BSE responds to NICE consultation on heart valve disease guidance

The British Society of Echocardiography (BSE) was recently invited to comment on the NICE consultation on proposed new guidance entitled Heart valve disease presenting in adults: investigation and management.

As a key stakeholder, we were delighted to provide feedback and formed a working group to review the guideline and evidence provided by NICE.

The key points of our feedback were as follows:

  • Consideration for the use of the most up to date BSE published guidance with respect to aortic and mitral valve disease
  • Promoting the evidence behind current normal reference interval poster / dataset with respect to adverse outcomes in valvular disease (e.g. LVEF% cut off)
  • Recommendation not to rely solely on symptom development before timely medical intervention and instead consider interval echo surveillance – especially in the case of mild AS or exercise echocardiography in asymptomatic severe MR
  • Highlighted the complexity of low gradient AS with impaired LVEF and the use of DSE to identify true or pseudo severe AS – sign posted to most up to date BSE guidance
  • Recommended the inclusion of the diagnosis, monitoring and intervention with respect to the tricuspid and pulmonary valve – neither of which were included in the original document

Professor Martin Stout, Vice-President of the Society and lead for the working group, said "Echocardiographers play an important role in the management of people with heart valve disease so it was critical that the BSE submitted comments on the guideline. We gathered wide ranging views and consulted with other key stakeholders including the British Heart Valve Society and the British Cardiovascular Society. We hope our comments will be taken on board and look forward to the publication of the final guidance."