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Highlights from the recent and upcoming EACVI recommendation papers

by Prof. T. Edvardsen, Scientific Documents Committee Chair at the European Association of Cardiovascular Imaging and Department Of Cardiology, Rikshospitalet, Oslo University Hospital, Norway



During the past few years, the scientific documents committee of the European Association of Cardiovascular Imaging (EACVI) has been very active. We have initiated lots of recommendation and expert consensus papers and, in the last year, one of the most important publications was the update to the recommendations for the evaluation of left ventricular diastolic function by echocardiography. 1 It was a joint paper between the EACVI and the American Society of Echocardiography, and Sherif Nagueh, Houston, Texas, USA, and Otto Smiseth, Oslo, Norway, were the co-chairs. One of the most important contributions to the updated recommendations was the development of a new algorithm for the diagnosis of left ventricular diastolic dysfunction in patients with normal left ventricular ejection fraction. It has cleared up some misunderstandings from earlier papers, and it was wellreceived by our members.

Another very important paper that was published in 2016 was on the imaging assessment of prosthetic heart valves, and how to follow these valves after implantation using all imaging modalities. 2 It was endorsed by the Chinese Society of Echocardiography, the Inter- American Society of Echocardiography and the Brazilian Department of Cardiovascular Imaging, and the lead author was EACVI Past-President Patrizio Lancellotti, Liège, Belgium.

Prosthetic heart valve dysfunction is a rare condition but can be life-threatening. It is therefore essential that the exact cause of prosthetic heart valve dysfunction is determined, together with the appropriate treatment strategy, and these topics are emphasised in this paper.

For 2017, there are two very important papers in the pipeline. One focuses on multimodality imaging in restrictive cardiomyopathies, and has EACVI President Gilbert Habib, Marseille, France, as the first author. This expert consensus document will offer specific and detailed information on the correct use of all non-invasive imaging techniques for the diagnosis, prognostic evaluation and management of patients with restrictive cardiomyopathies. This will be particularly relevant as it is a rare disease that is caused by a diverse group of myocardial diseases with a wide range of aetiologies, and this paper will help to differentiate between those diseases and make it easier for members to diagnose and evaluate such patients.

Another paper that will be published in 2017 is a consensus document on the comprehensive multi-modality imaging approach in arrhythmogenic cardiomyopathy, chaired by Kristina Haugaa, Oslo, Norway. The condition was previously known as arrhythmogenic right ventricular cardiomyopathy. However, that name was misleading as the disease is characterised by an acquired and progressive replacement of the ventricular myocardium by fibrous and fatty tissue that starts from the epicardium or mid-myocardium and then extends to become transmural in the right ventricle, leading to wall-thinning and aneurysms. There is, however, very convincing evidence that the condition also affects the left ventricle, and that is why we have changed the name to arrhythmogenic cardiomyopathy. The consensus document will make it clear how to follow these patients, how often they should be followed and what we should look for in the different imaging modalities and risk markers found in the different imaging techniques.

References

1. Nagueh SF, Smiseth OA, Appleton CP et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. In press 2016.

2. Lancellotti P, Pibarot P, Chambers J et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2016; 17: 589– 590.