As we continue to develop and implement our Pediatric & Congenital Heart Disease Council initiatives for 2012 and beyond, I thought it would be insightful to detail the ASE strategic goals that were recently developed and discuss how our own council plans to address them.

The ASE strategic goals are:

To improve the global dissemination and implementation of cardiovascular ultrasound quality in all clinical settings

Our council has been active in addressing and promoting quality in congenital echocardiography. My most recent council communication highlighted our recent expert consensus statement in JASE regarding the performance, interpretation, and training requirements of the neonatal echocardiogram in the intensive care setting. Additional guidelines addressing the performance of a pediatric echocardiogram and quantitation of ventricular performance in congenital heart disease have also been published through input from our council and have helped to establish and advance the quality benchmark in these areas. Additional documents are under consideration to address optimal imaging standards and exam performance in other pediatric subspecialty groups with congenital and acquired heart disease. Ongoing efforts include a task force on pediatric echocardiography laboratory organization and productivity. National surveys to assess the current staffing models in pediatric echo labs and to better define issues of laboratory set-up and personnel productivity have been designed and circulated, and these responses are being re-evaluated for further study. We have also been active in defining important quality initiatives with other societies, including the American College of Cardiology (ACC) and the Intersocietal Accreditation Commission (IAC) in Echocardiography. As we move forward, there continue to be many areas of quality that need to be addressed, including appropriateness criteria for echocardiography in the pediatric population.

To establish ASE as the premier worldwide organization for membership and education in cardiovascular ultrasound

Our council actively seeks to incorporate international participation in all facets of our activities. Recently published, as well as ongoing, consensus documents from our council have significant international society participation and support. Our track within the ASE Scientific Sessions has incorporated many joint ASE–EAE sessions to promote increased international collaboration within our council, including recent sessions on Diastology in Acquired & Congenital Heart Disease, Quantification in Pediatric Echo, Assessment of the Right Ventricle in Congenital Heart Disease, and at this year’s upcoming ASE meeting, Assessment of Ventricular Function & Mechanics . In addition, the number of ASE courses related to congenital heart disease continues to grow. Interest in attending these courses, as well as the attendance at our track at the ASE Scientific Sessions, has also grown significantly over the past several years. It is a high priority to continue to identify and develop additional areas of growth and collaboration with our sonographer and physician colleagues worldwide as well as continuing to foster diverse educational opportunities in congenital and acquired heart disease.

To promote research and innovation in cardiovascular ultrasound

Echocardiography is the primary diagnostic modality in our patients with congenital and acquired heart disease, and these non-invasive measurements are frequently used as primary or secondary end-points in clinical research studies involving medical or surgical therapies in children. However, there is a paucity of normal noninvasive data in the pediatric age group that significantly hinders these ongoing research efforts. To help address this need, our council is hoping to obtain funding for a large scale effort to derive normative data. The Pediatric Z-Score Database Project, headed by Leo Lopez MD, FASE, Wyman Lai MD, MPH, FASE, and Steven Colan MD, aims to prospectively establish a database of common two-dimensional, M-mode, and Doppler echocardiographic measurements performed in a normal population of children from multiple geographic areas. Goals for this study include: (1) establishment of Z-scores for commonly performed pediatric measurements obtained by two-dimensional, M-mode, and Doppler echocardiography and adjusted for body size, age, gender, and race; (2) accurate thresholds for normal and abnormal measurements in children; (3) establish the utility of both gender and race in the designation or definition of specific disease states; (4) improved identification of the adverse effects of certain disease states on the sizes of cardiovascular structures in children; (5) better clinical management of children with congenital and acquired heart diseases; and (6) increased research activities in pediatric cardiology by providing established reference values adjusted for body size, age, gender, and race. We believe that this project is foundational to ongoing research efforts in the field of pediatric cardiology both nationally and internationally.

In addition to establishing normative data with techniques that are in current clinical practice, the introduction and development of novel imaging modalities are key to improving the diagnosis and management of patients with congenital and acquired heart disease. Three-dimensional echocardiography and deformation imaging are just two examples of emerging technologies that will likely play a large role in our clinical management and research efforts. Our council wants to be proactive in developing standards for training and use of these modalities in our patient cohort as well as fostering research efforts with these cutting edge technologies.

To position echocardiography as the most valuable imaging technique in the changing healthcare environment

It is imperative in the current health care environment to have a vision for echocardiography both now and for the future. This requires all of us within ASE to be cognizant of reimbursement issues within our field as well as the need of educating our consumers on the value of echocardiography. This strategic vision requires our council to be vigilant in the ongoing development of non-invasive imaging in all areas of clinical practice, education and research.

This communication highlights several, but not all, of our council’s ongoing efforts to address the strategic vision of the ASE. Our initiatives are exciting and very important as we move forward, both clinically and academically, within our field. I anticipate that 2012 will be a very productive year and there are many ways for you to get involved within our council or within ASE. Please do not hesitate to let me, or my co-chair Leo Lopez, know if you would like to participate within our council, its various committees, or in other clinical, educational, or research activities within the ASE.