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Looking ahead to the annual ACC meeting

par Sean Ruck, Contributing Editor | April 26, 2021
Cardiology
From the April 2021 issue of HealthCare Business News magazine

YC: JACC: Cardiovascular Imaging is one of the top journals on imaging for the entire world. So we felt a special pressure, when people were finding all these changes, to bring out all the information about what was happening, what the cause is, and what should be done. It was a difficult time for my journal as well as other journals I’m sure. Everyone had to figure out the path they felt was best with the rush of papers coming in. We had a 35% increase year-over-year in the number of papers submitted to us — both COVID related and non-COVID related. So lots of people were doing research despite the difficult environment. However, most of these papers were small, they were observational studies… They needed to be confirmed with better studies before we could act on them. Even during a pandemic, though, it’s our responsibility to maintain quality. Papers have to be robust, they have to have sizable data. We, as a group, felt most of the submitted papers would not pass the traditional metrics of quality. Throughout the whole year, we only published four original papers on COVID. We may have gotten two or three hundred COVID-focused submissions and found just the four that cleared the bar. Our usual acceptance rate is about 5%.

HCB News: Aside from the pandemic, where is cardiac imaging making the biggest impact in clinical practice?
YC: Lots of areas. Some of the biggest impact immediately seen would be marrying imaging with structural intervention, like putting an aortic valve through a catheter or closing a leaky valve through a catheter. These techniques need a lot of imaging support. Similarly for electrophysiology procedures, where to burn, where the focus of the scar is, becomes very important.

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Then of course, there are new things happening in CT. Especially with CT perfusion gathering good data. In one test you can get anatomy, physiology and blood flow at the same time.
PET scans are coming up in a big way as well, because they allow you to measure blood flow and that, coupled with new neurotracers, will allow us to get better answers. CMR is the other that tops the list. There are lots of new things coming there. At this time, there isn’t much uptake, but in the next few years, it will be a very powerful tool.

HCB News: Despite lots of research showing its value, cardiac CT is underutilized and perhaps under-reimbursed. Has that been your impression?
YC: Very true. CT is probably the area with the strongest emerging evidence for its use. It is data-based, clearly showing where it’s useful and where it has limitations. We are gathering more knowledge about that faster than we have for technologies like echo and nuclear. CT has provided similar kinds of information in a much shorter time. And an important thing to note is that the evidence has been gathered from contemporary patients. It’s easy to do and it acts as a great gatekeeper to more invasive procedures.

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