Hierarchy of sources
- Current society guidelines (ASE, EACVI/ESC, ESICM, AHA, ACC, SCCM, ERC). Used for thresholds, grading schemes, and recommended acquisition technique.
- Primary validation studies for any parameter whose guideline threshold is contested or whose ICU performance differs from the ambulatory setting.
- Systematic reviews and meta-analyses for diagnostic accuracy figures.
- Physiological reasoning, explicitly labelled, where no direct evidence exists.
Attribution rules
- Every numeric threshold carries a citation resolving to the master bibliography.
- Where ASE and EACVI/ESC differ, both numbers are given with both attributions. They are not averaged.
- Where a guideline explicitly excludes a population — for example, the 2025 ASE diastolic algorithm excludes atrial fibrillation, LVADs, non-cardiac pulmonary hypertension, constriction, moderate/severe mitral annular calcification, mitral stenosis, severe primary mitral regurgitation, mitral repair/replacement/TEER, and heart transplant recipients — the exclusion list is reproduced in full rather than summarised.
- Prevalence and outcome figures are cited to the cohort that generated them, with the cohort described.
Labelling uncertainty
Label | Meaning |
Guideline-recommended | Appears as a recommendation in a current society document |
Validated in ICU cohorts | Diagnostic performance established in critically ill patients |
Extrapolated | Threshold derived in ambulatory populations, applied to ICU by convention |
Expert opinion | No supporting outcome or accuracy data |
Contested | Societies or major cohorts disagree; both positions stated |
What is deliberately excluded
- Numbers whose provenance cannot be traced to a named document.
- "Rules of thumb" that circulate in teaching but have no published derivation, unless flagged as such and named as folklore.
- Manufacturer-specific normal ranges presented as universal. Strain values in particular are vendor-dependent and are labelled accordingly.
Citations pending verification
Fourteen citations in this edition entered the book from a PMID list supplied at the project's outset rather than from a retrieved source document. The PMIDs are the authoritative identifier; author surnames, initials, journal volumes and page ranges for those entries have not been independently confirmed.
During a review pass, author initials that had been rendered without verification were removed rather than left to look authoritative. The affected PMIDs are: 31421279, 31580845, 32147001, 35778820, 32007409, 30603577, 35187694, 33173359, 34850332, 26252890, 33887587, 37059617 — together with the ESICM 2025 haemodynamic recommendations (volume and pages outstanding) and the 2025 ESC/EACTS valvular guidelines (end page outstanding).
One probable mismatch is flagged: the ASE's own focused cardiac ultrasound recommendations are Spencer KT, et al. JASE 2013;26:567–81 (verified, cited in Chapter 43). The separate 2019 entry from the supplied list is unverified and may be mis-attributed.
These should be resolved against PubMed before the book is published or cited. Fabricated bibliographic detail is worse than an incomplete citation, because it looks verifiable.
Known limitations of this edition
- No figures. Roughly a dozen concepts would benefit materially: the pressure–volume loop for Ea/Ees, septal morphology in pressure versus volume overload, the venous Doppler waveform ladder, PISA geometry, and the TEE view map.
- No external clinical review. Everything here has one author. Parts III and IV in particular should be read by a second reader with subspecialty expertise before clinical use.
- Prosthesis-specific normal gradient tables (ASE 2024 appendix tables) are referenced but not reproduced, as they are extensive and vendor-specific.