The March issue of JASE includes, “Comparing Costs of Noninvasive Cardiac Diagnostic Tests—a Population-Based Study.” Author Idan Roifman, MD, MSc, remarks, “In a large population-based cohort consisting of >2 million people from Ontario, Canada who were evaluated for chest pain, we report that receipt of any non-invasive test (NIT) for the diagnosis of coronary artery disease was associated with a 12% reduction in downstream costs when compared to no testing. Graded exercise stress testing (GXT) and stress echocardiography were associated with the least downstream costs (approximately 20% reductions), whereas CCTA and MPI were associated with the highest relative costs (approximately 30% and 25% increased costs, respectively). Our findings are important from a health policy perspective for the following reasons. First, we demonstrated that receipt of any NIT was associated with reductions in downstream costs when compared to no testing despite the added initial costs of the test itself. This is significant as it indicates that the initial cost of testing is more than offset by downstream healthcare cost savings. Second, given that stress imaging and anatomical testing have been demonstrated to be similar in terms of their related downstream clinical outcomes, our results reporting that stress echocardiography is the least expensive modality are important, as they may lead to prioritization of this test. This is especially important in healthcare systems that do not require pre-approval for stress echocardiography, but may require it for other types of NIT, such as many systems in the United States.”

This issue includes numerous clinical investigations reporting on safety of ultrasound enhancement agents, noninvasive testing for coronary heart disease, Doppler use in valvular heart disease, 3D TEE after transcatheter mitral valve repair and outcome, septal perforator flow in HCM, and LV function in children with chronic kidney disease. Don’t miss a Special Report on multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease. Additionally, there are two brief research communications—one explores low-dose application of ultrasound-enhancing agents without flush and the other reports on reproducibility of echocardiographic measures of aortic stenosis severity and its impact on severity grading. Five editorials accompany these reports, and a handful of letters to the editor on the topics of mitral regurgitation phenotype and moderate aortic stenosis conclude this issue.

With contributions from Rickey E. Carter, PhD, and David Ouyang, MD, FASE, Dr. Pellikka’s editorial outlines the artificial intelligence content of particular interest to JASE for authors interested in submitting on this topic. In accordance with International Congenital Heart Defects Awareness Day, Dr. Eidem’s President’s Message highlights congenital heart disease and ASE’s efforts to bring education and awareness to this important population during his presidency.

Be sure to check out March’s Author Spotlight to learn more from lead authors Mays T. Ali, MD, and Jeremy J. Thaden, MD, FASE, as they discuss their recent paper, Incidence of Severe Adverse Drug Reactions to Ultrasound Enhancement Agents in a Contemporary Echocardiography Practice. Please see the March ASE Education Calendar for a listing of educational opportunities far and wide.

Register Now

Register now to attend ASE’s Women Leading in Echocardiography Laboratories: Challenges and Solutions webinar, taking place March 12, 7:00 – 8:00 PM ET. An expert panel of accomplished women leaders in echocardiography will share their success stories and discuss the specific challenges women encounter in echocardiography laboratories, including gender bias, work-life balance, and professional development hurdles. Attendees will discuss and propose effective strategies for overcoming these challenges and focus on mentorship, skill development, supportive work environments, and diversity and inclusion.

Registration for the Foundation’s 15th Annual Research Awards Gala is now OPEN! The ASE Foundation cordially invites you to attend our Crystal Gala, our premiere fundraising event honoring ASE’s 2024 award recipients and celebrating cardiovascular ultrasound research. Join us Saturday, June 15, at the Hyatt Regency Portland, for a wonderful evening of entertainment, dinner, and dancing.

Please note, Gala Registration options start with full tables and Supporter Level tickets first. Individual tickets at the Advocate, Benefactor, and Patron level may be available at a later date. Questions about the Gala? Please email Gala@ASEcho.org. Tickets will not be available on site. 

The February 2024 Echo magazine is now online! This issue contains interesting articles written by ASE members, including:

• Navigating the Educational Landscape of ASE, page 4
• Sonographer Volunteer of the Month-February, Congratulations Cassie Huntington, BS, RCS, FASE, page 6
• Pathways for Critical Care Echocardiography Fellows, page 8
• Words to Live By-Pearls from Pediatric Imaging Masters, page 11
• New ASE Perioperative Echocardiography Council Steering Committee Members, page 17
• Highlights from the New Guideline for Performing a Comprehensive Pediatric Transthoracic Echocardiogram, page 20
• Introducing the 2024 Guidelines for Targeted Neonatal Echocardiography, page 22

Each monthly issue includes articles or images related to cardiovascular ultrasound that are not research-related, as well as communications from the ASE President, Councils, Specialty Interest Groups, and the ASE education calendar. All active ASE members are eligible to submit articles to Echo magazine. The submission deadline for the May 2024 issue is March 15. Email Echo@ASEcho.org with questions.

Last Friday Senators John Boozman (R-AR) and Peter Welch (D-VT) along with 30 bipartisan cosigners sent a letter to Senate leaders calling for a legislative solution to protect access to Medicare services by canceling the 3.37% cut to physician Medicare payments that went into effect on January 1.

If your Senators signed the letter (click link for full list), we encourage you and your membership to reach out to their offices on social media, email or phone via the Senate switchboard to thank them for their support and to remind them that the job is not done.

Time is of the essence—in the coming days Congress is expected to take up the 2024 appropriation funding bills, and we must ensure that full relief from the devastating 3.37% cut is included in this package. Behind the scenes negotiations are ongoing and it’s imperative that your Senators are engaged in fixing the problem.

If your Senators did not sign the letter, it’s still important that you contact them and let them know how damaging these cuts are to physicians and their patients in your state.

For additional resources please visit fixmedicarenow.org for more information.

The time is now to cancel the cut!

The ASE Foundation is accepting photograph submissions for the 2024 Images from the Heart photo exhibit. We are bringing back this beautiful display and we want your best shots! We are looking for pictures that you’ve taken from the heart that have meaning to you; they do not have to be medical in nature. Think of the phrases, “I left my heart in…” and “This has my heart” when considering what photos to submit. We invite you to share these memories (and tell us what they mean to you) for our exhibit, to be held during the ASE 2024 Scientific Sessions in Portland, OR, June 14 – 16.

Entries will be accepted until April 19. Full submission details can be found here. Give us your best shot! 

An important role in your ASE membership each year is to cast your vote for the ASE Board of Directors. Now is the time for you to select the 2024 Slate of Officers and Directors by using this ballot. You may choose to vote for the person nominated or write-in a nominee in the blank space provided. However, you can only vote for one person for each position, and all write-in nominees must be active ASE members. Your ballot must be received by March 24, 2024.

The new officers and directors will be introduced at the 35^th ASE Scientific Sessions during the State of ASE Presidential Address on Saturday, June 15, 2024. This session is open to all Scientific Sessions registrants and will be streamed live for virtual attendees.

We urge all members of the Society to contact their Senators by today or tomorrow (deadline is Thursday EOB Feb. 22) and request support of the Boozman-Welch Doc Cut Fix bill. This bill urges Senate action on the 3.37% Medicare physician fee schedule conversion factor reduction that went into place on January 1, 2024, and references year-over-year cuts, workforce shortages, and the need for long-term payment reform.

Here is an example of the message you can send to your U.S. Senate representatives:

“On behalf of the American Society of Echocardiography’s physicians and Medicare patients alike, I request your commitment to work together with your colleagues in a bipartisan fashion to include physician payment relief policies in the March 1st government funding legislation.”

Please contact your Senate offices (link goes to a site to help you identify your representative and send this message) and ask them to cosign this letter and support the medical community and your patients.

The latest issue of CASE is now available with intriguing reports, including “Coronary Artery Aneurysm Rupture in Kawasaki Disease and SARS-CoV-2 Infection” by Wood et al. Editor-In-Chief Vincent L. Sorrell, MD, FASE, remarked, “This CASE report describes an amazing rapid increase in coronary artery dimensions in a two month old with acute Kawasaki disease. Their images graphically demonstrate the profound changes seen with serial transthoracic echocardiography. The proximal coronaries were demonstrated to increase from normal size to large aneurysms with Z scores of >8 (RCA) and >20 (LAD) on day nine. I was flabbergasted by the massive dilation that occurred [over such a short time-frame] and saddened, but not entirely surprised, by the devastating clinical outcome.”

This issue presents two cases in Valvular Heart Disease, including one involving acute transvalvular MR after bioprosthetic MVR, and a report illustrating unique approaches to the management of acute prosthetic valve embolization including LVAD setting manipulation. Just Another Day in the Echo Lab offers two reports, one exemplifying the potential clinical merit of manufactured ultrasound enhancing agents to reveal the actual grade of MR, and another showing the value of TTE for patients presenting with a clinical syndrome suspicious for an acute myocardial infarction. Finally, a report for Veterinary Clinical Cardiovascular Medicine contains a surgical video with demonstrations of epicarditis and pericarditis in a dog, exploring the various origins of pericardial pathologies. Dr. Sorrell compares the impact of a worldwide pop star phenomenon to the daily impact of echo in this month’s editorial.

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. Be sure to check out the latest Sonographer Sound-Off and Unlock the CASE features on the CASE Homepage to view more extraordinary work from your colleagues.