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Reality and possibilities in cardiology imaging

March 17, 2020
Cardiology
From the March 2020 issue of HealthCare Business News magazine

By Tom Watson

Cardiac imaging is an active and growing area for clinical and technological innovations. While you can subdivide these technologies into large, highly complex market segments, the major cardiovascular solutions we will look at here are ultrasound (echocardiography), interventional fluoroscopic imaging (angiography), CT and MR.


I believe the transition of healthcare delivery from fee per procedure to a value-based model has likely suppressed activity and interest in many medical capital decisions. The ongoing merger and acquisition activities also make this time period somewhat of an anomaly for healthcare organizations. That said, the following reflects what our extensive network of healthcare organizations are doing relative to cardiac imaging.

Cardiovascular Ultrasound (Echocardiography)
Based on the quote volume sent to TractManager for analysis, there has been about a 20% increase in requests for cardiac and cardiovascular ultrasound solutions. The largest increase (about 12%) came in the premium market segment. I believe this suggests healthcare organizations are looking for high-end, advanced imaging solutions. Other areas showing growth were compact/portable solutions for point-of-care. Stable, yet significant was the specialty area of intra-cardiac echocardiography (ICE) and Transesophageal (TEE) solutions or options.

As we move further into 2020, look for artificial Intelligence (AI) to grow in the ultrasound space. Reliance on ultrasound will grow as a lower-cost, highly portable and quick access and validation for guidance and positioning in many areas of clinical cardiology and even non-cardiac therapeutics. We may also see expanded applications in ultrasound contrast solutions.

Cardiovascular Interventional Fluoroscopic Imaging (Angiography)
Overall, last year reflected a relatively flat market for fluoroscopy with a variance of less than 1% from the prior year. There was a slight increase of 6–7% in sub-market sections such as cardiovascular imaging. Hybrid OR saw increased growth in the prior year but was flat-to-declining in 2019. A likely reason is that the first wave of hybrid OR considerations were spurred by the growing success of catheter-based valvular, congenital, and electrophysiological interventions.

Recent expansion of transcatheter aortic valve replacement (TAVR) into low-risk patient populations has been noted, along with the possibility that other catheter-based interventional applications will also become available to a larger patient population. I believe this will continue to be a strong market and will likely show some growth in the coming year and beyond. Certainly, longer-term studies will be necessary to determine long-range outcomes compared to surgery, but some early success has driven technology development and active equipment acquisition strategies in this area and will continue to do so.

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