New ASE Guideline Clarifies Cardiac POCUS Nomenclature

FOR IMMEDIATE RELEASE

Contact: Angie Porter
919-297-7152
APorter@ASEcho.org

New ASE Guideline Clarifies Cardiac Point-of-Care Ultrasound Nomenclature
The guideline aims to standardize the nomenclature around cardiac point-of-care ultrasound to facilitate collaboration, reduce confusion and enhance patient safety

(DURHAM, NC, September 10, 2024)—A new guideline from the American Society of Echocardiography (ASE) addresses the ambiguity in the current terminology used for cardiac point-of-care ultrasound (POCUS).

The guideline, titled Recommendations for Cardiac Point-of-Care Ultrasound Nomenclature, outlines specific recommendations establishing a deliberate vocabulary of cardiac POCUS-related terms to improve consistency in patient-care and research settings.

Clinicians use cardiac POCUS to examine heart and vascular systems at a patient’s bedside. However, because this diagnostic tool is utilized by a multitude of clinicians from numerous specialties in different settings, there are currently inconsistencies in the language and terms surrounding cardiac POCUS.

“Many terms have been proposed to describe the use of ultrasound by bedside clinicians to image the heart, and the words we use matter,” said Chair of the Guideline Writing Group Dr. James N. Kirkpatrick, Professor of Medicine and Bioethics and Humanities, and Director of the Echocardiography Laboratory at the University of Washington Medical Center in Seattle. “We believe our recommended terms and definitions can be an important step in bringing together the different specialties that use cardiac POCUS to standardize what we do—all for the good of the patient.”

The writing group is co-chaired by Dr. Nova Panebianco, Professor of Emergency Medicine and Director of Emergency Ultrasound at the University of Pennsylvania, and Dr. Jose Luis Diaz-Gomez, Institute Chair—Integrated Hospital Care at Cleveland Clinic Abu Dhabi and Adjunct Professor of Anesthesiology at Baylor College of Medicine. Additionally, it includes healthcare professionals from multiple stakeholder medical societies and a specialist in medical linguistics.

The guideline focuses on four main areas:

  1. Review the evolution of cardiac POCUS-related terms.
  2. Outline specific recommendations, distinguishing between intrinsic and practical differences in ‘‘basic cardiac POCUS/FoCUS,’’ ‘‘advanced cardiac POCUS,’’ ‘‘consultative echocardiography,’’ and ‘‘ultrasound assisted physical examination.’’
  3. Address implications of these recommendations for current practice.
  4. Discuss the implications for novel technologies and future research.

Drs. Kirkpatrick, Panebianco and Diaz-Gomez believe that a standard nomenclature can set the stage for future consensus building around the coordination of imaging studies, credentialing processes, billing practices, liability considerations, training protocols, and research.

“We intend for this cardiac POCUS nomenclature to be a starting point for future work in more specific areas. Establishing a deliberate vocabulary is the foundation for the accurate and efficient transfer of medical knowledge among healthcare professionals, educators, administrators, insurance providers, credentialing bodies, and most importantly, patients,” Dr. Kirkpatrick commented.

This document is endorsed by the American College of Chest Physicians (CHEST), the American College of Emergency Physicians (ACEP), the American Institute of Ultrasound in Medicine (AIUM), the American Thoracic Society (ATS), the Society of Critical Care Medicine (SCCM), World Interactive Network Focused on Critical Ultrasound (WINFOCUS) and 26 ASE International Alliance Partners.

The new guideline is published in the September 2024 issue of the Journal of the American Society of Echocardiography. All guidelines published by ASE are available at ASEcho.org/Guidelines.

About American Society of Echocardiography
The American Society of Echocardiography (ASE) is the Society for Cardiovascular Ultrasound Professionals™. ASE is the largest global organization for cardiovascular ultrasound imaging serving physicians, sonographers, nurses, veterinarians, and scientists and as such is the leader and advocate, setting practice standards and guidelines for the field. The Society is committed to advancing cardiovascular ultrasound to improve lives. For more information, visit the ASE website ASEcho.org or social media pages on Facebook, X (formerly Twitter), LinkedIn, or Instagram.

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A September JASE Issue to Remember

The September issue of JASE includes, “Recommendations for Multimodality Imaging of Patients With Left Ventricular Assist Devices and Temporary Mechanical Support: Updated Recommendations from the American Society of Echocardiography.” Lead author Jerry Estep, MD, FASE, remarks, “Our guideline document serves as an update to the 2015 comprehensive ASE LVAD guideline. We provide detailed information and recommendations on temporary mechanical circulatory support devices, and we define the contemporary role of echocardiography and multimodality imaging in patient selection, pre-intra-and post-procedural surveillance, and troubleshooting with focus on the HM3 LVAD. We hope the framework we provide will improve patient outcomes by providing the best imaging strategies before and after durable and temporary device implantation.”

In addition to this guideline, readers can look forward to a second ASE guideline, “Recommendations for Cardiac Point-of-Care Ultrasound Nomenclature.” There are three clinical investigations in this issue including two on left atrial function in hypertension and one on the detection of myocardial ischemia by myocardial contrast echocardiography and LV strain in women with nonobstructive coronary artery disease. An editorial comment accompanies this last clinical investigation followed by an invited commentary on the noninvasive assessment of myocardial work in children. Three brief research communications round out this issue with reports on automated echocardiographic detection of heart failure, building an AI-driven echocardiographic data pipeline, and smaller LV in extreme of prematurity and postnatal growth.

Guest written by a few dedicated ASE members, this month’s President’s Message highlights the 50th anniversary of ASE in 2025 and how the Society will be celebrating its membership base during this milestone year. Be sure to read along to find out about exciting membership discounts and incentives!

Tune into our Author Spotlight page for interviews between JASE Editor-in-Chief Patricia Pellikka, MD, FASE, and authors of recently published papers. September’s interview features James Kirkpatrick, MD, FASE, discussing the new ASE guideline, “Recommendations for Cardiac Point-of-Care Ultrasound Nomenclature.”

Please see the September ASE Education Calendar for a listing of educational opportunities far and wide.

Save on 2025 Echo Hawaii Registration!

Register for the 34th Annual Echo Hawaii early to save up to $225! ASE’s 2025 Echo Hawaii is a live, in-person course taking place January 20-23, 2025, at the Fairmont Orchid resort on the Kohala Coast of the Big Island. This year’s program features in-depth, case-based learning on established and emerging cardiovascular ultrasound technologies in a beautiful and relaxed setting. Register early to secure the best rate!

Register for Echo in PCHD Virtual Experience – October 26-27

Register now for the 3rd Annual Echo in Pediatric & Congenital Heart Disease Echo Access Virtual Experience, which will take place October 26-27, 2024. This two-day virtual course will present the latest information on established and emerging cardiovascular ultrasound technologies, clinical care, and practical considerations in children and adults with congenital heart disease.

Expert physician and sonographer faculty, led by Course Co-Chairs Melissa Wasserman, RDCS, RCCS, FASE, and Shiraz Maskatia, MD, FASE, will discuss current technologies with a particular focus on how they can be effectively applied in the clinical setting. Faculty will join live to answer participant questions during dedicated Question and Answer time for each session. Participants can earn up to 13 CME/MOC credits. Remember to log in to your ASE Member Portal before accessing the Learning Hub to receive your member discount on registration.

A Normally Abnormal August CASE

The latest issue of CASE is now available with intriguing reports, including “To Drain or Not to Drain? Pericardial Decompression Syndrome.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Mathias et al. help educate readers on the lesser known post-pericardiocentesis complication of pericardial decompression syndrome. They reported their findings on a complex 59-year-old patient with multiple comorbidities including acute chronic kidney disease, acidosis, hyperkalemia, atrial fibrillation treated with warfarin, pulmonary hypertension, dilated cardiomyopathy with remote ventricular tachycardia, and a large pericardial effusion with worsening hypotension. The patient had a markedly elevated international normalized ratio (INR 11) and TTE findings of tamponade. Despite urgent pericardial drainage of 600cc bloody fluid, their hemodynamic status continued to deteriorate, and the patient did not survive. The authors do an excellent job describing their thorough evaluation, approach to management, and potential underlying mechanisms, including acute pericardial decompression syndrome. Additionally, the authors provide readers with steps for when to consider this rare syndrome and how to manage this with the goal toward a different clinical outcome.”

This Pericardial Pathologies report follows two cases in the Congenital Heart Disease category, including findings from a high-risk, anomalous left main coronary in a young patient with a complicated post-operative course. The other details the clinical and hemodynamic improvements of an ASD closure in an elderly patient with complex cardiovascular disease. Allow Echo Innovation to expand your sonic insights with Basit et al.’s collection of multimodality imaging findings in a case of RCA to SVC fistula. 3D TEE transillumination is used to identify a papillary fibroelastoma on the aortic valve in a highly detailed report from Gentile et al.

Contrary to the rare findings CASE often publishes, Dr. Sorrell’s editorial hones in on what it really means to mark a study as “normal.” Included is a table of 24 common cardiovascular findings that should be routinely reported in a normal study depending on the imaging modality.

Looking for a journal to submit your case report to? We want to hear from you! Email us with questions or submit your report today.

 

 

Deadline Approaching: Apply to Chair the ASEF Board by August 30

Now is your opportunity to become a leader in the ASE Foundation! We are seeking dedicated members to join the ASE Foundation Board of Directors, a 10-person governing board charged with supervision and direction of the affairs of the ASE Foundation. Currently, we are accepting nominations for the Chair position, which is a three-year term beginning in January 2025.

If you are an active member who meets the criteria outlined for the position, ask a friend or colleague who is also an ASE member to submit a nomination on your behalf. The deadline for candidates to submit all required materials is August 30, 2024. This position is open to any member regardless of their specialty, and ASE is looking for a diverse pool of nominees. Contact Nominations@ASEcho.org with questions.

Product of the Month: ASE 2024 Online Library

ASE members save $100 on the ASE 2024 Scientific Sessions: Online Library! Get unlimited online access for three years to recordings from the main six rooms from this year’s Scientific Sessions. The Library includes popular sessions like the Echo World Cup; ShowCASE; the Young Investigator’s and Sonographer Research Award Competitions; and all four special lectures!

Live audio, screen capture with animation, mouse pointer, and embedded videos are included from all sessions (excluding the DIY Workshops and Learning Labs). This product does not offer CME/MOC credit.

Register for Echo Florida by September 7 for the Best Price! Save Up To $225

There are just two weeks left to register for this year’s Echo Florida™ for the best rate. Individuals who register by September 7 can save up to $225! Join expert faculty—led by Course Director Matt M. Umland, ACS, RDCS, FASE, and Course Co-Director Vincent L. Sorrell, MD, FASE—from October 12-14 for a comprehensive review of echocardiography!

This year’s new interactive format enables attendees to practice measurements on their own laptop, and there is an opportunity to sign up for small group workshops for a hands-on learning experience (included with registration, but you must pre-register). Log in to the ASE Member Portal before registering to also receive your member registration discount!

After you register, book your discounted hotel room at Disney’s Grand Floridian Resort & Spa. This timeless Victorian-style Disney Resort features exquisite dining options, two pools, a full-service spa, and is located just one stop to Magic Kingdom park on the complimentary Resort Monorail. Attendees staying at the Grand Floridian will enjoy both comfort and convenience with no need to travel to another venue—everything takes place under one roof. ASE’s room block is filling up fast!

A Normally Abnormal August CASE

The latest issue of CASE is now available with intriguing reports, including “To Drain or Not to Drain? Pericardial Decompression Syndrome.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Mathias et al. help educate readers on the lesser known post-pericardiocentesis complication of pericardial decompression syndrome. They reported their findings on a complex 59-year-old patient with multiple comorbidities including acute chronic kidney disease, acidosis, hyperkalemia, atrial fibrillation treated with warfarin, pulmonary hypertension, dilated cardiomyopathy with remote ventricular tachycardia, and a large pericardial effusion with worsening hypotension. The patient had a markedly elevated international normalized ratio (INR 11) and TTE findings of tamponade. Despite urgent pericardial drainage of 600cc bloody fluid, their hemodynamic status continued to deteriorate, and the patient did not survive. The authors do an excellent job describing their thorough evaluation, approach to management, and potential underlying mechanisms, including acute pericardial decompression syndrome. Additionally, the authors provide readers with steps for when to consider this rare syndrome and how to manage this with the goal toward a different clinical outcome.”

This Pericardial Pathologies report follows two cases in the Congenital Heart Disease category, including findings from a high-risk, anomalous left main coronary in a young patient with a complicated post-operative course. The other details the clinical and hemodynamic improvements of an ASD closure in an elderly patient with complex cardiovascular disease. Allow Echo Innovation to expand your sonic insights with Basit et al.’s collection of multimodality imaging findings in a case of RCA to SVC fistula. 3D TEE transillumination is used to identify a papillary fibroelastoma on the aortic valve in a highly detailed report from Gentile et al.

Contrary to the rare findings CASE often publishes, Dr. Sorrell’s editorial hones in on what it really means to mark a study as “normal.” Included is a table of 24 common cardiovascular findings that should be routinely reported in a normal study depending on the imaging modality.

Looking for a journal to submit your case report to? We want to hear from you! Email us with questions or submit your report today.

 

 

An Olympic Feat: August JASE

The August issue of JASE includes, “Artificial Intelligence Assessment of Biological Age From Transthoracic Echocardiography: Discrepancies with Chronologic Age Predict Significant Excess Mortality.” Author Kobi Faierstein, MD, remarks, “Age estimation using deep-learning models is associated with an increased risk of mortality. It also has the potential to enhance POCUS devices, enabling improved risk stratification and supports the concept of computer-assisted diagnosis of heart diseases and non-cardiac conditions at the point of care.”

In addition to this report, readers can look forward to six other clinical investigations on an assortment of topics. These topics include: echocardiography in transgender patients and their distinct stress echo profiles compared to their age-matched cisgender counterparts; progression of mitral annulus calcification to mitral valve dysfunction and its impact on mortality; exercise echo in HFpEF; mitral geometry of LV outflow tract obstruction in HCM; a longitudinal study on the use of echo in Fabry disease and its outcomes; and the accuracy of 3D echo shunt volumes in patients with an atrial septal defect and a dilated RV.

Editorial comments accompany the first five clinical investigations, and a brief research communication on the merits of measuring linear LV mass with M-mode versus 2D linear measurements rounds out this issue.

Guest written by a few dedicated ASE sonographers, this month’s President’s Message reviews the historical and current level of sonographer engagement within ASE. “The State of Cardiac Sonography  ̶  A Fifty-Year Unique Partnership” looks to the future challenges and aspirations of growing the role of sonographers at ASE, a key goal of the current ASE President, Dr. Theodore Abraham. for his term.

Be sure to check out our Author Spotlight page for interviews between JASE Editor-in-Chief Patricia Pellikka, MD, FASE, and authors of recently published papers. This month features Rekha Mankad, MD, FASE, discussing her article, “Transgender Women Exhibit a Distinct Stress Echocardiography Profile Compared With Age-Matched Cisgender Counterparts: The Mayo Clinic Women’s Heart Clinic Experience.”

Please see the August ASE Education Calendar for a listing of educational opportunities far and wide.