Basic and Advanced Training in Pediatric Cardiology and Congenital Heart Disease Echocardiography: An Expert Consensus Paper from the European Paediatric and Congenital Cardiology (AEPC) Imaging Working Group and Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI)
15 affiliations
- 1Fondazione CNR-Regione Toscana G. Monasterio (FTGM), 54100 Massa, Italy
- 2Department of Pediatric Cardiology, Hospital Materno Infantil de Malaga, 29011 Málaga, Andalucia, Spain
- 3Department of Paediatric Cardiology, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands
- 4Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, 20097 Milan, Italy
- 5Department for Congenital Cardiology and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
- 6Division of Pediatric Cardiology, Spedali Riuniti, ASST Azienda Ospedaliera Papa Giovanni XXIII, 24127 Bergamo, Italy
- 7Paediatric Cardiology Department, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UK
- 8National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK
- 9The Heart Unit, Birmingham Children’s Hospital, Birmingham B4 6NL, UK
- 10Great Ormond Street Hospital for Children, London WC1N 3JH, UK
- 11Department of Pediatrics, Division of Pediatric Cardiology, Medical University Graz, 8036 Graz, Austria
- 12Department of Pediatric Cardiology, Evelina London Children’s Hospital, London SE1 7EH, UK
- 13Paediatric Cardiology and Congenital Heart Disease, Women and Children’s Health Department, University of Padua, Experimental Cardiology, Paediatric Research Institute, 35122 Padua, Italy
- 14Department of Paediatric Cardiology, Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland
- 15School of Medicine, University College of Dublin, D04 V1W8 Dublin, Ireland
Abstract
Bakcgroung: Training in pediatric and congenital echocardiography has progressed substantially over the past two decades, supported by structured recommendations in North America and Europe. However, while North American training pathways are generally more standardized and closely linked to accreditation and certification, European training remains heterogeneous. Differences in healthcare systems, regulatory frameworks, institutional organization, supervision, case exposure, and access to advanced imaging may result in unequal acquisition of competencies, with potential implications for patient care. The aim of this expert consensus document is to update European standards for training in pediatric and congenital echocardiography and to promote harmonization through a competency-based framework that complements, rather than replaces, national regulatory systems and existing certification pathways. Methods: Developed by the Imaging Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC), in collaboration with the Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI), the document defines three progressive levels of expertise: Basic, Advanced, and Specialized/Tertiary. Each level is characterized by specific competencies, indicative procedural experience, and expected professional responsibilities. Building on previous European recommendations and the recent joint statement addressing laboratory organization and service governance, this document focuses specifically on the educational pathway, progressive acquisition of clinical competencies, and assessment of individual practitioners. Results: The proposed framework emphasizes comprehensive training across the lifespan of congenital heart disease, including competencies bridging pediatric and adult cardiology. It incorporates contemporary imaging modalities, including three-dimensional echocardiography, myocardial deformation imaging, transesophageal and fetal echocardiography, and emerging blood speckle tracking and artificial intelligence applications. Minimum requirements for training centres, structured assessment, quality assurance, continuous professional development, research activity, and multidisciplinary collaboration are also addressed. Procedural volumes are proposed as indicative benchmarks to support training and assessment, not as stand-alone evidence of competence or universally mandatory thresholds. Conclusions: This consensus document provides a shared European reference framework designed to reduce unwarranted variability in training, facilitate professional mobility, promote competency-based progression, and ensure that pediatric and congenital echocardiography remain aligned with current clinical practice and technological innovation.
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BibTeX
@article{cantinotti2026basic,
title = {{Basic and Advanced Training in Pediatric Cardiology and Congenital Heart Disease Echocardiography: An Expert Consensus Paper from the European Paediatric and Congenital Cardiology (AEPC) Imaging Working Group and Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI)}},
author = {Massimiliano Cantinotti and Almudena Ortiz Garrido and Heynric B. Grotenhuis and Giulia Pasqualin and Inga Voges and Francesca Raimondi and Sylvia Krupickova and Tristan Ramcharan and Beatrice Bonello and Martin Köstenberger and Owen Miller and Giovanni Di Salvo and Colin J. McMahon},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15228819},
url = {https://www.mdpi.com/2077-0383/15/22/8819},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Basic and Advanced Training in Pediatric Cardiology and Congenital Heart Disease Echocardiography: An Expert Consensus Paper from the European Paediatric and Congenital Cardiology (AEPC) Imaging Working Group and Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI)
AU - Massimiliano Cantinotti
AU - Almudena Ortiz Garrido
AU - Heynric B. Grotenhuis
AU - Giulia Pasqualin
AU - Inga Voges
AU - Francesca Raimondi
AU - Sylvia Krupickova
AU - Tristan Ramcharan
AU - Beatrice Bonello
AU - Martin Köstenberger
AU - Owen Miller
AU - Giovanni Di Salvo
AU - Colin J. McMahon
PY - 2026
DA - 2026/11/11
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15228819
UR - https://www.mdpi.com/2077-0383/15/22/8819
AB - Bakcgroung: Training in pediatric and congenital echocardiography has progressed substantially over the past two decades, supported by structured recommendations in North America and Europe. However, while North American training pathways are generally more standardized and closely linked to accreditation and certification, European training remains heterogeneous. Differences in healthcare systems, regulatory frameworks, institutional organization, supervision, case exposure, and access to advanced imaging may result in unequal acquisition of competencies, with potential implications for patient care. The aim of this expert consensus document is to update European standards for training in pediatric and congenital echocardiography and to promote harmonization through a competency-based framework that complements, rather than replaces, national regulatory systems and existing certification pathways. Methods: Developed by the Imaging Working Group of the Association for European Paediatric and Congenital Cardiology (AEPC), in collaboration with the Congenital Heart Disease Shared Interest Group of the European Association of Cardiovascular Imaging (EACVI), the document defines three progressive levels of expertise: Basic, Advanced, and Specialized/Tertiary. Each level is characterized by specific competencies, indicative procedural experience, and expected professional responsibilities. Building on previous European recommendations and the recent joint statement addressing laboratory organization and service governance, this document focuses specifically on the educational pathway, progressive acquisition of clinical competencies, and assessment of individual practitioners. Results: The proposed framework emphasizes comprehensive training across the lifespan of congenital heart disease, including competencies bridging pediatric and adult cardiology. It incorporates contemporary imaging modalities, including three-dimensional echocardiography, myocardial deformation imaging, transesophageal and fetal echocardiography, and emerging blood speckle tracking and artificial intelligence applications. Minimum requirements for training centres, structured assessment, quality assurance, continuous professional development, research activity, and multidisciplinary collaboration are also addressed. Procedural volumes are proposed as indicative benchmarks to support training and assessment, not as stand-alone evidence of competence or universally mandatory thresholds. Conclusions: This consensus document provides a shared European reference framework designed to reduce unwarranted variability in training, facilitate professional mobility, promote competency-based progression, and ensure that pediatric and congenital echocardiography remain aligned with current clinical practice and technological innovation.
SN - 2077-0383
ER -