American societies come together to publish appropriate use criteria for valvular heart disease


The American College of Cardiology and several partnering societies—including the American Heart Association (AHA) and Society for Cardiovascular Angiography and Interventions (SCAI)—have released a joint appropriate use criteria document for the treatment of valvular heart disease. The document reviews the evaluation and use of multimodality imaging in the diagnosis and management of the disease.

The document, a press release reports, addresses the appropriate use of multiple imaging modalities available to clinicians in the evaluation of patients with valvular heart disease. It covers the spectrum of patients with valvular heart disease—from patients with no symptoms who are suspected of having valvular heart disease to patients with signs and symptoms ranging from mild to severe. A standardised approach was used to create different categories of indications with the goal of capturing actual real-world clinical scenarios. These clinical scenarios were developed by the writing committee to cover established and emerging treatment approaches for valvular heart disease. An independent rating panel scored the clinical scenarios, assessing whether the use of an imaging test for each indication fell into one of the following categories: Appropriate, May Be Appropriate or Rarely Appropriate.

The goal of the document, according to the press release, is to identify all imaging tests that are considered reasonable for a given clinical indication. Therefore, the testing modalities were rated for their level of appropriateness—specific to clinical scenarios rather than a forced rank order comparison against other testing modalities.

John U Doherty (Thomas Jefferson University, Philadelphia, USA), chair of the writing committee, says: “As imaging technologies and clinical applications continue to advance, the healthcare community must understand how best to incorporate these technologies into daily clinical care and how to choose between new and established imaging technologies.”

The ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 appropriate use criteria for multimodality imaging in valvular heart disease has been published in the Journal of the American College of Cardiology, the Journal of the American Society of Echocardiography, the Journal of Nuclear Cardiology and the Journal of Thoracic and Cardiovascular Surgery.


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