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Cardiologists from around the world are gathered at EuroEcho in Athens, Greece to discuss some of the latest advancements in cardiovascular imaging. One of the talks of the conference was GE's Automated Function Imaging (AFI), a software tool that automates 2D speckle tracking to measure in real-time the deformation (strain) of the myocardial wall. Available on multiple GE Vivid products, including the Vivid E9, Vivid S6, Vivid q, Vivid 7 and EchoPAC. AFI is a more sensitive method for assessment of left ventricular function than EF (ejection fraction).

At a GE Healthcare Satellite Symposium on December 5 at EuroEcho, some of the world's top cardiologists discussed the utilization of AFI and its application for routine clinical use.

Cardiovascular imaging experts Profs. J.U. Voigt, L. Badano and T. Marwick talked about current challenges as well as successful clinical applications of Speckle Tracking 2D Strain. According to Prof. L Badano, Department of Cardiac, Thoracic and Vascular Sciences University of Padua, Padua, Italy, "The joint collaboration between scientific societies and industry vendors like GE to standardize strain measurements will be very important in order to expand the role of deformation imaging into everyday clinical practice."

Echocardiography traditionally has been all about creating images for visual assessment. GE's cardiovascular ultrasound scanner technology has always provided data in a format and with a temporal and spatial resolution that enable objective means of quantifying LV function. The first tool, Anatomical M-Mode, was introduced in the early 1990s to generate M-Mode images from high-frame-rate, raw-data 2D loops, correcting for anatomical orientation. In 1995, GE introduced Tissue Velocity Imaging (TVI) and in 2000, Tissue Tracking to help assess longitudinal displacement. TSI (Tissue Synchronization Imaging derived from TVI) was released on the Vivid 7 in 2003 to support cardiac resynchronization therapy (CRT), and in 2004 GE introduced 2D Strain, a speckle tracking based quantification tool, which in 2006 resulted in the release of AFI.

AFI has been under continuous improvement since its introduction based on constructive feedback from an extensive installed based with experienced and enthusiastic users. The focus has been to further improve the ease-of-use and reproducibility, and reduce the user dependency through further automation. The method has now reached a level of robustness where it can be applied in a daily clinical setting. AFI has shown to be very useful as an add-on or substitute to ejection fraction.  Most of all, it has shown to be very helpful as a decision support tool in patients with subclinical LV dysfunction as an early marker of heart failure, including cancer patients under treatment with chemotherapy, for patients with diabetes and valve diseases. Other areas of application include the diagnosis of hypertrophic cardiomyopathy and amyloidosis. Its use in the evaluation of regional function includes a variety of other applications including ischemia (both rest and stress echo), better management of acute chest pain patients, estimation of infarct size, and as a predictor of outcome for post infarct patients.

According to Prof. Thomas Marwick at Menzies Research Institute, Hobart, Australia, "Global Longitudinal Strain from AFI has proved to be more sensitive than Ejection Fraction in detection of myocardial dysfunction, and I have found it very helpful particularly in subclinical dysfunction as an early indication of risk of heart failure".

There are currently over 400 scientific publications published based on this GE technology. As the pioneer in this field plus the healthymagination validation provided to the AFI technology, GE continues its commitment to drive implementations of solutions that are helping reduce the cost of care while improving the quality of care provided to patients around the world.