AHA 06 Review

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AHA President: U.S. healthcare must improve efficiency

American Heart Association President Raymond Gibbons, MD, FACC, said making healthcare more efficent should be a much higher priority.
Specific to imaging, Gibbons said the rise in spending for stress cardiac images in this country is a good example of inefficiency. “I doubt this 6 percent yearly increase in Medicare points is efficient,” he said, “It dwarfs the rate of increase of cardiac catheterization, revascularization, or acute MI.”

As a further example, Gibbons revealed some previously unpublished preliminary data from a study evaluating the ACC/ASNC appropriateness criteria for SPECT profusion. The study looked at studies ordered by Mayo Clinic physicians that reportedly had nothing to gain financially from the tests they ordered or the equipment to be used, he said. Of the 296 studies evaluated, 11 percent were ordered for reasons not listed in the criteria, 10 percent for “inappropriate” criteria, and 13 percent of the cases involved “uncertain” criteria. Improving efficiency in this particular area requires that cardiologists “strive to decrease the number of tests in these last two categories,” Gibbons said.

IVUS helpful in stent placement, locating vulnerable plaque

Intravascular ultrasound (IVUS) can play an important part in drug eluting stent placement as well as be a crucial tool in locating vulnerable plaques in heart patients, according to clinical data highlighted by Volcano Corp. at AHA.

The study looked at current IVUS applications related to optimal drug-eluting stent (DES) sizing and placement, post-DES confirmation of expansion and apposition, and the ability of Volcano’s proprietary VH IVUS technology to identify plaque composition, and in turn help identify angiographically silent or intermediate lesions potentially at risk for a future coronary event.

Vendor Roundup

Health IT vendor Cerner Corp. and Mortara Instrument, a non-invasive cardiology health­care technology company, announced a joint engineering effort that will utilize the DICOM open standard to provide full-featured diagnostic capabilities within an electronic medical record (EMR).

The agreement will see Cerner provide the E-Scribe ECG feature and functionality from its Millennium platform as part of PowerChart ECG — a system that will include the Mortara technology. PowerChart ECG also will improve ECG workflow in other Cerner systems including PowerChart electronic medical record, iNet for the ICU, FirstNet for the emergency room and CVNet for cardiology.

GE Healthcare’s major areas of focus was the company’s Vivid cardiovascular ultrasound platform, and in particular the Vivid 7 Dimension ‘06 which has been designed to help clinicians assess cardiovascular anatomy and LV function with more accuracy. This PC-based, software, raw data ultrasound platform can help improve a clinician’s ability to diagnose conditions by making 4D cardiovascular imaging easier to use during day-to-day clinical exams.

Omar Ishrak, president and CEO of the company’s Clinical Systems business, said that they expect by 2010 that 80 percent of the ultrasound systems they sell will have 4D capability.

GE also introduced new features as part of what it called its ‘Breakthrough 2006” for another part of this ultrasound line, the Vivid i. The new features add new quantitative analysis tools and a wider range of applications.

Towards its efforts in providing technologies that can assist clinicians in determining a patient’s risk for sudden cardiac death (SDC), GE highlighted two patented algorithms that meet new guidelines that help physicians make such judgments. These algorithms can be used in combination with technology that is portable, making diagnostic tests available to patients anywhere. The two algorithms include the Marquette Modified Moving Average (MMA) T-Wave Alternans algorithm and the Marquette Heart Rate Turbulence algorithm. 

Toshiba America Medical Systems highlighted the new SUREPlaque advanced software application. SUREPlaque is available on the Vital Images Vitrea workstation and allows clinicians to visualize and characterize plaques that are likely to cause acute coronary events. 
Also at AHA, Toshiba showcased its automated PhaseXact software (an additional component of the SURECardio package) that is able to automatically locate the optimal phase of the heartbeat to capture the best possible image. The software is designed to decrease image reconstruction