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Echocardiographic Core Laboratory

The Echocardiographic Core Laboratory (ECL) provides state-of-the-art echocardiographic imaging interpretation and analysis.

ECL Director Dr. Lissa Sugeng is a Yale faculty board-certified cardiologist and a leading national expert in 2- and 3-dimensional echocardiographic measures, having validated many of the newer measures of LV volume and function using 3-dimensional echocardiography.


The ECL has extensive experience in the evaluation of echocardiographic measures for national and international multicenter clinical trials, including the assessment of cardiac structural and valvular morphology and function in a wide range of interventions. Expertise includes development of acquisition and analysis plans for state-of-the art imaging modalities, including 2-D and 3-D echocardiography acquired via transthoracic (TTE) or transesophageal (TEE) approaches.

In particular, YCRG's expertise with real-time 3D echocardiography provides advantages in assessment of:

Ventricular function
  • Precise left and right ventricular volume and ejection fraction
  • Alternative method to detect left ventricular dyssynchrony
Valve anatomy and pathology
  • More accurate mitral valve area measurement
  • Quantitative assessment of the mitral valve apparatus
  • Precise delineation of the abnormal scallop in mitral valve prolapse
  • Valve sizing via precise aortic valve and left ventricular outflow tract measurement
  • Aortic-mitral coupling dynamics
  • Preliminary observations of the nature of the tricuspid valve annulus
Congenital Heart Disease
  • Congenital lesions such as atrial and ventricular septal defects and bicuspid aortic valves
  • Measurement of ASD and VSD lesions for device closure
Prosthetic valve performance
  • Unique visualization of the prosthesis using 3D TEE
  • Better delineation of prosthetic valve dehiscence
Left Atrial Appendage (LAA)
  • Accurate assessment of the orifice size and dimensions of LAA useful for LAA closure


YCRG-ECL methodology is based on widely accepted American Society of Echocardiography (ASE) guidelines. All currently employed methods have been developed and validated using standardized methods.

Case report form and analysis design are customized per protocol for accurate and reproducible analysis, including programming validation and built-in cross checks. The ECL provides site training services to optimize data quality and standardization. The reproducibility of all assessments is routinely tested, and the ECL conducts 100% quality control and over-reading.

The YCRG-ECL is staffed by two experienced sonographers using FDA-cleared Philips (Philips Healthcare, Andover, MA) and TomTec (TomTec Imaging Systems GmbH, Unterschleissheim, Germany) software. The ECL has been extensively involved in the design of the TomTec software and its customization for specific applications.

All ECL data is fully integrated into the Yale ITS system with extensive backup, security control, and data recovery implementation. The ECL has passed numerous vendor-initiated audits.