Key result
A survey of 689 respondents across ESC-affiliated countries revealed widespread adoption of VHD guidelines, though imaging modalities like CMR and PET-CT remain largely underused.
Why the study?
The study aimed to evaluate how current recommendations on valvular heart disease management have been adopted and identify discrepancies between guidelines and everyday clinical practice.
Cross-Sectional (n=689)
Yes
This European survey highlights widespread adoption of VHD guidelines but identifies significant underutilization of advanced imaging modalities like CMR and PET-CT.
Reveals gaps between VHD guidelines and real-world practice; leaves open the need for targeted interventions and confirmatory studies.
Aims: The aim of this survey is to analyze how current recommendations on valvular heart disease (VHD) management have been adopted. Identifying potential discrepancies between recommendations and everyday clinical practice would enable us to better understand and address the remaining challenges in this controversial and complex field. Methods and results: A total of 33 questions, distributed via email to all European Society of Cardiology (ESC) affiliated countries through the newsletter of the ESC council on VHD, were answered by 689 respondents, mainly from tertiary care settings. The results of this survey showed that VHD patients are mostly managed by tertiary care centres, where multi-disciplinary heart teams are frequently a reality. Cardiac computed tomography (CT) is often used in the preprocedural planning of transcatheter interventions, particularly for sizing and deliverability assessment. Echocardiography represents the most widely used imaging modality in the diagnostic, intra-operative and follow-up phase of VHD patients. Cardiac magnetic resonance (CMR) is still largely underused, also for conditions such as mitral annular disjunction, or for the assessment of left ventricle volumes where it is considered as the gold standard, despite 3D volumes by echocardiography having proved good comparability with CMR. As for endocarditis, despite still underused, transesophageal echocardiography (TEE) represents the approach of choice for the diagnosis of native and prosthesis valve endocarditis (up to 46% of the respondents use it). In this context, positron emission tomography-CT is largely underused. Conclusion: There is widespread adoption of current recommendation on the evaluation of VHD and these are frequently used to guide patient management. Nonetheless, there are still many discrepancies across centres and countries which need to be addressed with the aim of improving patients' management and outcomes and ultimately positively impacting on healthcare resources.
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Sannino et al. (2022) conducted a cross-sectional in Valvular heart disease (n=689). Clinical practice and adoption of VHD recommendations was evaluated on Adoption of current recommendations on VHD management. A survey of 689 respondents across ESC-affiliated countries revealed widespread adoption of VHD guidelines, though imaging modalities like CMR and PET-CT remain largely underused.
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