The Ultrasound Core Laboratory (UCL) has been reorganized and is now the Noninvasive Cardiovascular Ultrasound and Hemodynamic Laboratory. This reorganization consolidates all cardiovascular studies, pulmonary function studies and noninvasive hemodynamics under the same core lab.
Hypertension and heart failure are the research areas of focus of the Cardiovascular Group at MSM. The cardiovascular ultrasound-imaging core is a key component of the cardiovascular research infrastructure in evaluating the mechanisms of heart muscle and blood vessels changes in hypertension and its complications.
Director: Rigobert Lapu-Bula, MD, PhD is an Assistant Professor in the Department of Medicine, Section of Cardiology. By virtue of his doctoral training in cardiology, he has a long-standing interest and extensive experience in the use of echocardiographic techniques in evaluating the mechanisms and outcomes of congestive heart failure (CHF). His experience in cardiovascular-hemodynamics and exercise physiology has helped establish the Ultrasound Core.
Dr. Lapu Bula has been looking at the relationship between eNOS polymorphisms, endothelial derived flow mediated dilation, left ventricular hypertrophy and myocardial blood flow in hypertensive subjects. He is also continuing his pilot work on myocardial blood flow abnormalities using a new model of salt-sensitivity and pre-hypertension.
Cardiologists: Elizabeth Ofili , MD, MPH (Chief, Section of Cardiology and Director, CRC), Adefisayo Oduwole, MD ( Associate Professor of Medicine ), Anekwe Onwuanyi MD(Associate Professors of Medicine ). These cardiologists are board-certified with advanced training and experience in interpreting echocardiograms and conducting hemodynamic/echo stress testing.
Manager: Vonsina Clark, RDCS is a Registered Diagnostic Cardiac Sonographer with over 15 years of experience in the field of ultrasound. She is certified by the American Registry of Diagnostic Sonographers and received initial echocardiography training at Wake Forest University. She is trained in the areas of Carotid and Peripheral Vascular Duplex/Color Flow Imaging at Gulfcoast Ultrasound Institute.
As a senior sonographer, she participates in supporting clinical research services involving NIH and pharmaceutical sponsored Phase I clinical trials in congestive heart failure. (Bidil XR, Commander, Paragon). Pulmonary hypertension in persons with HIV (PAH), American Heart Association collaboration between Emory and Morehouse School of Medicine with a focus on cardiovascular health and resilience among African Americans with evaluation of vascular function and intima media thickness (MECA). (P4 - Women’s Health registry) assessment of factors influencing the development and progression of Cardiovascular disease in women’s throughout their life span.
Engaging in clinical research and providing diagnostic imaging support at our primary and specialty care practice at Morehouse Healthcare. In which the echocardiography lab has been recognized as an accredited laboratory by IAC the Inter-societal Accreditation Commission since 2009. www.intersocietal.org/echo/
Goals and Objectives: The purpose of the Noninvasive Cardiovascular Ultrasound and Hemodynamic Laboratory is to provide the technical and analytical support for various research projects in which the modality of cardiovascular ultrasound imaging is employed in humans. Specific objectives are:
- To provide high quality cardiovascular ultrasound procedures, which adhere to the established protocols of the given clinical research project.
- To expand the capabilities of the Ultrasound Core Lab to be able to analyze and manage cardiovascular ultrasound studies and data from designated remote clinical sites, with the Core Lab serving as the coordinating center.
- To integrate other CRC physiological resources into the "Non-invasive Cardiovascular Ultrasound and Hemodynamic Laboratory" thereby supporting a broader base of investigators.
Facilities and Equipment: The CRC Ultrasound Core Laboratory is a Digital Echo Lab. The digital image acquisition unit performs full digital recording from any echo system from designated remote sites to acquire full study data (including stress echo studies) with audio as well as single-frame capture for Doppler, M-mode and text screens. Dedicated core lab echocardiographic equipment consists of cutting-edge ultrasound imaging instruments, super- VHS video player/recorders, industrial grade color video monitors, digital frame grabbers, digital image archiving (storage/retrieval), digital imaging network, and high quality grade color page printers.
The center GE Vivid E9 and the Logiq S7 - ultrasound system was recently installed for all cardiac and vascular reactivity ultrasound studies. This GE upgrade allows output of digitally acquired images from the echo-system to a customized networked cardiovascular workstation (EchoPac) for off-line review/analysis.
Additional equipment for various vascular and hemodynamic testing/monitoring modalities expand the Ultrasound Core capability to a comprehensive performance Core Lab.
Training: The Core Director supervises the training of the technical staff. Training is conducted primarily at the Core Laboratory, and includes didactic and supervised "hands-on" learning, individually or in small groups. Training provides the study site ultrasonographer with the rationale, significance and technique of the ultrasound procedure.
Specific objectives include but not limited to: a) to correctly perform the sequence of tasks for the brachial artery ultrasound procedure; b) to acquire high-quality images for analysis by the Core Laboratory Directors; c) to avoid sources of variability in image acquisition, measurement error, and artifacts; d) to properly collect and record the study data; e) to properly label and ship videocassette tapes, CDs, images, and forms to the Core Laboratory; f) to maintain communication with the Core Laboratory regarding the technique and/or brachial ultrasound procedure.
Image acquisition is standardized. Operators (including senior sonographer, cardiologist or staff fellow) perform the same procedures using the same approach, patient position, machine setting and recording criteria in accordance with existing recommendations, mainly those of the American Society of Echocardiography. During ultrasound examination, the operator performs direct measurements of structure/diameters (M-mode or two-dimensional modalities) as well as of the Doppler signals, using on-line electronic calipers and tape-recording the whole procedure in addition to the digital clips.
The Images are stored in our secured central image network server (ImageVault) then reviewed on video or digital format by one of the cardiologists in the presence of the operator/senior sonographer or staff member participating in the acquisition sessions. In our lab, off-line revisions of clinical echo examinations are routinely performed for both teaching purposes and quality improvement. Total quality management of the Core Lab services has been connected with our comprehensive system of quality assurance, which integrates quality development, quality maintenance, and quality improvement. Each study is completed with a formal written report and interpretation. This report is kept on file with copies of image documentation (paper and/or tape or optical disk or server) for review or offline analysis.
List of Tests and Services:
- Cardiac and Vascular Imaging
- Transthoracic Echocardiography
- Quantitative Analysis of Echocardiograms
- Doppler Tissue Imaging (DTI)
- Myocardial Contrast Echocardiography (MCE)
- Dobutamine Stress Echocardiography
- Exercise Stress Echocardiography
- Brachial Artery Ultrasound Imaging
- Finger Plethysmography
- Carotid Ultrasound Imaging
- Vascular Compliance/Stiffness Pulse-Wave Analysi
- Stress Testing and Cardiovascular Hemodynamics
- Exercise ECG Stress Testing
- Maximal O 2 Uptake Testing
- Respiratory Energy Expenditure
- Twelve-Lead Electrocardiography (ECG)
- T-Wave Alternans
- Ambulatory Blood Pressure Monitoring
- Holter Monitoring
- Cardiovascular Hemodynamics