Everything we do in the practice of echocardiography is based on results of previously performed research. Few of us are exposed to the enormous amount of work that is undertaken prior to the introduction of something new into clinical practice, so there is generally very little appreciation of the resources (financial, intellectual, and manpower) that go into technology development and validation, as well as the performance of the experimental and clinical studies required prior to its introduction into the clinical setting. Despite how little or how much we are individually involved, our collective commitment to research should remain a top priority if we want our field to grow and remain relevant in these rapidly changing times.

Supporting research is one of the major missions of ASE. It is done through the presentation of original research at our annual scientific meeting; funding fellowships and grants-in-aid; and publishing our journal, JASE, featuring original research in echocardiography. So far ASE has awarded 4 million dollars in grants to fellows, sonographers, and faculty. The association has allocated part of its operational budget for this purpose, and some research funding was made possible through the generous support of the ASE Industry Round Table. Recently, however, numerous organizational needs, the adverse economic environment, and government restrictions on industry contributions to organizations for both research grants and educational offerings have made it imperative that we seek research grants from organizations where there is no perceived conflict of interest.

In 2005, approximately 100 billion dollars were spent on biomedical research in the US, of which about 10% was spent on cardiovascular disease and stroke. The majority (75%) of this funding came from industry, and most of it was directed towards pharmacological agents and devices. Research and development by industry on ultrasound was small compared to other imaging modalities. About 25% of the funding for cardiovascular disease and stroke came from the National Institutes of Health (NIH); only a miniscule amount (a few million dollars) was spent on echocardiography-related research. One of our goals at ASE is to increase funding for echocardiography research by engaging the NIH in this effort, as well as educating our members about funding possibilities from the NIH.

At our strategic planning retreat in March 2010, Dr. Nakela Cook of the NIH gave a comprehensive and masterful presentation on the pathways by which the NIH can foster echocardiography research. Her presentation is available on www.asecho.org . The NIH could increase funding for echocardiography research by awarding grants to established as well as new core laboratories that are trained in the qualitative and quantitative assessment of cardiac structure and function. These grants are part of larger NIH-funded multi-center studies that utilize echocardiography to assess the natural history of disease (the Framingham Study is an example) or the effect of therapeutic interventions. To do this we must identify areas where echocardiography has distinct advantages over other imaging modalities.

Another way to increase NIH funding is by increasing the number of imaging training grants. With more emphasis placed on multi-modality imaging and the possible creation of a cardiovascular imaging board in the future, it would behoove us to train our fellows in the general principles of imaging and the application of various imaging modalities (MRI, CT, nuclear, and echo) in different clinical scenarios. It would also be important to train them in investigation. Several institutions already have such grants, and their graduates generally have an edge in procuring career development awards.

When a new faculty member joins a department and has a track record as well as commitment to research, the K award is an attractive means to protect 75% of the individual’s time for research. Several investigators in echocardiography have received these awards and have used them to create a solid foundation for their research careers. Many more could compete for this award provided they receive commitment for protected time from their departments.

Yet another mechanism of increasing NIH funding is though biomedical research partnerships. These are large grants (typically 1 million dollars of direct costs per year) that are given for technology development and require partnership with industry. Successful examples include development of intra-cardiac ultrasound for electrophysiology and sonothrombolysis for acute myocardial infarction. Small business innovation research grants allow novel technology to be transformed into commercial entities through research that can support fellows and junior faculty.

The most common means of procuring NIH funding for an independent investigator is the RO1 mechanism, a highly competitive and prestigious grant usually given to investigators who are creating new paradigms, testing new hypotheses, or studying mechanisms of disease. These are generally not awarded for technology development or validation. Since most of echocardiography research is devoted to technology validation, very few investigators in the field are awarded these grants. Those who have RO1 grants are usually working in the interface between disciplines and doing exciting new things. To be successful in procuring these grants we have to be imaginative, take risks, merge different fields, seek basic science collaborators, and spend time training with solid scientists who have excellent track records prior to launching our own research careers.

There are, of course, other funding agencies besides the NIH. These include the American Heart Association, which supports fellowships, grants-in-aid, and career development awards; the Howard Hughes Institute, which supports basic research; the National Science Foundation, which is particularly suited for basic research in acoustic physics; and the Department of Defense, which supports innovative technology development. The DOD is currently supporting the development of an ultrasound probe that can be placed on a fingertip, with images transferred wirelessly to a screen worn like eyeglasses. Several other national foundations fund research, and some cities and states also have local foundations that support research.

To educate our membership on the means of procuring grants we have launched two major initiatives: establishing an Extramural Research Committee, and hosting a technology summit to be held in the fall in conjunction with the AHA annual scientific sessions. The Committee is examining ways by which to increase exposure of our membership to research funding opportunities and to direct industry to core laboratories run by our members. Most of this information will be ultimately provided on our Website. The technology summit will bring engineers, physicists, and echocardiographers together to brainstorm on the future of echocardiography and to highlight a few high priority areas that we believe deserve funding. The proceedings will be published in JASE and will serve as a roadmap for echocardiography research for the next 5 to 7 years. It is anticipated that we will use this roadmap to then schedule an open forum at the NIH sometime in the spring to discuss possible ways in which these ideas/projects can be funded. We will also feature some of the developments at the scientific sessions in Montreal.