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Cantinotti M, Voges I, Miller O, Raimondi F, Grotenhuis H, Bharucha T, Garrido AO, Valsangiacomo E, Roest A, Sunnegårdh J, Salaets T, Brun H, Khraiche D, Jossif A, Schokking M, Sebate-Rotes A, Meyer-Szary J, Deri A, Koopman L, Herberg U, du Marchie Sarvaas G, Leskinen M, Tchana B, Ten Harkel ADJ, Ödemis E, Morrison L, Steimetz M, Laser KT, Doros G, Bellshan-Revell H, Muntean I, Anagostopoulou A, Alpman MS, Hunter L, Ojala T, Bhat M, Olejnik P, Wacker J, Bonello B, Ramcharan T, Greil G, Marek J, DiSalvo G, McMahon CJ. Organisation of paediatric echocardiography laboratories and governance of echocardiography services and training in Europe: current status, disparities, and potential solutions. A survey from the Association for European Paediatric and Congenital Cardiology (AEPC) imaging working group. Cardiol Young 2024:1-9. [PMID: 38439642 DOI: 10.1017/s1047951124000131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND There is limited data on the organisation of paediatric echocardiography laboratories in Europe. METHODS A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (3) medical/paramedical staff employed, (4) time for echocardiographic studies and reporting, and (5) training, teaching, quality improvement, and research programs. RESULTS Respondents from forty-three centres (45%) in 22 countries completed the survey. Thirty-six centres (84%) have a dedicated paediatric echocardiography laboratory, only five (12%) of which reported they were European Association of Cardiovascular Imaging accredited. The median number of echocardiography rooms was three (range 1-12), and echocardiography machines was four (range 1-12). Only half of all the centres have dedicated imaging physiologists and/or nursing staff, while the majority (79%) have specialist imaging cardiologist(s). The median (range) duration of time for a new examination was 45 (20-60) minutes, and for repeat examination was 20 (5-30) minutes. More than half of respondents (58%) have dedicated time for reporting. An organised training program was present in most centres (78%), 44% undertake quality assurance, and 79% perform research. Guidelines for performing echocardiography were available in 32 centres (74%). CONCLUSION Facilities, staffing levels, study times, standards in teaching/training, and quality assurance vary widely across paediatric echocardiography laboratories in Europe. Greater support and investment to facilitate improvements in staffing levels, equipment, and governance would potentially improve European paediatric echocardiography laboratories.
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Affiliation(s)
- Massimiliano Cantinotti
- Fondazione CNR-Regione Toscana G. Monasterio (FTGM), National Research Institute (CNR), Pisa, Italy
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
| | - Inga Voges
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- DZHK (German Center for Cardiovascular Research), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Department for Congenital Cardiology and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Owen Miller
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Paediatric Cardiology, Evelina London Children's Hospital, London, UK
| | - Francesca Raimondi
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Division of Pediatric Cardiology, Meyer University Hospital, Florence University, Firenze, Italy
| | - Heynric Grotenhuis
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Pediatric Cardiology, Wilhelmina Children's Hospital / UMCU, Utrecht, The Netherlands
| | - Tara Bharucha
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Department of Paediatric Cardiology, University Hospital Southampton, Southampton, UK
| | - Almudena Ortiz Garrido
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Pediatric Cardiology, Hospital Materno Infantil, Malaga, AL, Spain
| | - Emanuela Valsangiacomo
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Department of Paediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Arno Roest
- Department of Pediatrics, Division of Pediatric Cardiology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, Netherlands
| | - Jan Sunnegårdh
- Children's Heart Centre, The Queen Silvia Children's Hospital Sahlgrenska University Hospital, Göteborg, Sweden
| | - Thomas Salaets
- Department Paediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Henrik Brun
- Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | | | - Antonis Jossif
- Paedi Center for Specialized Pediatrics, Strovolos, Cyprus
| | | | - Anna Sebate-Rotes
- Servicio de Cardiología Pediátrica, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Jaroslaw Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Antigoni Deri
- Department Paediatric Cardiology, Leeds University, Leeds, UK
| | - Laurens Koopman
- Division of Pediatric Cardiology, Department of Pediatrics, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ulrike Herberg
- Department or Pediatric Cardiology and Congenital Heart Disease, University of Aachen, Aachen, Germany
| | - Gideon du Marchie Sarvaas
- Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Markku Leskinen
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Bertrand Tchana
- Parma University Hospital, Department of Mother and Child Pediatric Cardiology Unit, Parma, Italy
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Ender Ödemis
- Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Louise Morrison
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Micheal Steimetz
- Department of Pediatric Cardiology and Intensive Care Medicine (M.S.), University Medical Center, Georg-August-University, Goettingen, Germany
| | - Kai Thorsten Laser
- Department of Congenital Heart Defects, Heart and Diabetes Center, North Rhine Westphalia Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Gabriela Doros
- Victor Babes UMF, IIIrd Pediatric Clinic, Louis Turcanu Emergency Children Hospital, Timisoara, Romania
| | | | - Iolanda Muntean
- Clinic of Paediatric Cardiology, Institute for Cardiovascular Diseases and Transplantation, UMFST "George Emil Palade", Timisoara, Romania
| | | | - Maria Sjoborg Alpman
- Pediatric Cardiology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Lindsey Hunter
- Department Paediatric Cardiology, Evelina London Children's Hospital, London, UK
| | - Tiina Ojala
- Department Pediatric Cardiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Misha Bhat
- Department of Pediatric Cardiology, Children's Heart Center, Skåne University Hospital in Lund, Lund, Sweden
| | - Peter Olejnik
- Pediatric Cardiology Center, Bratislava, Slovakia and Department of Pediatric Cardiology, Faculty of Medicine, National Institute of Cardiovascular Diseases, Comenius University, Bratislava, Slovakia
| | - Julie Wacker
- Pediatric Cardiology Unit, Department of Woman, Child and Adolescent Medicine, Children University Hospital of Geneva, Geneva, Switzerland
| | - Beatrice Bonello
- Department Paediatric Cardiology, Great Ormond Street NHS Trust, London, England
| | | | - Gerald Greil
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department of Pediatrics, Division of Pediatric Cardiology, UT Southwestern, Dallas, TX, USA
| | - Jan Marek
- Department Paediatric Cardiology, Great Ormond Street NHS Trust, London, England
| | - Giovanni DiSalvo
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Paediatric Cardiology Unit, Department of Woman's and Child's Health, University Hospital of Padova, University of Padua, Padua, Italy
| | - Colin J McMahon
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- University School of Medicine, University College Dublin 4, Dublin, Ireland
- Children's Health Ireland and Crumlin, Dublin, Ireland
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
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2
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Picano E, Pierard L, Peteiro J, Djordjevic-Dikic A, Sade LE, Cortigiani L, Van De Heyning CM, Celutkiene J, Gaibazzi N, Ciampi Q, Senior R, Neskovic AN, Henein M. The clinical use of stress echocardiography in chronic coronary syndromes and beyond coronary artery disease: a clinical consensus statement from the European Association of Cardiovascular Imaging of the ESC. Eur Heart J Cardiovasc Imaging 2024; 25:e65-e90. [PMID: 37798126 DOI: 10.1093/ehjci/jead250] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023] Open
Abstract
Since the 2009 publication of the stress echocardiography expert consensus of the European Association of Echocardiography, and after the 2016 advice of the American Society of Echocardiography-European Association of Cardiovascular Imaging for applications beyond coronary artery disease, new information has become available regarding stress echo. Until recently, the assessment of regional wall motion abnormality was the only universally practiced step of stress echo. In the state-of-the-art ABCDE protocol, regional wall motion abnormality remains the main step A, but at the same time, regional perfusion using ultrasound-contrast agents may be assessed. Diastolic function and pulmonary B-lines are assessed in step B; left ventricular contractile and preload reserve with volumetric echocardiography in step C; Doppler-based coronary flow velocity reserve in the left anterior descending coronary artery in step D; and ECG-based heart rate reserve in non-imaging step E. These five biomarkers converge, conceptually and methodologically, in the ABCDE protocol allowing comprehensive risk stratification of the vulnerable patient with chronic coronary syndromes. The present document summarizes current practice guidelines recommendations and training requirements and harmonizes the clinical guidelines of the European Society of Cardiology in many diverse cardiac conditions, from chronic coronary syndromes to valvular heart disease. The continuous refinement of imaging technology and the diffusion of ultrasound-contrast agents improve image quality, feasibility, and reader accuracy in assessing wall motion and perfusion, left ventricular volumes, and coronary flow velocity. Carotid imaging detects pre-obstructive atherosclerosis and improves risk prediction similarly to coronary atherosclerosis. The revolutionary impact of artificial intelligence on echocardiographic image acquisition and analysis makes stress echo more operator-independent and objective. Stress echo has unique features of low cost, versatility, and universal availability. It does not need ionizing radiation exposure and has near-zero carbon dioxide emissions. Stress echo is a convenient and sustainable choice for functional testing within and beyond coronary artery disease.
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Affiliation(s)
- Eugenio Picano
- Institute of Clinical Physiology of the National Research Council, CNR, Via Moruzzi 1, 56124 Pisa, Italy
| | - Luc Pierard
- University of Liège, Walloon Region, Belgium
| | - Jesus Peteiro
- CHUAC-Complexo Hospitalario Universitario A Coruna, CIBER-CV, University of A Coruna, 15070 La Coruna, Spain
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, University Clinical Centre of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia
| | - Leyla Elif Sade
- University of Pittsburgh Medical Center UPMC Heart & Vascular Institute, Pittsburgh, PA, USA
| | | | | | - Jelena Celutkiene
- Centre of Cardiology and Angiology, Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, 43100 Parma, Italy
| | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, 82100 Benevento, Italy
| | - Roxy Senior
- Imperial College, UK
- Royal Brompton Hospital Imperial College London, UK
- Northwick Park Hospital, London, UK
| | - Aleksandar N Neskovic
- Department of Cardiology, University Clinical Hospital Center Zemun-Belgrade Faculty of Medicine, University of Belgrade, Serbia
| | - Michael Henein
- Department of Public Health and Clinical Medicine Units: Section of Medicine, Umea University, Umea, Sweden
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Reid A, Dweck MR. Let there be light! The meteoric rise of cardiac imaging. BRITISH HEART JOURNAL 2022; 108:780-786. [PMID: 35459728 DOI: 10.1136/heartjnl-2021-320147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/02/2022] [Indexed: 11/04/2022]
Abstract
Imaging plays a central role in modern cardiovascular practice. It is a field characterised by exciting technological advances that have shaped our understanding of pathology and led to major improvements in patient diagnosis and care. The UK has played a key international role in the development of this subspecialty and is the current home to many of the leading global centres in multimodality cardiovascular imaging. In this short review, we will outline some of the key contributions of the British Cardiovascular Society and its members to this rapidly evolving field and look at how this relationship may continue to shape future cardiovascular practice.
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Affiliation(s)
- Anna Reid
- Department of Cardiology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Marc Richard Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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4
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Stress Echo 2030: The Novel ABCDE-(FGLPR) Protocol to Define the Future of Imaging. J Clin Med 2021; 10:jcm10163641. [PMID: 34441937 PMCID: PMC8397117 DOI: 10.3390/jcm10163641] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.
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5
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Kadoglou NPE, Papadopoulos CH, Papadopoulos KG, Karagiannis S, Karabinos I, Loizos S, Theodosis-Georgilas A, Aggeli K, Keramida K, Klettas D, Kounas S, Makavos G, Ninios I, Ntalas I, Ikonomidis I, Sahpekidis V, Stefanidis A, Zaglavara T, Athanasopoulos G, Karatasakis G, Kyrzopoulos S, Kouris N, Patrianakos A, Paraskevaidis I, Rallidis L, Savvatis K, Tsiapras D, Nihoyannopoulos P. Updated knowledge and practical implementations of stress echocardiography in ischemic and non-ischemic cardiac diseases: an expert consensus of the Working Group of Echocardiography of the Hellenic Society of Cardiology. Hellenic J Cardiol 2021; 64:30-57. [PMID: 34329766 DOI: 10.1016/j.hjc.2021.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 12/15/2022] Open
Abstract
Stress echocardiography (SE) is a well-established and valid technique, widely-used for the diagnostic evaluation of patients with ischemic and non-ischemic cardiac diseases. This statement of the Echocardiography Working Group of the Hellenic Society of Cardiology summarizes the consensus of the writing group regarding the applications of SE, based on the expertise of their members and on a critical review of current medical literature. The main objectives of the consensus document include a comprehensive review of SE methodology and training, focusing on the preparation, the protocols used and the analysis of the SE images and an updated, evidence-based knowledge about SE applications on ischemic and non-ischemic heart diseases, such as in cardiomyopathies, heart failure and valvular heart disease.
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Affiliation(s)
- Nikolaos P E Kadoglou
- Medical School, University of Cyprus, Nicosia, Cyprus; Second Cardiology Department, "Hippokration" Hospital, Aristotle University ofThessaloniki, Greece.
| | | | | | | | | | | | | | - Konstantina Aggeli
- 1st Cardiology Department, Hippokration University Hospital, Athens, Greece
| | - Kalliopi Keramida
- 2nd Cardiology Department, Attikon University Hospital, Athens, Greece
| | | | | | - George Makavos
- 3rd Cardiology Department, Sotiria University Hospital, Athens, Greece
| | - Ilias Ninios
- 2nd Cardiology Department, Interbalkan Center, Thessaloniki, Greece
| | | | | | | | | | | | | | - George Karatasakis
- 1st Cardiology Department, Onassis Cardiosurgical Center, Piraeus, Greece
| | | | - Nikos Kouris
- Cardiology Department, Thriasio Hospital, Elefsina, Greece
| | | | | | | | | | - Dimitrios Tsiapras
- 2nd Cardiology Department, Onassis Cardiosurgical Center, Piraeus, Greece
| | - Petros Nihoyannopoulos
- Metropolitan Hospital Center, Piraeus, Greece; Imperial College London, Hammersmith Hospital, London, UK
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6
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Ferrara F, Gargani L, Contaldi C, Agoston G, Argiento P, Armstrong WF, Bandera F, Cademartiri F, Citro R, Cittadini A, Cocchia R, D'Alto M, D'Andrea A, Douschan P, Ghio S, Grünig E, Guazzi M, Guida S, Kasprzak JD, Kolias TJ, Limongelli G, Marra AM, Mazzola M, Mauro C, Moreo A, Pieri F, Pratali L, Pugliese NR, Raciti M, Ranieri B, Rudski L, Saggar R, Salzano A, Serra W, Stanziola AA, Vannan M, Voilliot D, Vriz O, Wierzbowska-Drabik K, Naeije R, Bossone E. A multicentric quality-control study of exercise Doppler echocardiography of the right heart and the pulmonary circulation. The RIGHT Heart International NETwork (RIGHT-NET). Cardiovasc Ultrasound 2021; 19:9. [PMID: 33472662 PMCID: PMC7819251 DOI: 10.1186/s12947-021-00238-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/05/2021] [Indexed: 01/17/2023] Open
Abstract
Purpose This study was a quality-control study of resting and exercise Doppler echocardiography (EDE) variables measured by 19 echocardiography laboratories with proven experience participating in the RIGHT Heart International NETwork. Methods All participating investigators reported the requested variables from ten randomly selected exercise stress tests. Intraclass correlation coefficients (ICC) were calculated to evaluate the inter-observer agreement with the core laboratory. Inter-observer variability of resting and peak exercise tricuspid regurgitation velocity (TRV), right ventricular outflow tract acceleration time (RVOT Act), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler tricuspid lateral annular systolic velocity (S’), right ventricular fractional area change (RV FAC), left ventricular outflow tract velocity time integral (LVOT VTI), mitral inflow pulsed wave Doppler velocity (E), diastolic mitral annular velocity by TDI (e’) and left ventricular ejection fraction (LVEF) were measured. Results The accuracy of 19 investigators for all variables ranged from 99.7 to 100%. ICC was > 0.90 for all observers. Inter-observer variability for resting and exercise variables was for TRV = 3.8 to 2.4%, E = 5.7 to 8.3%, e’ = 6 to 6.5%, RVOT Act = 9.7 to 12, LVOT VTI = 7.4 to 9.6%, S’ = 2.9 to 2.9% and TAPSE = 5.3 to 8%. Moderate inter-observer variability was found for resting and peak exercise RV FAC (15 to 16%). LVEF revealed lower resting and peak exercise variability of 7.6 and 9%. Conclusions When performed in expert centers EDE is a reproducible tool for the assessment of the right heart and the pulmonary circulation.
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Affiliation(s)
- Francesco Ferrara
- Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Luna Gargani
- Institute of Clinical Physiology, C.N.R, Pisa, Italy
| | - Carla Contaldi
- Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Gergely Agoston
- Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Paola Argiento
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - William F Armstrong
- Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Francesco Bandera
- Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato University Hospital, Milan, Italy Heart Failure Unit, Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy.,Department for Biomedical Sciences for Health, University of Milano, Milan, Italy
| | | | - Rodolfo Citro
- Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Michele D'Alto
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonello D'Andrea
- Division of Cardiology, Umberto I° Hospital Nocera Inferiore, Nocera Inferiore, Italy
| | - Philipp Douschan
- Medical University of Graz, Graz, Austria and Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ekkehard Grünig
- Center of Pulmonary Hypertension, Thoraxklinik Heidelberg at Heidelberg University Hospital, Heidelberg, Germany
| | - Marco Guazzi
- Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato University Hospital, Milan, Italy Heart Failure Unit, Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy.,Department for Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - Stefania Guida
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jaroslaw D Kasprzak
- I Dept. and Chair of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland
| | - Theodore John Kolias
- Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Giuseppe Limongelli
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Ciro Mauro
- Cardiology Division, A Cardarelli Hospital, Naples, Italy
| | - Antonella Moreo
- A. De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Francesco Pieri
- Cardiology Department, Careggi University Hospital, Florence, Italy
| | | | | | - Mauro Raciti
- Institute of Clinical Physiology, C.N.R, Pisa, Italy
| | | | - Lawrence Rudski
- Azrieli Heart Center and Center for Pulmonary Vascular Diseases, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Rajan Saggar
- Lung & Heart-Lung Transplant and Pulmonary Hypertension Programs David Geffen School of Medicine, UCLA, Los Angeles, USA
| | | | - Walter Serra
- Cardiology Division, University Hospital, Parma, Italy
| | - Anna Agnese Stanziola
- Department of Respiratory Diseases, Monaldi Hospital, University "Federico II", Naples, Italy
| | - Mani Vannan
- Piedmont Heart Institute, Marcus Heart Valve Center, Atlanta, USA
| | - Damien Voilliot
- Centre Hospitalier Lunéville, Service de Cardiologie, Lunéville, France
| | - Olga Vriz
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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7
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Popescu (Chair) BA, Stefanidis A, Fox KF, Cosyns B, Delgado V, Di Salvo GD, Donal E, Flachskampf FA, Galderisi M, Lancellotti P, Muraru D, Sade LE, Edvardsen T. Training, competence, and quality improvement in echocardiography: the European Association of Cardiovascular Imaging Recommendations: update 2020. Eur Heart J Cardiovasc Imaging 2020; 21:1305-1319. [DOI: 10.1093/ehjci/jeaa266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract
The primary mission of the European Association of Cardiovascular Imaging (EACVI) is ‘to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging’. Echocardiography is a key component in the evaluation of patients with known or suspected cardiovascular disease and is essential for the high quality and effective practice of clinical cardiology. The EACVI aims to update the previously published recommendations for training, competence, and quality improvement in echocardiography since these activities are increasingly recognized by patients, physicians, and payers. The purpose of this document is to provide the general requirements for training and competence in echocardiography, to outline the principles of quality evaluation, and to recommend a set of measures for improvement, with the ultimate goal of raising the standards of echocardiographic practice. Moreover, the document aims to provide specific guidance for advanced echo techniques, which have dramatically evolved since the previous publication in 2009.
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Affiliation(s)
- Bogdan A Popescu (Chair)
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila” - Euroecolab, Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Sos. Fundeni 258, 022328 Bucharest, Romania
| | | | - Kevin F Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, UK
| | - Bernard Cosyns
- Department of Cardiology, Centrum voor Hart en vaatziekten (CHVZ), Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2300RC, The Netherlands
| | | | - Erwan Donal
- Service de Cardiologie Et Maladies Vasculaires Et CIC-IT 1414, CHU Rennes, 35000 Rennes, France
- Université de Rennes 1, LTSI, 35000 Rennes, France
| | - Frank A Flachskampf
- Department of Medical Sciences, Uppsala University, Clinical Physiology and Cardiology, Uppsala University Hospital, Uppsala, Sweden
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Anthea Hospital, Bari, Italy
| | - Denisa Muraru
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, P.le Brescia 201, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Leyla Elif Sade
- Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Thor Edvardsen
- Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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8
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Picano E, Zagatina A, Wierzbowska-Drabik K, Borguezan Daros C, D’Andrea A, Ciampi Q. Sustainability and Versatility of the ABCDE Protocol for Stress Echocardiography. J Clin Med 2020; 9:E3184. [PMID: 33008112 PMCID: PMC7601661 DOI: 10.3390/jcm9103184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022] Open
Abstract
For the past 40 years, the methodology for stress echocardiography (SE) has remained basically unchanged. It is based on two-dimensional, black and white imaging, and is used to detect regional wall motion abnormalities (RWMA) in patients with known or suspected coronary artery disease (CAD). In the last five years much has changed and RWMA is not enough on its own to stratify patient risk and dictate therapy. Patients arriving at SE labs often have comorbidities and are undergoing full anti-ischemic therapy. The SE positivity rate based on RWMA fell from 70% in the eighties to 10% in the last decade. The understanding of CAD pathophysiology has shifted from a regional hydraulic disease to a systemic biologic disease. The conventional view of CAD encouraged the use of coronary anatomic imaging for diagnosis and the oculo-stenotic reflex for the deployment of therapy. This has led to a clinical oversimplification that ignores the lessons of pathophysiology and epidemiology, and in fact, CAD is not synonymous with ischemic heart disease. Patients with CAD may also have other vulnerabilities such as coronary plaque (step A of ABCDE-SE), alveolar-capillary membrane and pulmonary congestion (step B), preload and contractile reserve (step C), coronary microcirculation (step D) and cardiac autonomic balance (step E). The SE methodology based on two-dimensional echocardiography is now integrated with lung ultrasound (step B for B-lines), volumetric echocardiography (step C), color- and pulsed-wave Doppler (step D) and non-imaging electrocardiogram-based heart rate assessment (step E). In addition, qualitative assessment based on the naked eye has now become more quantitative, has been improved by contrast and based on cardiac strain and artificial intelligence. ABCDE-SE is now ready for large scale multicenter testing in the SE2030 study.
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Affiliation(s)
- Eugenio Picano
- Biomedicine Department, CNR Institute of Clinical Physiology, 56124 Pisa, Italy
| | - Angela Zagatina
- Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
| | - Karina Wierzbowska-Drabik
- First Department and Chair of Cardiology, Bieganski Hospital, Medical University, 90926 Lodz, Poland;
| | | | | | - Quirino Ciampi
- Cardiolody Division, Fatebenefratelli Hospital, 82100 Benevento, Italy;
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9
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Čelutkienė J, Lainscak M, Anderson L, Gayat E, Grapsa J, Harjola VP, Manka R, Nihoyannopoulos P, Filardi PP, Vrettou R, Anker SD, Filippatos G, Mebazaa A, Metra M, Piepoli M, Ruschitzka F, Zamorano JL, Rosano G, Seferovic P. Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2019; 22:181-195. [PMID: 31815347 DOI: 10.1002/ejhf.1678] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 10/15/2019] [Accepted: 10/24/2019] [Indexed: 12/28/2022] Open
Abstract
Acute heart failure is one of the main diagnostic and therapeutic challenges in clinical practice due to a non-specific clinical manifestation and the urgent need for timely and tailored management at the same time. In this position statement, the Heart Failure Association aims to systematize the use of various imaging methods in accordance with the timeline of acute heart failure care proposed in the recent guidelines of the European Society of Cardiology. During the first hours of admission the point-of-care focused cardiac and lung ultrasound examination is an invaluable tool for rapid differential diagnosis of acute dyspnoea, which is highly feasible and relatively easy to learn. Several portable and stationary imaging modalities are being increasingly used for the evaluation of cardiac structure and function, haemodynamic and volume status, precipitating myocardial ischaemia or valvular abnormalities, and systemic and pulmonary congestion. This paper emphasizes the central role of the full echocardiographic examination in the identification of heart failure aetiology, severity of cardiac dysfunction, indications for specific heart failure therapy, and risk stratification. Correct evaluation of cardiac filling pressures and accurate prognostication may help to prevent unscheduled short-term readmission. Alternative advanced imaging modalities should be considered to assist patient management in the pre- and post-discharge phase, including cardiac magnetic resonance, computed tomography, nuclear studies, and coronary angiography. The Heart Failure Association addresses this paper to the wide spectrum of acute care and heart failure specialists, highlighting the value of all available imaging techniques at specific stages and in common clinical scenarios of acute heart failure.
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Affiliation(s)
- Jelena Čelutkienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,State Research Institute Centre For Innovative Medicine, Vilnius, Lithuania
| | - Mitja Lainscak
- Department of Cardiology and Department of Research and Education, General Hospital Celje, Celje, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Lisa Anderson
- Department of Cardiology, Royal Brompton Hospital, Imperial College London, London, UK
| | - Etienne Gayat
- Department of Anesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France
| | - Julia Grapsa
- Barts Heart Center, St Bartholomew's Hospital, London, UK
| | - Veli-Pekka Harjola
- Emergency Medicine, Helsinki University, Helsinki, Finland.,Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland
| | - Robert Manka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - Petros Nihoyannopoulos
- Unit of Inherited Cardiovascular Diseases/Heart Center of the Young and Athletes, First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece; National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Rosa Vrettou
- Department of Clinical Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefan D Anker
- Department of Cardiology (CVK); and Berlin-Brandenburg Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gerasimos Filippatos
- Department of Clinical Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandre Mebazaa
- Department of Anesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Massimo Piepoli
- Cardiac Department, Guglielmo da Saliceto Polichirurgico Hospital AUSL Piacenza, Piacenza, Italy
| | - Frank Ruschitzka
- Department of Cardiology, Heart Failure Clinic and Transplantation, University Heart Center Zurich, Zurich, Switzerland
| | | | - Giuseppe Rosano
- Clinical Academic Group, St George's Hospitals NHS Trust, London, UK; Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy
| | - Petar Seferovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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10
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Neskovic AN, Skinner H, Price S, Via G, De Hert S, Stankovic I, Galderisi M, Donal E, Muraru D, Sloth E, Gargani L, Cardim N, Stefanidis A, Cameli M, Habib G, Cosyns B, Lancellotti P, Edvardsen T, Popescu BA. Focus cardiac ultrasound core curriculum and core syllabus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2019. [PMID: 29529170 DOI: 10.1093/ehjci/jey006] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is a growing trend of using ultrasound examination of the heart as a first-line diagnostic tool for initial patient evaluation in acute settings. Focus cardiac ultrasound (FoCUS) is a standardized but restricted cardiac ultrasound examination that may be undertaken by a range of medical professionals with diverse backgrounds. The intention of this core curriculum and syllabus is to define a unifying framework for educational and training processes/programmes that should result in competence in FoCUS for various medical professionals dealing with diagnostics and treatment of cardiovascular emergencies. The European Association of Cardiovascular Imaging prepared this document in close cooperation with representatives of the European Society of Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology, the Acute Cardiovascular Care Association of the European Society of Cardiology and the World Interactive Network Focused On Critical Ultrasound. It aims to provide the key principles and represents a guide for teaching and training of FoCUS. We offer this document to the emergency and critical care community as a reference outline for teaching materials and courses related to FoCUS, for promoting teamwork and encouraging the development of the field.
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Affiliation(s)
- Aleksandar N Neskovic
- Department of Cardiology, Clinical Hospital Center Zemun, Vukova 9, 11080 Belgrade, Faculty of Medicine, University of Belgrade, Serbia
| | - Henry Skinner
- Department of Anaesthesiology, Nottingham University Hospitals, Hucknall Rd, Nottingham NG5 1PB, UK
| | - Susanna Price
- Adult Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK
| | - Gabriele Via
- Department of Anesthesia and Intensive Care, Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Ivan Stankovic
- Department of Cardiology, Clinical Hospital Center Zemun, Vukova 9, 11080 Belgrade, Faculty of Medicine, University of Belgrade, Serbia
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5, 80131 Napoli, Italy
| | - Erwan Donal
- Department of Cardiology, University Hospital of Rennes, rue H Le Guillou - Hôpital Pontchaillou, 35000 Rennes, France
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128 Padua, Italy
| | - Erik Sloth
- Department of Anaesthesiology and Intensive Care Medicine, Operation and Intensive Care East Section, Aarhus University Hospital, Skejby, 99 Palle Juul-Jensens Boulevard, 8200 Aarhus N, Denmark
| | - Luna Gargani
- Institute of Clinical Physiology - National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Nuno Cardim
- Cardiology Department, Hospital da Luz, Av. Lusíada, n° 100 - 1500-650 Lisbon, Portugal
| | | | - Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Viale Bracci 1, Policlinico Le Scotte, 53100 Siena, Italy
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Boulevard Jean Moulin, 13005 Marseille, France.,Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Boulevard Jean Moulin, 13005, Marseille, France
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten (CHVZ), Unversitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, Domaine Universitaire du Sart Tilman - B.35?-?4000 Liège, Belgium
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Sognvannsveien 20, NO-0027 Oslo, Norway
| | - Bogdan A Popescu
- Cardiology Department, University of Medicine and Pharmacy 'Carol Davila' - Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
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11
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Coisne A, Dreyfus J, Bohbot Y, Pelletier V, Collette E, Cescau A, Cariou E, Alexandrino C, Coulibaly S, Seemann A, Karsenty C, Theron A, Caspar T, Soulat-Dufour L, Ternacle J. Transoesophageal echocardiography current practice in France: A multicentre study. Arch Cardiovasc Dis 2018; 111:730-738. [PMID: 30539734 DOI: 10.1016/j.acvd.2018.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/29/2018] [Accepted: 03/20/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Few data are available on the application of transoesophageal echocardiography (TOE) recommendations in daily practice. AIMS To evaluate TOE practice based on echocardiography societies' guidelines, and to determine complication rates and factors associated with patient feelings. METHODS Between April and June 2017, we prospectively included all consecutive patients referred to 14 French hospitals for a transoesophageal echocardiogram (TOE). A survey was taken just after the examination, which included questions about pre-procedural anxiety, and any pain, unpleasant feeling or breathing difficulties experienced during the examination. RESULTS Overall, 1718 TOEs were performed, mainly for stroke evaluation. A standardized operating procedure checklist was completed in half of the patients before the examination. TOE was unpleasant for 62.4% of patients, but was stopped for agitation or intolerance in 3.5 and 1.4% of cases, respectively. We observed one severe complication (pulmonary oedema). The mean TOE duration was short (9.2±4.6minutes), but was longer with residents than with more experienced physicians (11±4.7 vs. 8.8±4.7minutes for junior physicians [P=0.0027]; vs. 8.9±4.8minutes for senior physicians [P=0.0013]; and vs. 7.5±4.1minutes for associate professors/professors [P<0.0001]). The visual analogue scale (VAS) score after TOE was good (8.3±1.7 out of 10), and was better in patients with general anaesthesia (GA) than in those without GA (9.3±0.9 vs. 8.1±1.7; P<0.0001). In patients without GA, the VAS score was similar with and without local anaesthesia (8.1±1.7 vs. 8.2±1.6; P=0.19). After multivariable adjustment, absence of anxiety before TOE and greater operator experience were consistently associated with a higher VAS score. CONCLUSIONS TOE is safe, with a low rate of complications and few stops for intolerance. A shorter TOE duration and better patient feelings were observed for experienced operators, highlighting the importance of the learning curve, and paving the way for teaching on a TOE simulator.
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Affiliation(s)
- Augustin Coisne
- Department of clinical physiology and echocardiography, Heart Valve Clinic, Institut Cœur-Poumon, CHU de Lille, 59000 Lille, France.
| | - Julien Dreyfus
- Department of cardiology, Centre Cardiologique du Nord, 93200 Saint-Denis, France
| | - Yohann Bohbot
- Department of cardiology, Amiens University Hospital, 80054 Amiens, France
| | - Vincent Pelletier
- Department of cardiology, SOS Endocardites, Henri-Mondor Hospital, 94010 Creteil, France
| | | | - Arthur Cescau
- Department of cardiology and radiology, Lariboisière Hospital, 75010 Paris, France
| | - Eve Cariou
- Department of cardiology, CHU de Toulouse, 31059 Toulouse, France
| | | | | | - Aurélien Seemann
- NCT+ Saint Gatient Alliance, Institut Cardiologique Saint-Gatien, 37000 Tours, France
| | - Clément Karsenty
- Department of cardiology, European Hospital Georges-Pompidou, 75015 Paris, France
| | - Alexis Theron
- Department of cardiac surgery, La Timone Hospital, Aix-Marseille University, 13005 Marseille, France
| | - Thibault Caspar
- Nouvel Hôpital Civil, Strasbourg University Hospital, 67091 Strasbourg, France
| | | | - Julien Ternacle
- Department of cardiology, SOS Endocardites, Henri-Mondor Hospital, 94010 Creteil, France
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12
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Ingram TE, Baker S, Allen J, Ritzmann S, Bual N, Duffy L, Ellis C, Bunting K, Black N, Peck M, Hothi SS, Sharma V, Pearce K, Steeds RP, Masani N. A patient-centred model to quality assure outputs from an echocardiography department: consensus guidance from the British Society of Echocardiography. Echo Res Pract 2018; 5:G25-G33. [PMID: 30400064 PMCID: PMC6241248 DOI: 10.1530/erp-18-0053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/27/2018] [Indexed: 12/28/2022] Open
Abstract
Background Quality assurance (QA) of echocardiographic studies is vital to ensure that clinicians can act on findings of high quality to deliver excellent patient care. To date, there is a paucity of published guidance on how to perform this QA. The British Society of Echocardiography (BSE) has previously produced an Echocardiography Quality Framework (EQF) to assist departments with their QA processes. This article expands on the EQF with a structured yet versatile approach on how to analyse echocardiographic departments to ensure high-quality standards are met. In addition, a process is detailed for departments that are seeking to demonstrate to external bodies adherence to a robust QA process. Methods The EQF consists of four domains. These include assessment of Echo Quality (including study acquisition and report generation); Reproducibility & Consistency (including analysis of individual variability when compared to the group and focused clinical audit), Education & Training (for all providers and service users) and Customer & Staff Satisfaction (of both service users and patients/their carers). Examples of what could be done in each of these areas are presented. Furthermore, evidence of participation in each domain is categorised against a red, amber or green rating: with an amber or green rating signifying that a quantifiable level of engagement in that aspect of QA has been achieved. Conclusion The proposed EQF is a powerful tool that focuses the limited time available for departmental QA on areas of practice where a change in patient experience or outcome is most likely to occur.
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Affiliation(s)
| | - Steph Baker
- Grantham and District Hospital, Grantham, UK
| | - Jane Allen
- York Hospital NHS Foundation Trust, York, UK
| | - Sarah Ritzmann
- Doncaster & Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Nina Bual
- Imperial College Healthcare NHS Trust, London, UK
| | - Laura Duffy
- York Hospital NHS Foundation Trust, York, UK
| | - Chris Ellis
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Karina Bunting
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Noel Black
- South Eastern Health and Social Care Trust, Dundonald, UK
| | | | - Sandeep S Hothi
- Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK
| | - Vishal Sharma
- Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
| | - Keith Pearce
- University Hospitals of South Manchester NHS Foundation Trust, Manchester, UK
| | - Richard P Steeds
- University Hospitals of Birmingham NHS Foundation Trust, Birmingham, UK
| | - Navroz Masani
- University Hospital of Wales, Cardiff & Vale NHS University Health Board, Cardiff, UK
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13
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Sampaio F, Ribeiras R, Galrinho A, Teixeira R, João I, Trabulo M, Quelhas I, Cabral S, Ribeiro J, Mendes M, Morais J. Documento de Consenso e Recomendações para a realização de Ecocardiografia Transtorácica em Portugal. Rev Port Cardiol 2018; 37:637-644. [DOI: 10.1016/j.repc.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/16/2018] [Accepted: 05/14/2018] [Indexed: 11/25/2022] Open
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14
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Consensus document on transthoracic echocardiography in Portugal. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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15
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Timing on echocardiography and blood laboratory test is important for future outcome association in hospitalized heart failure patients. J Cardiol 2018; 71:71-80. [DOI: 10.1016/j.jjcc.2017.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 03/24/2017] [Accepted: 04/18/2017] [Indexed: 01/09/2023]
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16
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Quality control of regional wall motion analysis in stress Echo 2020. Int J Cardiol 2017; 249:479-485. [PMID: 28986062 DOI: 10.1016/j.ijcard.2017.09.172] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/13/2017] [Accepted: 09/18/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The trial "Stress Echo (SE) 2020" evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. METHODS One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31years (mean value 18years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥90%). RESULTS Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7±13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r=-0.161, p=0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p<0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt. CONCLUSIONS In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit.
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17
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Steeds RP, Garbi M, Cardim N, Kasprzak JD, Sade E, Nihoyannopoulos P, Popescu BA, Stefanidis A, Cosyns B, Monaghan M, Aakhus S, Edvardsen T, Flachskampf F, Galiuto L, Athanassopoulos G, Lancellotti P, Delgado V, Donal E, Galderisi M, Lombardi M, Muraru D, Haugaa K. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review. Eur Heart J Cardiovasc Imaging 2017; 18:1191-1204. [DOI: 10.1093/ehjci/jew333] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 12/19/2022] Open
Affiliation(s)
- Richard P. Steeds
- University Hospital Birmingham NHS Foundation Trust, Mindelsohn Road, Edgbaston, Birmingham, UK B15 2GW and Honorary Reader, Institute of Cardiovascular Sciences, University of Birmingham; UK
| | - Madalina Garbi
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS UK
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz Av. Lus죡, n° 100 - 1500-650, Lisbon, Portugal
| | - Jaroslaw D. Kasprzak
- Department of Cardiology, Bieganski Hospital Medical University of Lodz, Kniaziewicza 1/5, 91-347, Lodz, Poland
| | - Elif Sade
- Department of Cardiology, Baskent University School of Medicine, Fevzi ơkmak Cad. 10. Sok. Bahcelievler 06490 Ankara, Turkey
| | - Petros Nihoyannopoulos
- Imperial College London, NHLI Hammersmith Hospital, Du Cane Road, London W12 0NN, UK and University of Athens, Greece
| | - Bogdan Alexandru Popescu
- University of Medicine and Pharmacy “Carol Davila”–Euroecolab, Institute of Cardiovascular Diseases, Sos. Fundeni 258, sector 2, 022328, Bucharest, Romania
| | - Alexandros Stefanidis
- 1st Department of Cardiology, General Hospital of Nikea, 3 P. Mela str., 184 54, Athens, Greece
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten) Universitair Ziekenhuis, VUB, Laarbeeklaan 101, 1090 Jette, Brussel, Belgium
| | - Mark Monaghan
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS UK
| | - Svend Aakhus
- Department of Cardiology, Oslo University Hospital, postboks 4950 Nydalen, 0424 Oslo and Faculty of Medicine, Norwegian University of Science and Technology, NTNU, 7491 Trondheim
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, NO-0027 Oslo , Norway
| | - Frank Flachskampf
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Akademiska ingang 40, 751 85 Uppsala, Sweden
| | - Leonarda Galiuto
- Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Largo A Gemelli 8, 00168 Roma, Italy
| | | | - Patrizio Lancellotti
- Departments of Cardiology, University of Lie`ge Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Lie‘ge, Belgium and Gruppo Villa Maria Care and Research, Anthea, Hospital, Bari, Italy
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18
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Lancellotti P, Pellikka PA, Budts W, Chaudhry FA, Donal E, Dulgheru R, Edvardsen T, Garbi M, Ha JW, Kane GC, Kreeger J, Mertens L, Pibarot P, Picano E, Ryan T, Tsutsui JM, Varga A. The Clinical Use of Stress Echocardiography in Non-Ischaemic Heart Disease: Recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2017; 30:101-138. [DOI: 10.1016/j.echo.2016.10.016] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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19
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Picano E, Ciampi Q, Citro R, D’Andrea A, Scali MC, Cortigiani L, Olivotto I, Mori F, Galderisi M, Costantino MF, Pratali L, Di Salvo G, Bossone E, Ferrara F, Gargani L, Rigo F, Gaibazzi N, Limongelli G, Pacileo G, Andreassi MG, Pinamonti B, Massa L, Torres MAR, Miglioranza MH, Daros CB, de Castro e Silva Pretto JL, Beleslin B, Djordjevic-Dikic A, Varga A, Palinkas A, Agoston G, Gregori D, Trambaiolo P, Severino S, Arystan A, Paterni M, Carpeggiani C, Colonna P. Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease. Cardiovasc Ultrasound 2017; 15:3. [PMID: 28100277 PMCID: PMC5242057 DOI: 10.1186/s12947-016-0092-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information. The study is endorsed by the Italian Society of Cardiovascular Echography and organized in 10 subprojects focusing on: contractile reserve for prediction of cardiac resynchronization or medical therapy response; stress B-lines in heart failure; hypertrophic cardiomyopathy; heart failure with preserved ejection fraction; mitral regurgitation after either transcatheter or surgical aortic valve replacement; outdoor SE in extreme physiology; right ventricular contractile reserve in repaired Tetralogy of Fallot; suspected or initial pulmonary arterial hypertension; coronary flow velocity, left ventricular elastance reserve and B-lines in known or suspected CAD; identification of subclinical familial disease in genotype-positive, phenotype- negative healthy relatives of inherited disease (such as hypertrophic cardiomyopathy). RESULTS We expect to recruit about 10,000 patients over a 5-year period (2016-2020), with sample sizes ranging from 5,000 for coronary flow velocity/ left ventricular elastance/ B-lines in CAD to around 250 for hypertrophic cardiomyopathy or repaired Tetralogy of Fallot. This data-base will allow to investigate technical questions such as feasibility and reproducibility of various SE parameters and to assess their prognostic value in different clinical scenarios. CONCLUSIONS The study will create the cultural, informatic and scientific infrastructure connecting high-volume, accredited SE labs, sharing common criteria of indication, execution, reporting and image storage of SE to obtain original safety, feasibility, and outcome data in evidence-poor diagnostic fields, also outside the established core application of SE in CAD based on regional wall motion abnormalities. The study will standardize procedures, validate emerging signs, and integrate the new information with established knowledge, helping to build a next-generation SE lab without inner walls.
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Affiliation(s)
- Eugenio Picano
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Rodolfo Citro
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Antonello D’Andrea
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Maria Chiara Scali
- Cardiology Department, Pisa University and Nottola (Siena) Hospital, Pisa, Italy
| | | | | | - Fabio Mori
- Cardiology Department, Careggi Hospital, Florence, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | | | - Lorenza Pratali
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Eduardo Bossone
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Francesco Ferrara
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Luna Gargani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Fausto Rigo
- Division of Cardiology, Ospedale dell’Angelo Mestre-Venice, Mestre, Italy
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Parma, Italy
| | | | - Giuseppe Pacileo
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | | | - Bruno Pinamonti
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Laura Massa
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Marco A. R. Torres
- Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Albert Varga
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Attila Palinkas
- Department of Internal Medicine, Elisabeth Hospital, Hodmezovasarhely, Hungary
| | - Gergely Agoston
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Dario Gregori
- Department of Biostatistics, University of Padua, Padua, Italy
| | | | | | - Ayana Arystan
- RSE, Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Marco Paterni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Clara Carpeggiani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico of Bari, Bari, Italy
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Relation of red blood cell distribution width with CHADS 2 and CHA 2DS 2-VASc score in Chinese patients with non-valvular atrial fibrillation. Int J Cardiol 2016; 228:861-864. [PMID: 27889552 DOI: 10.1016/j.ijcard.2016.11.255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Higher red cell distribution width (RDW) predicts adverse events in patients with cardiovascular diseases. However, there are limited data regarding the relationship between RDW and thromboembolism risk in the patients with atrial fibrillation (AF). We aimed to investigate the association between RDW and CHADS2, CHA2DS2-VASc scores used for the evaluation of thromboembolic risk in patients with non-valvular atrial fibrillation (AF). METHODS Our study included 99 patients with AF (68 paroxysmal AF; 31 persistent AF). We calculated CHADS2 and CHA2DS2-VASc risk scores for each patient, and we carefully recorded clinical characteristics as well as laboratory and echocardiographic parameters. According to CHADS2 and CHA2DS2-VASc scores, we divided the AF patients into 2 groups (low-intermediate risk and high risk group). Subsequently, we compared the aforementioned parameters between the 2 groups, and we evaluated the relationship between RDW and CHADS2/CHA2DS2-VASc score. Finally, multivariate logistic regression analysis was performed to find independent predictors of high CHADS2, CHA2DS2-VASc scores. RESULTS Patients with high CHADS2, CHA2DS2-VASc scores had older age, higher RDW, and creatinine levels, increased left atrial diameter and lower left ventricular ejection fraction, compared to the low CHADS2, CHA2DS2-VASc score group. Multivariate logistic regression analysis showed that RDW was an independent predictor for high CHADS2, CHA2DS2-VASc scores(OR: 2.184 and OR: 5.748; all P<0.05). CONCLUSION RDW is significantly correlated with CHADS2 and CHA2DS2-VASc score in the patients with AF, while is an independent predictor for high CHADS2 and CHA2DS2-VASc score.
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21
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Affiliation(s)
- Mathivathana Indrajith
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Madalina Garbi
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Mark J Monaghan
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
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22
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Lancellotti P, Pellikka PA, Budts W, Chaudhry FA, Donal E, Dulgheru R, Edvardsen T, Garbi M, Ha JW, Kane GC, Kreeger J, Mertens L, Pibarot P, Picano E, Ryan T, Tsutsui JM, Varga A. The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016; 17:1191-1229. [DOI: 10.1093/ehjci/jew190] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 12/20/2022] Open
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23
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Eskandari M, Kramer CM, Hecht HS, Jaber WA, Marwick TH. Evidence Base for Quality Control Activities in Cardiovascular Imaging. JACC Cardiovasc Imaging 2016; 9:294-305. [DOI: 10.1016/j.jcmg.2015.11.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/06/2015] [Accepted: 11/11/2015] [Indexed: 11/28/2022]
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24
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López-Sendón JL, González-Juanatey JR, Pinto F, Castillo JC, Badimón L, Dalmau R, Torrecilla EG, Mínguez JRL, Maceira AM, Pascual-Figal D, Moya-Prats JLP, Sionis A, Zamorano JL. Quality markers in cardiology: measures of outcomes and clinical practice--a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery. Eur Heart J 2016; 37:12-23. [PMID: 26491106 PMCID: PMC4692288 DOI: 10.1093/eurheartj/ehv527] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/04/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- José-Luis López-Sendón
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | - Fausto Pinto
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - José Cuenca Castillo
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Lina Badimón
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Regina Dalmau
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | | | - Alicia M Maceira
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Domingo Pascual-Figal
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | - Alessandro Sionis
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - José Luis Zamorano
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
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25
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Indicadores de calidad en cardiología. Principales indicadores para medir la calidad de los resultados (indicadores de resultados) y parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): Declaración de posicionamiento de consenso de SEC/SECTCV. CIRUGIA CARDIOVASCULAR 2015. [DOI: 10.1016/j.circv.2015.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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26
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López-Sendón JL, González-Juanatey JR, Pinto F, Castillo JC, Badimón L, Dalmau R, Torrecilla EG, Mínguez JRL, Maceira AM, Pascual-Figal D, Moya-Prats JLP, Sionis A, Zamorano JL. Quality markers in cardiology: measures of outcomes and clinical practice —a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery1. CIRUGIA CARDIOVASCULAR 2015. [DOI: 10.1016/j.circv.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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27
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Indicadores de calidad en cardiología. Principales indicadores para medir la calidad de los resultados (indicadores de resultados) y parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): Declaración de posicionamiento de consenso de SEC/SECTCV. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2015.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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28
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper. ACTA ACUST UNITED AC 2015; 68:976-995.e10. [PMID: 26315766 DOI: 10.1016/j.rec.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 07/21/2015] [Indexed: 02/06/2023]
Abstract
Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.
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Affiliation(s)
- José López-Sendón
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.
| | - José Ramón González-Juanatey
- Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Fausto Pinto
- European Society of Cardiology; Department of Cardiology, University Hospital Santa Maria, Lisbon, Portugal
| | - José Cuenca Castillo
- Sociedad Española de Cirugía Torácica-Cardiovascular; Servicio de Cirugía Cardiaca, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Lina Badimón
- Centro de Investigación Cardiovascular (CSIC-ICCC), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Regina Dalmau
- Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - Esteban González Torrecilla
- Unidad de Electrofisiología y Arritmias, Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - José Ramón López-Mínguez
- Unidad de Cardiología intervencionista, Servicio de Cardiología, Hospital Infanta Crsitina, Badajoz, Spain
| | - Alicia M Maceira
- Unidad de Imagen Cardiaca, Servicio de Cardiología, ERESA Medical Center, Valencia, Spain
| | - Domingo Pascual-Figal
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - Alessandro Sionis
- Unidad de Cuidados Intensivos Cardiológicos, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Luis Zamorano
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Edvardsen T, Bucciarelli-Ducci C, Saraste A, Pierard LA, Knuuti J, Maurer G, Habib G, Lancellotti P. The year 2014 in the European Heart Journal - Cardiovascular Imaging. Part I. Eur Heart J Cardiovasc Imaging 2015; 16:712-8. [DOI: 10.1093/ehjci/jev150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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30
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Lancellotti P, P o ska-Go ciniak E, Garbi M, Bucciarelli-ducci C, Cosyns B, Cardim N, Galderisi M, Edvardsen T, Neglia D, Plein S, Kitsiou A, Nieman K, Stefanidis A, Maurer G, Popescu BA, Habib G. Cardiovascular imaging practice in Europe: a report from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16:697-702. [DOI: 10.1093/ehjci/jev116] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 04/13/2015] [Indexed: 11/12/2022] Open
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31
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Cosyns B, De Diego JJG, Stefanidis A, Galderisi M, Ernande L, Underwood SR, Bucciarelli-Ducci C, Lancellotti P, Habib G. E-learning in cardiovascular imaging: another step towards a structured educational approach. Eur Heart J Cardiovasc Imaging 2015; 16:463-5. [DOI: 10.1093/ehjci/jev022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 01/25/2015] [Indexed: 11/13/2022] Open
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32
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Lancellotti P, Price S, Edvardsen T, Cosyns B, Neskovic AN, Dulgheru R, Flachskampf FA, Hassager C, Pasquet A, Gargani L, Galderisi M, Cardim N, Haugaa KH, Ancion A, Zamorano JL, Donal E, Bueno H, Habib G. The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2015; 4:100-132. [PMID: 25378666 DOI: 10.1177/2048872614549739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart disease including endocarditis, acute disease of the ascending aorta and post-intervention complications. Specific issues regarding echocardiography in other acute cardiovascular care scenarios are also described.
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Affiliation(s)
- Patrizio Lancellotti
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | - Susanna Price
- Adult Intensive Care Unit, Royal Brompton Hospital, London, UK
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital and University of Oslo, Norway
| | - Bernard Cosyns
- Department of Cardiology, Univeristair ziekenhuis, VUB, Centrum Voor Hart-en Vaatziekten (CHVZ), Brussels, Belgium
| | | | - Raluca Dulgheru
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | | | - Christian Hassager
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark
| | - Agnes Pasquet
- Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain and Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Luna Gargani
- Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Maurizio Galderisi
- Department of Medical Translational Sciences, Federico II University Hospital, Naples, Italy
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital and University of Oslo, Norway
| | - Arnaud Ancion
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | | | - Erwan Donal
- Cardiology Department, CHU Rennes and LTSI, Université Rennes-1, France
| | - Héctor Bueno
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón & Universidad Complutense de Madrid, Spain
| | - Gilbert Habib
- Aix-Marseille Université, APHM, La Timone Hospital, Cardiology Department, France
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Garbi M, McDonagh T, Cosyns B, Bucciarelli-Ducci C, Edvardsen T, Kitsiou A, Nieman K, Lancellotti P. Appropriateness criteria for cardiovascular imaging use in heart failure: report of literature review. Eur Heart J Cardiovasc Imaging 2014; 16:147-53. [PMID: 25550363 DOI: 10.1093/ehjci/jeu299] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The Imaging Task Force appointed by the European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging (EACVI) identified the need to develop appropriateness criteria for the use of cardiovascular imaging in heart failure as a result of continuously increasing demand for imaging in diagnosis, definition of aetiology, follow-up, and treatment planning. This article presents the report of literature review performed in order to inform the process of definition of clinical indications and to aid the decisions of the appropriateness criteria voting panel. The report is structured according to identified common heart failure clinical scenarios.
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Affiliation(s)
- Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Theresa McDonagh
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Bernard Cosyns
- Universitair Ziekenhuis van Brussel, CHVZ and ICMI Laboratory, CHIREC, Brussels, Belgium
| | - Chiara Bucciarelli-Ducci
- Bristol NIHR Cardiovascular Biomedical Research Unit (BRU), Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Norway
| | | | - Koen Nieman
- Department of Cardiology and Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Patrizio Lancellotti
- Department of GIGA Cardiovascular Sciences, Heart Valve Clinic, Department of Cardiology, University of Liège Hospital, University Hospital SartTilman, Liège, Belgium Department of GVM Care and Research, Bologna, Italy
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Lancellotti P, Price S, Edvardsen T, Cosyns B, Neskovic AN, Dulgheru R, Flachskampf FA, Hassager C, Pasquet A, Gargani L, Galderisi M, Cardim N, Haugaa KH, Ancion A, Zamorano JL, Donal E, Bueno H, Habib G. The use of echocardiography in acute cardiovascular care: recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association. Eur Heart J Cardiovasc Imaging 2014; 16:119-46. [PMID: 25378470 DOI: 10.1093/ehjci/jeu210] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/ critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart disease including endocarditis, acute disease of the ascending aorta and post-intervention complications. Specific issues regarding echocardiography in other acute cardiovascular care scenarios are also described.
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Affiliation(s)
- Patrizio Lancellotti
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | - Susanna Price
- Adult Intensive Care Unit, Royal Brompton Hospital, London, UK
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital and University of Oslo, Norway
| | - Bernard Cosyns
- Department of Cardiology, Univeristair ziekenhuis, VUB, Centrum Voor Hart-en Vaatziekten (CHVZ), Brussels, Belgium
| | | | - Raluca Dulgheru
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | | | - Christian Hassager
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark
| | - Agnes Pasquet
- Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain and Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Luna Gargani
- Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Maurizio Galderisi
- Department of Medical Translational Sciences, Federico II University Hospital, Naples, Italy
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital and University of Oslo, Norway
| | - Arnaud Ancion
- University of Liège Hospital, Cardiology Care Unit, GIGA Cardiovascular Sciences, Department of Cardiology, University Hospital Sart Tilman, Belgium
| | | | - Erwan Donal
- Cardiology Department, CHU Rennes and LTSI, Université Rennes-1, France
| | - Héctor Bueno
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón & Universidad Complutense de Madrid, Spain
| | - Gilbert Habib
- Aix-Marseille Université, APHM, La Timone Hospital, Cardiology Department, France
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Popescu BA, Stefanidis A, Nihoyannopoulos P, Fox KF, Ray S, Cardim N, Rigo F, Badano LP, Fraser AG, Pinto F, Zamorano JL, Habib G, Maurer G, Lancellotti P. Updated standards and processes for accreditation of echocardiographic laboratories from The European Association of Cardiovascular Imaging: an executive summary. Eur Heart J Cardiovasc Imaging 2014; 15:1188-93. [DOI: 10.1093/ehjci/jeu057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Petersen SE, Almeida AG, Alpendurada F, Boubertakh R, Bucciarelli-Ducci C, Cosyns B, Greil GF, Karamitsos TD, Lancellotti P, Stefanidis AS, Tann O, Westwood M, Plein S. Update of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance Certification Exam. Eur Heart J Cardiovasc Imaging 2014; 15:728-9. [PMID: 24855220 DOI: 10.1093/ehjci/jeu076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
An updated version of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance (CMR) Certification Exam is now available online. The syllabus lists key elements of knowledge in CMR. It represents a framework for the development of training curricula and provides expected knowledge-based learning outcomes to the CMR trainees, in particular those intending to demonstrate CMR knowledge in the European CMR exam, a core requirement in the CMR certification process.
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Affiliation(s)
- Steffen E Petersen
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Ana G Almeida
- Department of Cardiology, Non-invasive Cardiac Imaging Unit, University Hospital Santa Maria, Faculty of Medicine of Lisbon University, Lisbon, Portugal
| | - Francisco Alpendurada
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, UK
| | - Redha Boubertakh
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Chiara Bucciarelli-Ducci
- NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Bernard Cosyns
- Cardiology Department, CHIREC, UZ Brussel, ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Free University of Brussels, Brussels, Belgium
| | - Gerald F Greil
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St. Thomas' Hospital, London, UK
| | - Theodoros D Karamitsos
- 1st Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Departments of Cardiology, Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, Belgium
| | | | - Oliver Tann
- Cardiorespiratory Unit, Great Ormond Street Hospital, Great Ormond Street, London, UK
| | - Mark Westwood
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre, The Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
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