Miami,Florida RangueilTeachingHospital Toulouse,France EmoryUniversitySchoolofMedicine Atlanta,Georgia JulienMagne,PhD ResearchAssociate MosesMathur,MD,MSc JonathanLessick,MD,DSc GIGACardiovascularSciences FellowinTraining DirectorofCardiacCT&MRI DepartmentofCardiology DepartmentofMedicine DepartmentofCardiology HeartValveClinic SectionofCardiology RambamHealthCareCampus; UniversityofLie`geHospital TempleUniversityHospital AssistantProfessor UniversityHospitalSartTilman Philadelphia,Pennsylvania BruceRappaportFacultyofMedicine Lie`ge,Belgium Technion–IsraelInstituteofTechnology Haifa,Israel RobertMcCully,MD,MBChB HaifaMahjoub,MD ProfessorofMedicine StevenJ.Lester,MD,FASE DepartmentofMedicine DivisionofCardiovascularDiseasesand DivisionofCardiovascularDiseases QuebecHeartandLungInstitute InternalMedicine MayoClinic LavalUniversity MayoClinic Rochester,Minnesota Quebec,Quebec,Canada Rochester,Minnesota x Contributors EdwinC.McGee,MD MonicaMukherjee,MD VuyisileT.Nkomo,MD,MPH SurgicalDirectorofHeart AssistantProfessorofMedicine AssociateProfessorofMedicine TransplantationandMechanical DepartmentofCardiology DivisionofCardiovascularDiseases Assistance JohnsHopkinsUniversity MayoClinic ProfessorofSurgery Baltimore,Maryland Rochester,Minnesota DepartmentofThoracicand CardiovascularSurgery SilvanaMu€ller,MD ErwinOechslin,MD LoyolaUniversityMedicalCenter UniversityClinicofInternalMedicineIII Director,AdultCongenitalHeartDisease Mayfield,Illinois MedicalUniversityInnsbruck Program Innsbruck,Austria TheBitoveFamilyProfessorofAdult CongenitalHeartDisease ElizabethMcNally,MD,PhD DepartmentofMedicine Director SharonL.Mulvagh,MD,FACC,FASE PeterMunkCardiacCentre CenterforGeneticMedicine ProfessorofMedicine UniversityHealthNetwork NorthwesternUniversityFeinbergSchool DepartmentofMedicine Toronto,Ontario,Canada ofMedicine CardiovascularDivision Chicago,Illinois MayoClinic JoanOlson,BS,RDCS,RVT Rochester,Minnesota DivisionofCardiology SudhirKenMehta,MD,MBA UniversityofNebraskaMedicalCenter Chairman DenisaMuraru,MD,PhD Omaha,Nebraska DepartmentofPediatrics DepartmentofCardiac,Thoracic,and FairviewHospital; VascularSciences JohnPalios,MD ClinicalAssociateProfessorofPediatrics UniversityofPadua DepartmentofMedicine DepartmentofPediatricCardiology Padua,Italy DivisionofCardiology ClevelandLernerCollegeofMedicine EmoryUniversitySchoolofMedicine ClevelandClinicChildren’sHospital GillianMurtagh,MD Atlanta,Georgia Cleveland,Ohio CardiovascularImagingFellow DepartmentofCardiology GauravParikh,MBBS,MRCP(UK) ToddMendelson,MD UniversityofChicago CardiologyFellow CardiologyFellow Chicago,Illinois DepartmentofCardiology LeonH.CharneyDivisionofCardiology UniversityofMassachusettsMedical NewYorkUniversityLangoneMedical SherifF.Nagueh,MD,FASE School Center ProfessorofMedicine Worcester,Massachusetts NewYork,NewYork WeillCornellMedicalCollege; MedicalDirector AmitR.Patel,MD EchocardiographyLaboratory DepartmentofMedicine IssamA.Mikati,MD MethodistDeBakeyHeartandVascular UniversityofChicago ProfessorofMedicineandRadiology Center Chicago,Illinois DivisionofCardiology Houston,Texas NorthwesternUniversityFeinbergSchool AmitV.Patel ofMedicine; TasneemZ.Naqvi,MD,FRCP(UK), CardiologyFellow AssociateDirector MMM DepartmentofCardiology EchocardiographyLaboratory ProfessorofMedicine NewYorkUniversityMedicalCenter NorthwesternMemorialHospital Director NewYork,NewYork Chicago,Illinois EchocardiographyLaboratory AneetPatel,MD DepartmentofInternalMedicine KarenModesto,MD ChiefCardiovascularDiseasesFellow DivisionofCardiology IchanSchoolofMedicineatMountSinai DepartmentofMedicine MayoClinic NewYork,NewYork DivisionofCardiology Scottsdale,Arizona UniversityofWashington MarkMonaghan,MSc,PhD SandeepNathan,MD,MSc Seattle,Washington ConsultantClinicalScientist AssociateProfessorofMedicine DirectorofNon-InvasiveCardiology Director AnupaPatel,MBBCh(Universityof KingsCollegeHospital InterventionalCardiology Witwatersrand),FCP(SA),Cert London,UnitedKingdom UniversityofChicagoMedicine Cardiology(SA) DepartmentofCardiology Chicago,Illinois ChrisHaniBaragwanathHospital FaroukMookadam,MD,MSc(HRM), Johannesburg,SouthAfrica FRCPC,FACC KazuakiNegishi,MD,PhD ConsultantandProfessor MenziesInstituteforMedicalResearch TimothyE.Paterick,MD,JD DepartmentofCardiovascularDisease Hobart,Tasmania,Australia Director,Non-InvasiveImaging MayoClinic ProfessorofMedicine Scottsdale,Arizona PetrosNihoyannopoulos,MD,FRCP, UniversityofFlorida,Jacksonville FESC,FACC,FAHA Jacksonville,Florida MarieMoonen,MD,PhD Professor DepartmentofCardiology Cardiology,NHLI LailaA.Payvandi,MD UniversityHospital ImperialCollegeLondon Cardiologist UniversityofLie´ge HammersmithHospital UnityPointClinicCardiology Lie´ge,Belgium London,UnitedKingdom CedarRapids,Iowa

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Written and endorsed by world experts from the American Society of Echocardiography (ASE), this unique multimedia resource uses text, case studies, and online components to cover the latest uses of echocardiography, including the most recent 2D and 3D advances. Unlike other existing textbooks in ech