Historically in most inter-American countries, cardiovascular ultrasound is performed by physicians and in very few, by technicians. This practice is not expected to change substantially in the near future. In some countries, echocardiograms are performed by general cardiologists without specific training. Only a few inter-American countries offer formal echocardiography training programs.
In inter-America, the greatest challenges related to the practice of echocardiography are: the need for training for echocardiographers through programs supported by medical schools or cardiology societies; the accreditation of those experienced in echocardiography; the promotion of accreditation of echocardiography laboratories; improved technology for ultrasound equipment; the development of guidelines and consensus documents on the appropriate use of echocardiography; and the establishment of fair income for the performance of echocardiographic examinations.
To address these needs, Jorge Lowenstein, MD, gathered the leaders of the inter-American echocardiography societies to form the Asociacion de Ecocardiografia de la Sociedad Interamericana de Cardiologia (ECOSIAC), a 2,100 member organization focused on education, the promotion of standards and guidelines, and support for accreditation for the profession.
ECOSIAC has motivated regional leaders to develop joint meetings between ECOSIAC and the cardiology societies of their respective countries. ECOSIAC has played an active role in the echocardiographic portions of the national cardiology meetings in Argentina, Uruguay, Perú, Chile, Colombia, Venezuela, Brasil, Mexico, Panama, and Costa Rica.
Since its formation, six echocardiography symposia have been completed. In October of this year, the first Caribbean and Central American ECOSIAC symposium took place in Guatemala. The VII ECOSIAC meeting will take place in Santiago de Chile, December 2-4, 2010. For the first time, this meeting will include the presentation of abstracts, with a special acknowledgment provided for the best research contributions.
For several years, ECOSIAC has been invited to participate in the ASE Scientific Sessions, with joint administrative meetings of the ASE and the European Association of Echocardiography (EAE). In 2011, ECOSIAC will have a pivotal role in organizing, together with ASE and EAE, the first World Summit of International Echocardiography Societies, to be held in Buenos Aires, Argentina, in July. This idea originated from conversations held between the Boards of Directors of ASE and the EAE, and Drs. Roberto Lang and José Zamorano have provided unconditional support for ECOSIAC to organize this meeting. It will be a historic event in which the world’s most important international societies of echocardiography will participate. The local coordination of the event will be handled by Dr. Jorge Lowenstein.
ECOSIAC’s Website, www.ecosiac.org , organized by the outstanding work of Drs. Victor Darú and Leandro Francolino, provides information on academic meetings undertaken or endorsed by the society and provides clinical cases, forums, Webcasts with multiple lectures on echocardiography, and links to other societies and Web pages. ASE guidelines and consensus documents are searchable on the site, as are ECOSIAC’s guidelines on accreditation of physicians and echocardiography laboratories. The secretarial assistance of Nadia di Radio has also been key to our association’s success.
The Latin American Echocardiographers’ Forum has been a fundamental tool for communication. Academic topics have been discussed, as well as issues concerning our everyday practice; the last forum included debate on whether intraoperative echocardiography should be performed by cardiovascular anesthesiologists or cardiologists (echocardiographers). All debates have had great participation and deep insight and have provided useful information for all societies.
To achieve its current success, ECOSIAC has relied on extraordinary friends from other societies and countries. Among them are Drs. Roberto Lang (immediate past president of ASE); Juan Carlos Plana (Cleveland Clinic); Leonardo Rodriguez (ASE, Cleveland Clinic); Mario García (ASE, Montefiore Hospital); Miguel Angel García Fernández (president of Sociedad Española de Imágenes); José Luis Zamorano (president of EAE); and Petros Nihoyannopoulus (immediate past president of EAE).
What Other Challenges Await ECOSIAC?
ECOSIAC must build an administrative and legal structure as an association of echocardiography. ECOSIAC is no stranger to a world of political, academic, and economic interests, and has gained political and academic positioning; now it needs economic support to maintain its operation and growth.
The second challenge is the support of accreditation for echocardiographers and laboratories at the inter-American level. Accreditation is a voluntary process; ECOSIAC will provide support to all countries willing to undertake the process, and will provide backup and support to credentialed physicians and labs which have obtained accreditation.
ECOSIAC’s third challenge is the promotion of the training of experts in echocardiography in individual countries following the guidelines and accreditation advice of ECOSIAC, together with individual university endorsement. Specialists in echocardiography should undergo periodical recertification to assure continued competency.
The fourth challenge is to continue to offer clinical forums and workshops on topics including stress echocardiography, valvular heart disease, myocardiopathy, and ventricular function, and to encourage the implementation of multi-centric registers and research studies.
The fifth challenge is to continue interaction with imaging societies that promote techniques which complement the information provided by echocardiography. ECOSIAC must continue to support the development of multimodality meetings with participation by specialists in magnetic resonance imaging (MRI), computed tomography (CT) scanning of the heart, nuclear medicine, and peripheral vasculature.
The last and most important challenge is for ECOSIAC to keep all inter-American echocardiographic societies united, allowing it to continue to grow, encouraging and promoting interchange and creativity among societies.