CME Information: 1.50 credits; ABIM MOC Points: 1.50
Expiration Date: January 31, 2019
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Very complete and informative article.
“Recommendations for Multimodality Cardiac Imaging in Patients with
CME Information: 1.50 credits
date: January 2018 Valid through: January 2019
Introduction/Statement of Need:
Chagas disease (ChD) is a significant public health problem in most Latin American countries. Observed mainly in rural areas, in recent decades it has spread to cities and
to nonendemic countries, mostly as a result of migration of infected people. Increasing numbers of cases are now being identified in the United States, Spain, and other countries, which makes its diagnosis and management of increasing interest worldwide. There are two clinical phases of T.cruzi infection: acute ChD, seen early after acquiring the infection, and chronic ChD, lasting for decades. About 70% to 80% of individuals with chronic T. cruzi infection remain asymptomatic (indeterminate form), while 20% to 30% develop cardiac and/or gastrointestinal disease. Patients with chronic Chagas heart disease (ChHD) are staged according to the severity of myocardial damage and symptoms of congestive heart failure. The purpose of this document is to provide recommendations for the use of cardiac ultrasound and other imaging modalities in the diagnosis, classification, and risk assessment of myocardial damage from early to advanced forms of ChHD.
This activity is designed for all cardiac sonographers and cardiovascular physicians with a primary interest and knowledge base in the field of echocardiography; in
addition, residents, researchers, clinicians, intensivists, and other medical professionals.
At the end of this activity the reader will better be able to:
2. Recognize the potential role of multiple cardiac imaging modalities in the management of patients with ChD and Chagas Heart Disease (ChHD)
3. Define the overall goals of imaging in the symptomatic stages of ChHD
4. Characterize the clinical phases – acute ChD, (indeterminate), and chronic ChD – of T. cruzi infection
5. Recognize the special features of EKG and each other imaging modality in relation to ChD
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education for physicians.
The American Society of Echocardiography designates this enduring material for
a maximum of 1.50 AMA
PRA Category 1 CreditsTM. Physicians should claim only
the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.50 MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
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The American Society of Echocardiography is committed to ensuring that its educational mission and all sponsored educational programs are not influenced by the special interests of
any corporation or individual, and its mandate is to retain only those authors whose financial interests can be effectively resolved to maintain the goals and
educational integrity of the activity. While a monetary or professional affiliation with a corporation does not necessarily influence an author’s presentation, the Essential Areas and policies of the ACCME require that any relationships that could possibly conflict with the educational value of the activity be resolved prior to publication and disclosed to the audience. Disclosures of faculty and commercial support relationships, if any, have been indicated.
Harry Acquatella, MD, FASE, Federico M. Asch, MD, FASE, Marcia M. Barbosa, MD, PhD, FASE, Marcio Barros, MD, PhD, Caryn Bern, MD, MPH, Joao L. Cavalcante, MD, FASE, Luis
Eduardo Echeverria Correa, MD, Joao Lima, MD, Rachel Marcus, MD, Jose Antonio Marin-Neto, MD, PhD, Ricardo Migliore, MD, PhD, Jose Milei, MD, PhD, Carlos A. Morillo, MD, Maria Nunes, MD, PhD, Marcelo Luiz Campos Vieira, MD, PhD, Rodolfo Viotti, MD
According to ACCME policy, ASE implemented mechanisms to resolve all conflicts of interest prior to the planning and implementation of this activity.
authors reported no actual or potential conflicts of interest in relation to this document:
Acquatella, MD, FASE, Federico M. Asch, MD, FASE, Marcia M. Barbosa, MD, PhD, FASE, Marcio Barros, MD, PhD, Joao L. Cavalcante, MD, FASE, Jose Antonio
Marin-Neto, MD, PhD, Ricardo Migliore, MD, PhD, Jose Milei, MD, PhD, Maria Nunes, MD, PhD, Marcelo Luiz Campos Vieira, MD, PhD, Rodolfo Viotti, MD
The following authors reported relationships with one or more commercial interests:
Caryn Bern, MD, MPH: Chemogroup (Consultant, Advisor); Luis Eduardo Echeverria Correa, MD: Roche (Research Grant Support (Including PI)); Joao Lima, MD:
Toshiba Medical Systems (Research Grant Support (Including PI)); Rachel Marcus, MD: Bayer (Consultant, Advisor);Carlos A. Morillo, MD,: Canadian Institute for
Health Research: (Research Grant Support (Including PI)); TDR-WHO (BENEFIT trial): (Research Grant Support (Including PI)); Merck Shape & Dohme (STOP-CHAGAS trial): (Research Grant Support (Including PI)); Bayer: (Research Grant Support (Including PI)), (Speaker / Speaker’s Bureau); BMS/Pfizer: (Research Grant Support (Including PI));
Boehringer Ingelheim (Speaker / Speaker’s Bureau); Boston Scientific (Consultant, Advisor)
The following 2017-2018 ASE Board of Directors, Guidelines and Standards Committee and a representative for the Society for Cardiovascular Magnetic Resonance reviewed this document and reported
no actual or potential conflicts of interest in relation to this document:
Reviewers included Bonita Anderson, MApplSC, DMU, AMS, ACS, AFASA, FASE, Federico Asch, MD, FASE, Stephen Little, MD, FASE, Azin Alizadehasl, MD, FASE, Kim Baker, BS, RDCS, RVT, FASE, Scott Choyce, RDCS, RVT, RDMS, FASE, Frederick Cobey, MD, FASE, Benjamin W. Eidem, MD, FASE, Mark Friedberg, MD, FASE, Edward Gill, MD, FASE, Neal Gerstein, MD, FASE, Yvonne Gilliland, MD, FACC, FASE, Robi
Goswami, MD, FASE, Lanqi Hua, RDCS, (AE/PE/FE), FASE, Renuka Jain, MD, FASE, Pei-Ni Jone, MD, FASE, James Kirkpatrick, MD, FASE, Allan L. Klein, MD, FASE, Stephen H. Little, MD, FASE, Elizabeth McIlwain, MPH, RCS, FASE, Maryellen H. Orsinelli, RN, RDCS, FASE, Alan Pearlman, MD, FASE, Andy Pellett, PhD, RCS, RDCS, FASE, Dermot Phelan, MD, PhD, FACC, FASE, Michael Picard, MD, FASE, Sue D. Phillip, RCS, FASE, Sorin Pislaru, MD, PhD, FASE, Juan Carlos Plana, MD, FASE, Charlene Porcelli, RDCS, RDMS, FASE, Geoffrey Rose, MD, FASE, David Rubenson, MD, FASE, Liza Sanchez, RCS, FASE, Fadi Shamoun, MD, FASE, Elaine Shea, ACS, RCS, RCCS, FASE, Madhav Swaminathan, MD, FASE, James D. Thomas, MD, FASE, David Wiener, MD, FASE
The following board and guidelines and standards committee members reported relationships with one or more commercial interests:
Alicia Armour, BS, MA, RDCS, FASE – Philips Healthcare (Speakers Bureau), Jao Cavalcante, MD, FASE – Medtronic Inc. (Grants or Research Support), Keith Collins, MDS, RDCS, FASE – IBM (Stockholdership), Sabe De, MD, FASE – Bayer (Speakers Bureau); Astra Zeneca (Speakers Bureau), Craig Fleishman, MD, FASE – W.L. Gore Echo Core Lab (Scientific Advisory Committee), John Gorcsan III, MD, FASE -
Medtronic (Research Grant Support, Including PI); Hitachi Aloka (Research Grant Support, including PI); GE (Research Grant Support, Including PI), Steve Heitner, MD, FASE – Bracco Diagnostics (Scientific Advisory Committee); Alnylam Pharmaceuticals (Scientific Advisory Committee); Amgen Pharmaceuticals (Scientific Advisory Committee); Takeda Pharmaceuticals (Scientific Advisory Committee); MyoKardia (Scientific Advisory Committee), Jonathan Lindner, MD, FASE – GE Healthcare (Research Grant Support, Including PI), Rick Meece, ACS, RDCS, RCS, RCIS, FASE – Philips Healthcare (Speakers Bureau); Abbott Medical (Speakers Bureau); Edwards Lifesciences (Speakers Bureau), William Perez, MD, FASE – Alibaba Holdings (Stockowernership); Myriad Genetics (Stockownership), American Energy Industries (Stockownership), Vera H. Rigolin, MD, FASE – Pfizer (Stockownership), Raymond Stainback, MD, FASE – GE (Stockownership), Douglas Shook, MD, FASE – Edwards Life Sciences (Research Grant Support, Including PI); Liva-Nova (Education); Boston Scientific (Education); Edwards Lifesciences (Consultant/Advisor)
The following ACCME reviewers, ASE Staff and CME editors reported no actual or potential conflicts of interest in relation to this document:
Pricilla Peters, BA, RDCS, Andra Duncan, MD, FASE, Tia Gordon, RDCS, FASE, Mary Lawson, and Christina LaFuria
The following ACCME reviewers, ASE Staff and CME editors reported relationships with one or more commercial interests:
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