Barbieri Andrea, Camilli Massimiliano, Bisceglia Irma, Mantovani Francesca, Ciampi Quirino, Zito Concetta, Canale Maria Laura, Khoury Georgette, Antonini-Canterin Francesco, Carerj Scipione, Campana Marco, Riccio Carmine, Gulizia Michele Massimo, Grimaldi Massimo, Gabrielli Domenico, Colivicchi Furio, Pepi Mauro, Oliva Fabrizio
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy.
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 1, Rome 00168, Italy.
Eur Heart J Imaging Methods Pract. 2024 Aug 12;2(3):qyae081. doi: 10.1093/ehjimp/qyae081. eCollection 2024 Jul.
The need for cardio-oncology competencies is constantly growing, and with the establishment of cardio-oncology services, cardiovascular imaging, particularly transthoracic echocardiography (TTE), has become pivotal in patients' management. However, care pathways for oncologic patients largely depend on local health structures' resources. This survey from Associazione Italiana Medici Cardiologi Ospedalieri and the Italian Society of Echocardiography and Cardiovascular Imaging aimed at investigating the use of echocardiography in cardio-oncology services and knowledge levels on cancer patients' care.
Data were obtained via an electronic survey based on a structured questionnaire uploaded to the promoting societies' websites. Responses came from 159 centres with echocardiography. According to one-third of participating centres, workload related to cancer patients represented >30% of the total requests. The most common TTE indication (85%) was left ventricular ejection fraction (LVEF) evaluation. Many centres (55%) still assessed LVEF solely by bidimensional method or visual estimation in case of inadequate acoustic windows. At the same time, almost 40% of centres reported routinely using global longitudinal strain when feasible. We further performed a sub-analysis according to the presence (33%) or absence (77%) of dedicated cardio-oncologists, revealing significant differences in cardiovascular surveillance strategies and cardiotoxicity management.
This survey on echocardiography practice for cancer patients reveals a significant gap between actual clinical practice and standards proposed by recommendations, underlying the need for stronger partnerships between cardiologists and oncologists and dedicated, well-structured cardio-oncology services.
对心脏肿瘤学能力的需求持续增长,随着心脏肿瘤学服务的建立,心血管成像,尤其是经胸超声心动图(TTE),在患者管理中已变得至关重要。然而,肿瘤患者的护理路径很大程度上取决于当地卫生机构的资源。意大利医院心脏病学家协会和意大利超声心动图与心血管成像学会开展的这项调查旨在研究超声心动图在心脏肿瘤学服务中的应用情况以及对癌症患者护理的知识水平。
数据通过基于上传至发起协会网站的结构化问卷的电子调查获得。来自159个具备超声心动图检查的中心提供了回复。据三分之一的参与中心称,与癌症患者相关的工作量占总检查需求的30%以上。最常见的TTE检查指征(85%)是左心室射血分数(LVEF)评估。许多中心(55%)在声学窗口不佳时仍仅通过二维方法或视觉估计来评估LVEF。与此同时,近40%的中心报告在可行时常规使用整体纵向应变。我们还根据是否有专门的心脏肿瘤学家(有占33%,无占77%)进行了亚分析,结果显示在心血管监测策略和心脏毒性管理方面存在显著差异。
这项针对癌症患者超声心动图实践的调查揭示了实际临床实践与指南建议标准之间存在显著差距,突显了心脏病学家和肿瘤学家之间加强合作以及建立专门的、结构完善的心脏肿瘤学服务的必要性。