ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography

Douglas, Pamela S.; García, Mario J.; Haines, David E.; Lai, Wyman W.; Manning, Warren J.; Patel, Ayan R.; Picard, Michael H.; Polk, Donna M.; Ragosta, Michael; Ward, R. Parker; Weiner, Rory B.; Bailey, Steven R.; Alagona, Peter; Anderson, Jeffrey L.; DeCara, Jeanne M.; Dolor, Rowena J; Fazel, Reza; Gillespie, John A.; Heidenreich, Paul A.; Leykum, Luci K.; Marine, Joseph E.; Mishkel, Gregory; Pellikka, Patricia A.; Raff, Gilbert; Vijayaraghavan, Krishnaswami; Weissman, Neil J.; Wu, Kathérine C.; Wolk, Michael J.; Hendel, Robert C.; Kramer, Christopher M.; Min, James K.; Patel, Manesh R.; Shaw, Leslee J.; Stainback, Raymond F.; Allen, Joseph M.

doi:10.1016/j.jacc.2010.11.002

Cited by 615 publications

(204 citation statements)

References 45 publications

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“…19 Routines included measurement of conventional and Doppler-derived parameters: interventricular septum thickness in diastole and LV posterior wall diameter, LV enddiastolic and end-systolic dimensions and volumes were registered for systolic, early (E) and late (A) mitral inflow velocities, early myocardial relaxation velocity (e9) and deceleration time for diastolic function. Indices for fraction of shortening, stroke volume, ejection fraction, and the quotients E/A and E/e9 were calculated automatically.…”

Section: Patients and Study Designmentioning

confidence: 99%

Serum-Mediated Inhibition of Enzyme Replacement Therapy in Fabry Disease

Lenders

Stypmann

Duning

et al. 2016

Journal of the American Society of Nephrology

111

113

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Fabry disease (FD) is a progressive multisystemic disorder, treatable with recombinant enzyme replacement therapy (agalsidase). However, recent studies suggest an endogenous inhibition of agalsidase in patients with FD, as reported for other lysosomal storage diseases. To assess the clinical consequences of serum-mediated agalsidase inhibition in affected patients, we determined the agalsidase inhibition status of 168 patients (68 male) with FD and compared outcomes of inhibition-positive patients with those of inhibition-negative patients. The assessment included clinical events during time on agalsidase, determination of renal and cardiac function, and evaluation of FD-related symptoms. The frequency of serum-mediated agalsidase inhibition was 40% in agalsidase-treated males. Inhibition did not depend on the compound initially used (agalsidase-a or -b). Agalsidase inhibition was associated with higher lysoglobotriaosylceramide levels and worse disease severity scores in patients. Compared with agalsidase inhibition-negative men, agalsidase inhibition-positive men showed greater left ventricular mass (P=0.02) and substantially lower renal function (difference in eGFR of about -30 ml/min per 1.73 m 2 ; P=0.04), which was confirmed by a longitudinal 5-year retrospective analysis. Additionally, affected patients presented more often with FD-typical symptoms, such as diarrhea, fatigue, and neuropathic pain, among others. Therefore, patients with poor clinical outcome on agalsidase should be tested for agalsidase inhibition. Future studies are warranted to determine if affected patients with FD benefit from acute reduction of anti-agalsidase antibodies or long-term immune modulation therapies to suppress agalsidase inhibition and to identify mechanisms that minimize antibody generation against agalsidase.

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Section: Patients and Study Designmentioning

confidence: 99%

Serum-Mediated Inhibition of Enzyme Replacement Therapy in Fabry Disease

Lenders

Stypmann

Duning

et al. 2016

Journal of the American Society of Nephrology

111

113

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“…Only one patient's indication was seen as inappropriate when compared with the AUC. [14] The major contribution of TTE was the information provided to aid the diagnosis of heart failure (29.0%) and ischaemic heart disease (23.8%) ( Table 4). Of all participants, onethird had impaired left ventricular (LV) function.…”

Section: Clinical Utility and Association With Impactmentioning

confidence: 99%

“…These AUC identify common clinical scenarios in which ECHO can be applied and aim at improving health outcomes by means of the equitable allocation of resources in cardiovascular imaging. [14] There is a paucity of data regarding the impact of ECHO in subSaharan Africa. Various definitions of impact and the different concepts of a district or general hospital limit the generalisability to resourceconstrained areas, where, paradoxically, the clinical impact of ECHO may be of more value than the traditionally accepted clinical indications.…”

mentioning

confidence: 99%

Impact of transthoracic echocardiography at district hospital level

et al. 2015

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Background. The use of and demand for echocardiography (ECHO) has increased worldwide. In developed countries, this has not translated into improved access outside tertiary centres. Previous studies have favoured the appropriate use of ECHO over its clinical impact, limiting generalisability to resourceconstrained settings. Objectives. To assess the impact of an ECHO service at district hospital level in Cape Town, South Africa. Methods. A prospective, crosssectional study was performed. A total of 210 consecutive patients, referred to the ECHO clinic over a 5month period, were recruited. Transthoracic ECHO was evaluated in terms of its indication, new information provided, correlation with the referring doctor's diagnosis and subsequent management plan. Impact included the escalation and deescalation of treatment, as well as usefulness without a change in management. Results. The results show that 83.8% of the patients' management was impacted on by echocardiography. Valvular lesions were the main indication. The most frequent contribution was information provided towards the diagnosis of heart failure and assessment after myocardial infarction. Of the echocardiograms, 56.2% confirmed the referring doctor's diagnosis, yet were still associated with a significant impact. The rational prescription of medication had the major impetus, followed by deescalation of therapy and screening patients to determine referral to a tertiary facility. Conclusion. ECHO has a positive impact on patient management outside tertiary settings, where the definition of impact appears to be different. The value of a normal study, screening prior to upstream referral and usefulness irrespective of change have been established. This should alert policy makers against restriction of access to ECHO and promote training of personnel in its use.

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“…ON the other hand, Kirkpatrick et al 8 showed a frequency of 8%, similar to that observed in our study (7.8%). When comparing the Brazilian guidelines 3 with the ACC criteria 5 , it can be observed that SBC guidelines of 2009 only consider 41 requests as inadequate, while the ACC criteria consider 71 indications for echocardiography as inadequate. This difference suggests the need to review the current Brazilian guidelines aiming to extend its applicability.…”

Section: Introductionmentioning

confidence: 99%