ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography⁎⁎Developed in accordance with the principles and methodology outlined by ACCF: Patel MR, Spertus JA, Brindis RG, Hendel RC, Douglas PS, Peterson ED, Wolk MJ, Allen JM, Raskin IE. ACCF proposed method for evaluating the appropriateness of cardiovascular imaging. J Am Coll Cardiol 2005;46:1606–13.

Douglas, Pamela S.; Khandheria, Bijoy K.; Stainback, Raymond F.; Weissman, Neil J.; Peterson, Eric D.; Hendel, Robert C.; Blaivas, Michael; Prez, Roger D. Des; Gillam, Linda D.; Golash, Terry; Hiratzka, Loren F.; Kussmaul, William G.; Labovitz, Arthur J.; Lindenfeld, Jo Ann; Masoudi, Frederick A.; Mayo, Paul H.; Porembka, David T.; Spertus, John A.; Wann, L. Samüel; Wiegers, Susan E.; Brindis, Ralph G.; Patel, Manesh R.; Wolk, Michael J.; Allen, Joseph M.

doi:10.1016/j.jacc.2007.12.005

Cited by 178 publications

(23 citation statements)

References 20 publications

(11 reference statements)

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“…Although performance of this modality has been well studied in patients who do not have HCM and criteria about appropriate use of the test exist, 222 aspects of the HCM phenotype would in theory undermine performance. Patients with HCM have heterogeneous wall-thickness patterns, and wall motion at rest may appear abnormal in regions of hypertrophied myocardium.…”

Section: Stress Echocardiographymentioning

confidence: 99%

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

et al. 2011

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Section: Stress Echocardiographymentioning

confidence: 99%

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

et al. 2011

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“…49 indications addressed stress SPECT, 1 viability, and 2 radiocineangiography. Appropriateness criteria were subsequently developed for stress echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and coronary revascularization [4–6]. SPECT criteria were reviewed in 2007 with new designations suggested for some indications [7].…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of the Appropriateness Use Criteria for Single-Photon Emission-Computed Tomography: Differences by Patient Population, Physician Specialty, and Patient Outcomes

2011

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Objectives. Determine outcome of the 2005 appropriateness use criteria (AUC) for SPECT in a diverse population of patients and physicians. Background. AUC for SPECT were the first cardiology document to identify 52 clinical indications for imaging, 49 of them for stress SPECT. AUC have been proposed as cornerstone of responsible use of perfusion imaging. Methods. 585 consecutive patients undergoing SPECT were evaluated prospectively. Appropriateness was examined for demographic variables, clinical variables, and for physician and patient subgroups. Combined end-point of total mortality, cardiac revascularization, and cardiac admissions at 1 year post SPECT was evaluated. Results. SPECT indications were: appropriate, 63%; uncertain, 20%; inappropriate, 14%; not assigned, 3%. Most appropriate SPECT were observed in patients with known coronary disease (72%), chest pain syndrome (89%), high pre-test likelihood of disease (100%), men (70%), inpatients (72%), and cardiovascular physicians' referrals (69%). End-point was reached in 53 patients (97.4% follow up). Unadjusted event rates were: appropriate (12%), uncertain (7.1%), inappropriate (2.4%) SPECT (P = .01). Conclusion. Appropriateness of SPECT differs in subgroups of patients and physicians. Clinically significant outcomes occur more frequently in the appropriate stress SPECT group. Focused efforts are need for outpatients, asymptomatic patients, women, and non-cardiovascular physicians.

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“…The evidence to support the use of several stress imaging modalities is substantial and has been synthesized in recent appropriate use criteria and clinical practice guidelines (1–3). The published evidence base for stress nuclear imaging and echo-cardiography as effective tools for diagnosis of coronary artery disease (CAD) and risk stratification is extensive, and there is growing evidence supporting the role of stress cardiac magnetic resonance (CMR).…”

mentioning

confidence: 99%

Comparative Definitions for Moderate-Severe Ischemia in Stress Nuclear, Echocardiography, and Magnetic Resonance Imaging

Shaw¹,

Berman²,

Picard³

et al. 2014

JACC: Cardiovascular Imaging

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The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with ≥10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that ≥10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, ≥3 newly dysfunctional segments portend a median rate of CAD death or MI of 4.5%/year (interquartile range: 3.8% to 5.9%). Although imprecisely delineated, moderate-severe ischemia on cardiac magnetic resonance may be indicated by ≥4 of 32 stress perfusion defects or ≥3 dobutamine-induced dysfunctional segments. Risk-based thresholds can define equivalent amounts of ischemia across the stress imaging modalities, which will help to translate a common understanding of patient risk on which to guide subsequent management decisions.

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Cited by 178 publications

References 20 publications

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

Clinical Evaluation of the Appropriateness Use Criteria for Single-Photon Emission-Computed Tomography: Differences by Patient Population, Physician Specialty, and Patient Outcomes

Comparative Definitions for Moderate-Severe Ischemia in Stress Nuclear, Echocardiography, and Magnetic Resonance Imaging

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