The American Society of Echocardiography (ASE) is marking its 50th anniversary during the 2025 Scientific Sessions in Nashville, Tennessee, on September 5-7, 2025, with record meeting attendance and a program packed with late-breaking research, new guidelines, and international collaboration.

 

For Jordan Strom, MD, MSc, FASE, this year’s meeting highlights both how far the field has come and the opportunities ahead. Dr. Strom is the Director of the Echocardiography Laboratory and Director of Echocardiographic Research at Beth Israel Deaconess Medical Center; Associate Professor of Medicine at Harvard Medical School; and the Section Head for Cardiovascular Imaging Research at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology. In this interview with Conexiant Cardiology, Dr. Strom—who is also a member of the ASE 2025 Program Committee—shares his perspective on ASE 2025’s most significant sessions, the promise of contrast echocardiography, and the urgent need to strengthen the sonographer workforce.

 

 

Dr. Strom: There are a number of things I’m excited about. Of course, seeing old friends and colleagues and connecting over our shared love for echo and new advances coming out is always meaningful, but the scientific program itself is especially strong this year. ASE will host a large 50th anniversary celebration, including a presentation featuring all past presidents of the society, with photos and memories spanning ASE’s history to highlight the innovative role that ASE has played in spearheading the growth of echocardiography.

 

We also have nine learning pathways, and three new “Episode of Care” sessions developed in partnership with the Cardiovascular Research Foundation. These involve interactive case presentations using touch boards from iFactive, allowing attendees to manipulate images in real time and discuss management and next steps with experts across disciplines.

 

There will also be a “Shark Tank” competition, where three industry-supported finalists—Echo IQ, Microvascular Therapeutics, and Sonus Microsystems—will pitch their innovations to entrepreneurs, academics, thought leaders, and venture capitalists to evaluate their potential impact on clinical care.

 

On top of that, ASE has received a record number of poster submissions and will have a record number of attendees this year, making this our largest meeting yet.

 

Other highlights include:

It’s truly a packed program and I think it’s going to be very exciting.

 

 

Dr. Strom: This guideline is designed to harmonize how we communicate across sites by defining common descriptors and terms that we can all use. That consistency helps improve quality and communication, facilitates multicenter echo research, and allows data to be extracted and analyzed more effectively.

 

One of the big parts of this guideline is the inclusion of recommendation statements. For example, an echocardiographer will now be able to say, “This patient has severe aortic stenosis and should be referred to the structural heart team for consideration of further treatment.” I think that will go a long way in moving echo from solely being a diagnostic tool toward becoming a translational tool that [directly informs clinical decision-making] and patient referrals. The hope is that this will help bridge the gap between what is identified in the echo report and what [brings the patient into a cardiac clinic to be treated].

 

We also hope this creates momentum for reporting software manufacturers—Siemens syngo, Fujifilm, and others—to implement ASE templates that make standardized reporting easier for our physicians.

 

Now that [this exists as] a flag post, we’re working with individual companies to implement these guidelines, and they are very happy to have one circumscribed way of reporting. Over time, we hope these guidelines will be disseminated out into labs across the US to lead toward a more common, reliable echo report. Hopefully that will lead to reduced variability, duplication of care, and missed elements in echo reports for [efficient and beneficial] care.

 

 

Dr. Strom: We recognize that a lot of places may not be able to incorporate these standards into their practice yet. [Adoption will take time.] But for those that can, these guidelines set a clear standard. With collaboration from software vendors to build ASE templates, it will hopefully become easier for practices to adopt and implement.

 

 

Dr. Strom: Another important upcoming guideline will address echocardiography for patients with temporary and durable mechanical circulatory support, led by Jerry Estep, MD. That will be an exciting addition to the field.

 

 

Dr. Strom: The Kalmanson Lecture, which was initially supported by the International Cardiac Doppler Society, reflects the transformative role of Doppler ultrasound in the field of cardiology. Daniel Kalmanson helped us understand—as early as 1976—that we can use Doppler and ultrasound techniques to characterize cardiac structure and function. In my lecture, I hope to link that foundation to the birth and evolution of contrast echocardiography.

 

Contrast echo began with saline injections to identify right-sided structures and quantify right atrial function and cardiac output, and has progressed to ultrasound contrast and the development of stable microbubbles capable of crossing the pulmonary capillary bed into the left ventricle. This eventually led to effective left ventricular contrast when the initial aim was only for coronary vessel visualization. A serendipitous discovery—that the resonant frequency of microbubbles that were small enough to crash through the lungs, also aligned within the range of medical ultrasound frequencies that we use—opened the door to better image quality and inform echo as a whole. Then, one of the pioneers in our field, Roberto Lang, MD, [showed us that] harmonic imaging and contrast techniques could be used for and improve not only contrast studies, but also non-contrast echocardiography. Now that’s become a staple in what we do in practice in primary imaging. [Sadly, Dr. Lang passed away in June, following a brief illness.]

 

Looking forward to other work being performed to improve imaging, I want to highlight some contemporary work using machine learning techniques to enhance the contrast between the blood pool and tissue, as well as research leveraging microbubbles as targeted molecular imaging for theranostics and for improved patient treatment and care. One of the ways this is being done is through the use of ultrasound microbubbles as complex antibodies to target markers of ischemia. There has been great work done by Brian Davidson, MD, and others showing that you can develop a targeted marker for areas that are relatively malperfused, which was always the hope with contrast echo, and we’re closer than ever to accomplishing that.

 

Other areas of use for microbubbles are for therapeutics from the perspective of sonothrombolysis, where high-intensity pulses of ultrasound with an infusion of microbubbles can help break up clots in the heart. This has been shown to improve success rates of thrombolysis. There’s a large study out of Brazil that showed reduced pacemaker or ICD requirements in that population. Then this leads to other things as well, like the use of microbubble cavitation to disrupt the blood–brain barrier, allowing for the delivery of higher concentrations of chemotherapeutics for brain cancers. It could also be used as a drug delivery drive for chemotherapy or gene therapy in the future. Then there’s one company working on an ongoing phase 2 clinical study using microbubbles that are complex to a peptide with strong affinity for a VEGF2 receptor to identify and visualize areas of inflammation or new tumor growth to determine if the tumor is progressing or not. To do this we need some standardization of drug dosing and process, and more work is being done now in this particular area.

 

 

Dr. Strom: Despite all this promise, the reality is that even though this microbubble technology has been developed over the course of 20 to 30 years, it is mostly not used. Poor quality imaging occurs in about 10% to 20% of echoes, yet contrast is used in only ~7% of outpatient transthoracic echoes and ~21% of stress echoes. Utilization varies widely by state. In Minnesota at the Mayo Clinic you have about a 20% chance of getting contrast vs about a 1.1% chance at a hospital in Delaware. There’s about a 4.4-fold difference in usage that is unexplained by patient or institutional characteristics. As a society and as a profession, [we really need to push to use and] understand that this has huge potential value. We need to be at the forefront using all the technologies at our disposal to learn and take advantage of the important role we play in both diagnostic and therapeutic aspects of care.

 

 

Strom: Our sonographer workforce is burnt out. Many are leaving the field or have not returned to it since COVID, and so labs now struggle to meet study volume requirements due to hiring difficulties. ASE is working to recruit and retain the next generation by emphasizing the value of sonography as a career and by supporting technological advances that reduce workload.

A number of commercial innovations being released at this meeting may help ease workflow, where automated aspects lead to improved efficiency and quality of imaging as well as to improve the quality of life of our sonographers. We are also focusing on career ladders for sonographers and training.

 

More broadly, there’s also a lot of work being done to expand the broad pool of ultrasound. There will also be more focus next year and the year after that on a standardized framework for point-of-care ultrasound (POCUS) and getting requisite training, so that hospitalists, emergency medicine physicians, and internal medicine physicians are all able to review the images and verify the reports. The ASE has been increasingly taking a larger role in POCUS to try to understand and provide the necessary training to interested individuals.

 

ASE is a very strong critical care special interest council and this overlaps with some of the other foci of the meeting—educating summits on pediatrics, vascular ultrasound, anesthesia, and structural care. ASE has always led from an educational standpoint, and that continues to be the case with the ASE 2025 Scientific Sessions.