Cardiovascular Ultrasound Department

I. History of the Department

Cardiac color Doppler ultrasound is a young yet important branch of ultrasound medicine. With the continuous improvement brought about by the adoption of new ultrasound technologies, it has continued to integrate and develop with clinical departments, playing a major role in the diagnosis and treatment of diseases and occupying an increasingly important position in the medical service system.

The Cardiac Color Doppler Ultrasound Department of the First Affiliated Hospital of Dalian Medical University was established in 1999 by Professor Wang Ke. After being led by Director Zhang Shulong, the department is now under the direction of Director Cong Tao. Following many years of effort, it has developed into a department integrating clinical diagnosis and treatment, teaching, and scientific research. The department is currently mainly responsible for cardiovascular ultrasound examinations and related surgical monitoring for inpatients and outpatients at the Lianhe Road Campus.

The department has developed from one examination room to five, and the number of ultrasound machines has increased from one to seven. Our department possesses internationally advanced large-scale cardiac ultrasound equipment: six cardiac ultrasound diagnostic systems, including GE ViVid 9 and Philip E9, with different uses and functional characteristics. They are equipped with dedicated data-sampling and integrated-processing chips. The displayed Doppler information features low noise and clear spectral information, thereby optimizing the measurement of important blood-flow parameters. The display processors are flexible and diverse, allowing optimal settings for image parameters and display formats. An ultrasound imaging and reporting workstation is used to computerize the management of reports and archives and is connected to the hospital medical network, enabling the performance of various cardiac ultrasound diagnostic procedures.

II. Human Resources

The department currently has eight physicians, including 3 with senior professional titles and 5 with intermediate professional titles, forming a rational and excellent talent structure. There are 3 doctors of medicine and 5 masters of medicine, including 1 professor and 2 associate professors.

III. Expert Team

Director Cong Tao, head of the department and academic leader, is a doctor of medicine and a master's supervisor. Professor Cong Tao currently serves as a member of the Cardiovascular Contrast-Enhanced Ultrasound Group of the Ultrasound Medicine Branch of the China Association for the Promotion of International Medical and Healthcare Exchange; a youth member of the Ninth Committee of the Ultrasound Medicine Branch of the Liaoning Medical Association; a director of the Seventh Council of the Liaoning Society of Medical Imaging; a member of the Ultrasound Medicine Branch of the Dalian Medical Association; and a supervisor of the Dalian Heart Association, among other positions.

Sun Yinghui, associate chief physician and doctor of medicine. She graduated from the Department of Medical Imaging of China Medical University. Since 2005, she has been engaged in clinical, teaching, and scientific research work in cardiac ultrasound at the First Affiliated Hospital of Dalian Medical University. In 2016, she studied cardiac ultrasound at Prince of Wales Hospital of The Chinese University of Hong Kong for six months. She specializes in the echocardiographic diagnosis of common and difficult cardiac diseases and is proficient in applying new echocardiographic technologies, including transesophageal ultrasound, real-time three-dimensional ultrasound, and tissue speckle tracking.

Shang Zhijuan, associate chief physician and doctor of medicine, graduated from China Medical University. She has been engaged in cardiac ultrasound diagnosis for more than 10 years and specializes in the ultrasound diagnosis of valvular disease, cardiomyopathy, coronary heart disease, congenital heart disease, and other conditions. She has published several articles in core journals and SCI-indexed journals.

IV. Medical Services

The cardiac ultrasound diagnostic technologies currently available include conventional two-dimensional echocardiography, three-dimensional echocardiography, strain technology, adenosine stress echocardiography, exercise stress echocardiography, intracardiac and myocardial contrast echocardiography, and many other technologies.

Echocardiography has developed from the initial M-mode one-dimensional imaging to current real-time 2DE and 3DE. It is the only examination method that can dynamically display intracardiac structures, cardiac motion, and blood flow, and it causes no harm to the human body. The cardiac probe is like a camera lens. As the probe rotates, the various structures of the heart are clearly displayed on the screen, mainly showing the cardiac valves, intracardiac structures, cardiac motion, and blood flow.

Clinically, reliable, noninvasive technologies are needed for the diagnosis and risk stratification of coronary heart disease. Adenosine stress echocardiography uses adenosine as the stress medication and contrast agents to enhance echocardiography for observing changes in wall motion. It has been confirmed that changes in wall motion before and after stress are indicators for the early detection of myocardial ischemia. At the same time, ASE can also be used to detect viable myocardium, measure coronary flow reserve, and perform risk stratification in patients with coronary heart disease.

The basic principle of exercise stress echocardiography is to increase myocardial oxygen consumption to a level at which coronary blood-flow reserve is insufficient to meet the demand, thereby inducing myocardial ischemia and abnormalities in myocardial contractility. Echocardiography can then detect segmental or global wall-motion abnormalities. After the stress is terminated, myocardial oxygen consumption gradually decreases, and the duration of wall-motion abnormalities may vary from person to person.

Intracardiac and myocardial contrast echocardiography refers to the use of microbubbles capable of passing through the pulmonary capillary bed. Under specialized contrast imaging technology, the contrast agent interacts with ultrasound waves to enhance the echo from myocardial tissue and obtain clear images of the left ventricle or myocardial tissue, thereby enabling the diagnosis of ischemic heart disease.

V. Academic Level and Newly Developed Technologies

The department has achieved a high level in the diagnosis of coronary heart disease, valvular heart disease, cardiomyopathy, congenital heart disease, and other conditions. New technologies developed in recent years include adenosine stress echocardiography, exercise stress echocardiography, intracardiac and myocardial contrast echocardiography, and others.

VI. Teaching Achievements

Our department also undertakes teaching responsibilities for undergraduate students, graduate students, international students, and other enrolled students at Dalian Medical University, as well as advanced training for other ultrasound personnel. As a national demonstration base for standardized residency training, it has trained many outstanding standardized trainees in recent years. Our department also organizes various national continuing medical education courses.

1. Undergraduate teaching: Ultrasound Imaging for international students and clinical undergraduate students; 2. Graduate students: In the early period, assisted Professors Wang Ke and Zhang Shulong in training more than 20 graduate students specializing in cardiology; currently trains graduate students in ultrasound imaging, of whom 2 have graduated and 2 remain enrolled; 3.Standardized training: As part of the standardized training base for cardiovascular medicine, assists in training more than 20 standardized trainees specializing in internal medicine each year, while also assisting the standardized ultrasound training base in completing the training of more than 10 ultrasound imaging personnel.

VII. Research Expertise

The department attaches importance to research projects and has published numerous articles in core journals, SCI-indexed journals, and other publications. In particular, in recent years, under the leadership of academic leader Director Cong Tao, it has established a research team, promoted multidisciplinary collaboration, and participated in multiple domestic multicenter studies.

1.Noninvasive assessment of cardiac systolic and diastolic function, with related work receiving the Third Prize for Municipal Scientific and Technological Progress; 2. Combining ultrasound speckle-tracking technology and three-dimensional ultrasound technology with cardiac device therapy (dual-chamber cardiac pacing, three-chamber pacing, vagus nerve stimulation, etc.) to assess treatment efficacy and guide further improvement, with related work receiving one grant each from the National Natural Science Foundation and the National Natural Science Foundation for Young Scientists. 3. In the field of ischemic heart disease, applying ultrasound speckle-tracking technology, three-dimensional ultrasound technology, and other methods to evaluate cardiac remodeling after myocardial infarction and its prognosis, with related work receiving one provincial scientific research grant; applying stress contrast-enhanced ultrasound technology, coronary blood-flow velocity measurement technology, and other methods to assess coronary microvascular function, with related work receiving one Provincial Natural Science Foundation grant. 4. Using three-dimensional ultrasound technology to evaluate structural heart disease, such as the quantitative analysis of each valve in moderate-to-severe valvular regurgitation. More than 40 English SCI-indexed articles and more than 40 articles in Chinese core journals have been published in the above fields.

VIII. Specialty Features

1. Stress echocardiography—exercise and pharmacological stress echocardiography, combined with contrast-enhanced ultrasound technology for the diagnosis and risk stratification of coronary heart disease; pharmacological stress echocardiography combined with coronary blood-flow measurement technology to assess coronary microvascular function. 2. Applying transesophageal three-dimensional echocardiography for preoperative screening, intraoperative monitoring, and postoperative assessment of advanced procedures such as left atrial appendage occlusion and transcatheter aortic valve replacement. 3. Ultrasound evaluation and monitoring of cardiac complications after antitumor treatment in patients with tumors, such as myocardial toxic injury, pericarditis, coronary heart disease, and valvular disease. 4.Contrast-enhanced ultrasound technology: right-heart contrast echocardiography for evaluating right-to-left shunting in patent foramen ovale; intracardiac contrast echocardiography for the accurate assessment of left-heart function and the detection of abnormal intracardiac echoes, such as thrombi and masses; myocardial contrast echocardiography for evaluating myocardial microcirculatory blood-flow perfusion and thereby assessing myocardial viability. This technology can also be used to understand the blood-flow perfusion status of intracardiac masses, thereby helping determine whether a mass is benign or malignant.

IX. Departmental Services

With a patient-centered approach, the department comprehensively improves service standards and earns patients' respect through excellent technology and high-quality services. It strengthens communication with clinical departments, improves diagnostic standards, and achieves comprehensive cooperation with all departments in diagnosis, treatment, post-treatment assessment, scientific research, and other areas, providing physicians in all specialties and patients with safe, effective, timely, and real-time ultrasound diagnostic results. Inpatients are scheduled at staggered times, humanized services are provided, and critically ill and emergency patients are given priority. Service procedures are continuously optimized to reduce patient waiting times.

X. Departmental Honors Cardiovascular Medicine is a national key discipline, and Cardiovascular Ultrasound is the ultrasound imaging component of this discipline. It has a strong academic atmosphere and is of great significance in promoting the development and advancement of the discipline. The discipline has strong academic expertise and a rational academic structure. It has currently achieved a certain number of high-level scientific research accomplishments and has a strong capacity for mutual support with related disciplines. The Cardiovascular Ultrasound Department is a technical group with strong pioneering and innovative capabilities.