Cardiac imaging in the spotlight

The spotlight of ESC Congress 2022 is cardiac imaging, with its profound implications for CVD prevention, diagnosis, decision making, guiding interventions and therapeutic follow-up.

Assistant Professor Victoria Delgado (Germans Trias i Pujol University Hospital - Badalona, Spain), an expert multimodality imager and Coordinator of CV Imaging for the ESC Congress Programme Committee, tells us more about why cardiac imaging was chosen and picks out some highlights of this year’s Spotlight Track:

“Cardiac imaging is diverse and relevant for all cardiology subspecialties. Imaging also links cardiology with other non-cardiology specialities – it bridges disciplines. Nowadays, patients with CV pathology often have multiple comorbidities. In addition, patients without known CVD but with other diseases (e.g. renal diseases, cancer and lung diseases) may receive treatments associated with CV side effects. Therefore, it is more important than ever to make an accurate assessment to ensure the most appropriate course of action is selected.

To highlight how crucial cardiac imaging is to today’s cardiologist, its key role will be evident in each of this year’s new ESC Clinical Practice Guidelines. In terms of bridging disciplines, cardio-oncology exemplifies an area where imaging provides an essential link between two diseases, informing follow-up and further treatment. In addition, there are new guidelines on the CV assessment and management of patients undergoing non-cardiac surgery. Patients with CV pathology need robust risk stratification to undergo non-CV interventions and imaging plays an important role in this process.

One of the highlights of the Spotlight Track is a symposium on the assessment of left ventricular function beyond ejection fraction. With the current shift away from using ejection fraction alone, this highly relevant topic will discuss what is known about other measures. Another session looking beyond ejection fraction focusses on how imaging can improve risk stratification for sudden cardiac death, related to the subject of today’s new ESC guidelines. In addition, the role of different imaging modalities in the assessment and management of patients suffering from cardiac arrest will be discussed in a joint session with the European Resuscitation Council.

Multimodality imaging is also very important in pulmonary hypertension – the topic of new guidelines presented on Sunday. To support improvements in the use of imaging, a moderated ePoster session will investigate various measures that could be used in pulmonary hypertension, including chronic thrombo-embolic pulmonary hypertension.

In addition to the guidelines topics, the Spotlight Track covers the use of imaging in several other CVDs. A symposium on Saturday focusses on how to image patients with heart failure and preserved ejection fraction (HFpEF), which is particularly important given the heterogeneous nature of HFpEF and the need for accurate phenotyping to tailor therapy to aetiology.

On Monday, there will be a Practical Seminar on using imaging to guide transcatheter intervention in tricuspid regurgitation. As we celebrate the 20th anniversary of transcatheter interventions for valvular aortic stenosis, it is clear that this technique is both flourishing and evolving. We now have transcatheter mitral valve interventions and the next step is transcatheter tricuspid valve interventions. Many pathologies can lead to tricuspid regurgitation and 3D echocardiography has taken centre stage in guiding interventions, but there is a need for greater training on its use.

Across the four days of ESC Congress 2022, make the most of all the opportunities on offer to learn how cardiac imaging can help improve the outcomes of your patients.”