@dysanborn
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Cardiologist @mghhearthealth | #Echofirst @mghecho | @ASE360 | co-Editor @ACCinTouchEchoSAP |Tweets≠endorsement
Massachusetts, USA
Joined June 2020
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Danita Sanborn retweeted
🫀 AF diastology tip
💡 Look at beat-to-beat variability in mitral inflow
📉 Less variability in E velocity across cycles → suggests elevated LV filling pressure
Record multiple beats at sweep speed ~50 mm/s to assess this pattern.
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🫀 Transplant diastology pearl
Early after heart transplantation, restrictive mitral inflow can be seen despite normal LV filling pressures, often related to myocardial edema.
🔄 This pattern often improves or normalizes on follow-up as edema resolves.
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
Moderate/severe MAC reduces mitral orifice area → higher E wave.
Lateral e′ reduced from limited annular excursion.
➡️ E/e′ can be elevated even when LV filling pressures are normal.
#ASEchoJC
Danita Sanborn retweeted
Remember to always check the source data. The algorithm works best for high LAP but not as accurate at diagnosing normal LAP. #ASEchoJC
Danita Sanborn retweeted
How should LV filling pressures be estimated in patients with MAC? #ASEchoJC
Danita Sanborn retweeted
Conclusion: Diastolic stress echo evaluates patients with unexplained dyspnea and preserved EF by measuring exercise changes in E/e′ and TR velocity; E/e′ ≥15 with TR velocity >3.4 m/s during exercise indicates elevated filling pressures and supports HFpEF. #ASEchoJC
Danita Sanborn retweeted
🔑 Pulmonary vein ratio nuance
🔹 PV S/D ratio ≤0.67 → suggests ↑ LAP
📌 Most reliable in LV systolic dysfunction
⚠️ With normal LVEF, the ratio may remain >0.67 despite ↑ filling pressures
🧠 Always integrate other indices
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🔑 High yield IVRT pearl
🔹 IVRT ≤70 ms → supports ↑ LAP
📌 In patients with normal LVEF, IVRT can help confirm ↑ filling pressures when pulmonary vein indices are inconclusive.
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🔑 TR jet acquisition pearl
🔹 Acquire TR velocity from multiple windows
🔹 Contrast (agitated saline or UEAs) can help obtain a complete TR envelope
⚠️ Avoid blooming artifacts — they can falsely ↑ velocity
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🚴 Diastolic Stress Echocardiography — Interpretation
How do we interpret exercise diastolic stress echo findings?
Quick visual guide 👇
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🚴 Diastolic Stress Echocardiography — Protocol
A quick visual guide to how diastolic stress echo is performed.
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
LA strain is a useful tool in diastology assessment! #ASEchoJC
Left Atrial Strain (Advanced Technique)
📍 Acquisition
• Optimize A4C & A2C LA views (avoid foreshortening)
• ↓ Gain/compression → clean blood pool–tissue border
• Narrow sector → frame rate 50–70 fps
• Good ECG with visible P wave, use R–R gating
• Dedicated LA strain software
• Exclude pulmonary veins & LAA
• Track underside of annulus along LA wall
#ASEchoJC #EchoFirst @ASE360
Danita Sanborn retweeted
🚨 TONIGHT at 8 PM ET! #ASEchoJC is back! 📷
Join us as we decode the updated @ASE360
Diastology Guidelines with our expert guest authors:
@SNagueh | @dysanborn | @BonitaEcho
alongside my amazing co-moderators @PWesslyMD
& @HeartToProve
Expect a high-yield, practical & interactive discussion to help make #diastology less daunting & more dynamic. 🫀✨
📷Bring your questions & cases — see you tonight! #CardioX #EchoFirst #Cardiotwitter #HFpEF #ACCFIT
Danita Sanborn retweeted
Join us TONIGHT from 8-9 PM ET for our ASE Journal Club on X! 🙌 #ASEchoJC
The live social event will be moderated by @NadeenFaza, @PWesslyMD and @HeartToProve. Guest authors include @BonitaEcho, @SNagueh and @dysanborn.
Sign up: bit.ly/4l32fAC
