Videos | Cardiac Imaging | February 01, 2022

VIDEO: Why the ASNC Did Not Endorse the 2021 Chest Pain Guidelines

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

705 Views

Recent Videos View all 644 items

Sponsored Videos View all 46 items

Cardiovascular Ultrasound | July 20, 2022

Enhanced features on the Philips EPIQ CVx ultrasound system provide a next level photorealistic 3D rendering, making it easy for users to interpret what they are seeing. The TrueVue feature enhances the sense of depth and space, producing images that appear natural and realistic to the human eye.  

Watch the video to check out how TrueVue can help improve views of LAA and MV morphology. 

Cardiovascular Ultrasound | July 07, 2022

Automated features on the Philips EPIQ CVx cardiology ultrasound system are helping to bring consistency and speed to every echo exam. The AI-empowered algorithm delivers fast and consistent measurements – in half the time of manual methods.*  

Watch the video to see how you can put “smart”  to work with the latest AI-powered quantification tools. 

*External study with external sonographers comparing the results of 18 exams with and without AutoMeasure

Cardiovascular Ultrasound | June 14, 2022

The X5-1c transducer from Philips provides enhanced clinical information in transthoracic imaging over a standard phased array transducer. When combined with nSIGHT Plus image formation on the EPIQ CVx cardiology ultrasound system, the X5-1c transducer enables image quality rarely seen from a transthoracic transducer. 

Watch the video to learn about the benefits which may include decreased exam time due to faster access to echo windows, increased confidence in quantification results and more. 

Cardiovascular Ultrasound | May 31, 2022

Philips recently announced an update to their flagship EPIQ CVx premium cardiology ultrasound system. Watch the video to learn about the latest features including the next-generation nSIGHT Plus imaging architecture system that leverages both hardware and software to support sophisticated image formation and enhanced image quality.

Conference Coverage View all 460 items

Cath Lab View all 316 items

Cardiac Imaging View all 287 items

Cardiac Diagnostics View all 78 items

EP Lab View all 83 items

Information Technology View all 169 items

Subscribe Now