April 2018

Valvular and structural heart disease encompass a significant proportion of cardiovascular disease conditions. Initial diagnosis and subsequent follow-up frequently rely on imaging with more than 1 imaging modality. Rapidly evolving less-invasive and transcatheter treatment options have fueled the need for precise preprocedural and intraprocedural anatomic and functional imaging. The publication of appropriate use criteria (AUC) reflects 1 of several ongoing efforts by the American College of Cardiology (ACC) and its partners to assist clinicians who are caring for patients with cardiovascular diseases and in support of high-quality cardiovascular care. The ACC/American Heart Association clinical practice guidelines provide a foundation for summarizing evidence-based cardiovascular care and, when evidence is lacking, expert consensus opinion that is approved in review by the ACC and American Heart Association. However, in many areas, variability remains in the use of cardiovascular imaging modalities, raising questions of overuse or underuse. The AUC provide a practical standard upon which to assess and better understand variability.