European Heart Journal - Cardiovascular Imaging最新文献

{"title":"3D transoesophageal echocardiographic assessment of acute reverse remodelling of the tricuspid annulus after transcatheter edge-to-edge repair.","authors":"Valeria Cammalleri, Giorgio Antonelli, Valeria Maria De Luca, Mariagrazia Piscione, Myriam Carpenito, Dario Gaudio, Annunziata Nusca, Nino Cocco, Simona Mega, Francesco Grigioni, Gian Paolo Ussia","doi":"10.1093/ehjci/jeae278","DOIUrl":"10.1093/ehjci/jeae278","url":null,"abstract":"<p><strong>Aims: </strong>Our study aims to evaluate the acute remodelling of the tricuspid valve annulus immediately after the tricuspid transcatheter edge-to-edge repair (T-TEER) by using intraprocedural transoesophageal 3D echocardiography.</p><p><strong>Methods and results: </strong>We prospectively enrolled 62 consecutive symptomatic patients with at least severe tricuspid regurgitation (TR), who underwent T-TEER with the TriClip System between March 2021 and June 2024. The following parameters were assessed using a multiplanar reconstruction analysis performed off-line using a 3D data set: septal-lateral (SL) and antero-posterior (AP) annulus diameters; annulus area; annulus perimeter; and eccentricity index. The acute procedural success was achieved in 85.5%. We observed an acute reduction in SL (from a median of 43 to 38 mm, P < 0.0001), AP (from a median of 46 to 45 mm, P < 0.0001), area (from a median of 17.9 to 15.95 cm2, P < 0.0001), perimeter (from a median of 145.5 to 137 mm, P < 0.0001), and eccentricity index (from 0.92 to 0.87, P < 0.0001). The tricuspid valve (TV) annulus was progressively larger in patients with higher residual TR. Analysis of the subgroups according to procedural success showed an acute inverse remodelling of the TV annulus independent of the acute procedural success.</p><p><strong>Conclusion: </strong>The TV geometry necessitates the use of 3D echocardiography for accurate assessment of annular remodelling post T-TEER. The reduction in TR grade and TV annulus dimensions begins immediately after TriClip implantation. Concurrently, the baseline TV geometry influences the procedural results.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"316-324"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of aortic calcification among Japanese in Japan and white and Japanese Americans: a prospective cohort study.","authors":"Mengyi Li, Akira Fujiyoshi, Bradley J Willcox, Jiatong Li, Aya Kadota, Sayaka Kadowaki, Todd Seto, Takashi Kadowaki, Yuefang Chang, Rhobert Evans, Katsuyuki Miura, Daniel Edmundowicz, Tomonori Okamura, Kamal H Masaki, Hirotsugu Ueshima, Akira Sekikawa","doi":"10.1093/ehjci/jeae270","DOIUrl":"10.1093/ehjci/jeae270","url":null,"abstract":"<p><strong>Aims: </strong>Continued low mortality from coronary heart disease in Japan, despite deleterious changes in traditional risk factors, remains unexplained. Since aortic calcification (AC) was an early predictor of cardiovascular mortality, we compared the progression and incidence of AC between Japanese in Japan, white Americans, and third-generation Japanese Americans in the ERA JUMP cohort. We examined whether higher blood levels of marine-derived n-3 fatty acids (FAs) in Japanese than in Americans accounted for the difference.</p><p><strong>Methods and results: </strong>Men (n = 700) aged 40-49 years (252 Japanese in Japan, 238 white, and 210 Japanese Americans) were examined at baseline and 4-7 years later. AC was evaluated from the aortic arch to the iliac bifurcation with computed tomography and quantified by the Agatston method. Robust linear regression and linear mixed models were used to compare the progression of AC. Multivariable logistic regression models were fitted to compare the incidence of AC (AC ≥ 50 at follow-up) among those with baseline AC < 50. Japanese in Japan had a significantly slower progression of AC than white and Japanese Americans after adjusting for age, baseline AC, follow-up time, and traditional risk factors. White Americans had a significantly higher incidence of AC than Japanese in Japan [OR = 4.61 (95% CI, 1.27-16.82)]. Additional adjustment for blood levels of n-3 FAs accounted for the difference in AC incidence but not progression.</p><p><strong>Conclusion: </strong>Japanese in Japan had a significantly slower progression and lower incidence of AC than white Americans. High levels of marine-derived n-3 FAs in Japanese in Japan partly accounted for the difference in incidence.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"273-279"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative and quantitative assessment of atrial functional mitral regurgitation: analysis from the REVEAL-AFMR registry.","authors":"Azusa Murata, Tomohiro Kaneko, Masashi Amano, Yukio Sato, Yohei Ohno, Masaru Obokata, Kimi Sato, Taiji Okada, Akira Sakamoto, Naoki Hirose, Kojiro Morita, Tomoko Machino-Ohtsuka, Yukio Abe, Tohru Minamino, Victoria Delgado, Nobuyuki Kagiyama","doi":"10.1093/ehjci/jeae288","DOIUrl":"10.1093/ehjci/jeae288","url":null,"abstract":"<p><strong>Aims: </strong>The prevalence, characteristics, and prognosis of atrial functional mitral regurgitation (AFMR) based on severity remain unclear. No studies have systematically evaluated quantitative thresholds, such as effective regurgitant orifice area (EROA) or regurgitant volume, in relation to outcomes in AFMR. This multicentre study aimed to clarify the clinical implications of both qualitative and quantitative assessments of AFMR severity.</p><p><strong>Methods and results: </strong>In this first multicentre study across 26 centres, patients with at least moderate AFMR-defined by preserved left ventricular (LV) function, enlarged left atrium (LA), and absence of primary mitral valve changes-were retrospectively analysed. AFMR severity was evaluated using a comprehensive approach, including EROA, regurgitant volume, and regurgitant fraction. Among the 1007 patients, 728 (72.3%) had moderate, 146 (14.5%) moderate-to-severe, and 133 (13.2%) severe AFMR. Age, sex, natriuretic peptide levels, and LV ejection fraction were similar across all groups. Patients with severe AFMR had longer atrial fibrillation history, worse heart failure symptoms, larger LV and LA, and more severe tricuspid regurgitation. AFMR severity was independently associated with a higher risk of death, heart failure hospitalization, and mitral valve intervention (hazard ratio 1.51, P = 0.001 for moderate-to-severe, 2.80, P < 0.001 for severe). Quantitative thresholds showed a significantly higher event risk with EROA ≥ 0.30, regurgitant volume ≥ 60 mL, and regurgitant fraction ≥ 50%.</p><p><strong>Conclusion: </strong>Severe AFMR was common and linked to greater atrial fibrillation burden, cardiac structural issues, and an increased risk of adverse clinical events. Quantitative thresholds offer valuable guidance for clinical decision-making and treatment planning.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"299-306"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of lesion-specific pericoronary adipose tissue attenuation? Importantly, but not yet!","authors":"Yu Du, Hongkai Zhang, Xuelian Gao","doi":"10.1093/ehjci/jeae318","DOIUrl":"10.1093/ehjci/jeae318","url":null,"abstract":"","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"382"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implication of DPD quantification in transthyretin cardiac amyloidosis.","authors":"René Rettl, Franz Duca, Christina Kronberger, Christina Binder, Robin Willixhofer, Nikita Ermolaev, Michael Poledniczek, Felix Hofer, Christian Nitsche, Christian Hengstenberg, Roza Badr Eslam, Johannes Kastner, Jutta Bergler-Klein, Marcus Hacker, Raffaella Calabretta, Andreas A Kammerlander","doi":"10.1093/ehjci/jeae295","DOIUrl":"10.1093/ehjci/jeae295","url":null,"abstract":"<p><strong>Aims: </strong>Quantification of cardiac [99mTc]-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake enhances diagnostic capabilities and may facilitate prognostic stratification in patients with transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to evaluate the association of quantitative left ventricular (LV) DPD uptake with myocardial structure and function, and their implications on outcome in ATTR-CA.</p><p><strong>Methods and results: </strong>Consecutive ATTR-CA patients (n = 100) undergoing planar DPD scintigraphy with Perugini grade 2 or 3, alongside quantitative DPD single-photon emission computed tomography/computed tomography imaging and speckle-tracking echocardiography between 2019 and 2023, were included and divided into two cohorts based on median DPD retention index (low DPD uptake: ≤5.4, n = 50; high DPD uptake: >5.4, n = 50). The DPD retention index showed significant, albeit weak to modest, correlations with LV global longitudinal strain (LV-GLS: r = 0.366, P < 0.001), right ventricular free wall longitudinal strain (RV-FW-LS: r = 0.316, P = 0.002), LV diastolic function (E/e' average: r = 0.304, P = 0.013), NT-proBNP (r = 0.332, P < 0.001), troponin T (r = 0.233, P = 0.022), 6 min walk distance (6MWD: r = -0.222, P = 0.033), and National Amyloidosis Centre (NAC) stage (r = 0.294, P = 0.003). ATTR-CA patients in the high DPD uptake cohort demonstrated more advanced disease severity regarding longitudinal cardiac function (LV-GLS: P = 0.012, RV-FW-LS: P = 0.036), LV diastolic function (E/e' average: P = 0.035), cardiac biomarkers (NT-proBNP: P = 0.012, troponin T: P = 0.044), exercise capacity (6MWD: P = 0.035), and disease stage (NAC stage I: P = 0.045, III: P = 0.006), and experienced adverse outcomes compared with the low DPD uptake cohort [composite endpoint: all-cause death or heart failure hospitalization, HR: 2.873 (95% CI: 1.439-5.737), P = 0.003; DPD retention index: adjusted HR 1.221 (95% CI: 1.078-1.383), P = 0.002].</p><p><strong>Conclusion: </strong>In ATTR-CA, enhanced quantitative LV DPD uptake indicates advanced disease severity and is associated with adverse outcome. DPD quantification may facilitate prognostic stratification when diagnosing patients with ATTR-CA.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"251-260"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid cardiovascular imaging: a clinical consensus statement of the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI) of the ESC.","authors":"Federico Caobelli, Craig Balmforth, Marc R Dweck, Domenico Albano, Olivier Gheysens, Panagiotis Georgoulias, Stephan Nekolla, Olivier Lairez, Lucia Leccisotti, Mark Lubberink, Samia Massalha, Carmela Nappi, Christoph Rischpler, Antti Saraste, Fabien Hyafil","doi":"10.1093/ehjci/jeaf023","DOIUrl":"https://doi.org/10.1093/ehjci/jeaf023","url":null,"abstract":"","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial disarray and fibrosis across hypertrophic cardiomyopathy stages associate with ECG markers of arrhythmic risk.","authors":"Z Ashkir, A H A Samat, R Ariga, L E M Finnigan, S Jermy, M A Akhtar, G Sarto, P Murthy, B W Y Wong, M P Cassar, N Beyhoff, E C Wicks, K Thomson, M Mahmod, E M Tunnicliffe, S Neubauer, H Watkins, B Raman","doi":"10.1093/ehjci/jeae260","DOIUrl":"10.1093/ehjci/jeae260","url":null,"abstract":"<p><strong>Aims: </strong>Myocardial disarray, an early feature of hypertrophic cardiomyopathy (HCM) and a substrate for ventricular arrhythmia, is poorly characterized in pre-hypertrophic sarcomeric variant carriers (SARC+LVH-). Using diffusion tensor cardiac magnetic resonance (DT-CMR) we assessed myocardial disarray and fibrosis in both SARC+LVH- and HCM patients and evaluated the relationship between microstructural alterations and electrocardiographic (ECG) parameters associated with arrhythmic risk.</p><p><strong>Methods and results: </strong>Sixty-two individuals (24 SARC+LVH-, 24 HCM, and 14 matched controls) were evaluated with multi-parametric CMR including stimulated echo acquisition mode DT-CMR, and blinded quantitative 12-lead ECG analysis. Mean diastolic fractional anisotropy (FA) was reduced in HCM compared with SARC+LVH- and controls (0.49 ± 0.05 vs. 0.52 ± 0.04 vs. 0.53 ± 0.04, P = 0.009), even after adjustment for differences in extracellular volume (ECV) (P = 0.038). Both HCM and SARC+LVH- had segments with significantly reduced diastolic FA relative to controls (54 vs. 25 vs. 0%, P = 0.002). Multiple repolarization parameters were prolonged in HCM and SARC+LVH-, with corrected JT interval (JTc) being most significant (354 ± 42 vs. 356 ± 26 vs. 314 ± 26 ms, P = 0.002). Among SARC+LVH-, JTc duration correlated negatively with mean diastolic FA (r = -0.6, P = 0.002). In HCM, the JTc interval showed a stronger association with ECV (r = 0.6 P = 0.019) than with mean diastolic FA (r = -0.1 P = 0.72). JTc discriminated SARC+LVH- from controls [area under the receiver operator curve 0.88, confidence interval 0.76-1.00, P < 0.001], and in HCM correlated with the European Society of Cardiology HCM sudden cardiac death risk score (r = 0.5, P = 0.014).</p><p><strong>Conclusion: </strong>Low diastolic FA, suggestive of myocardial disarray, is present in both SARC+LVH- and HCM. Low FA and raised ECV were associated with repolarization prolongation. Myocardial disarray assessment using DT-CMR and repolarization parameters such as the JTc interval demonstrate significant potential as markers of disease activity in HCM.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"218-228"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic T1 mapping as a novel cardio-hepatic axis imaging biomarker early after ST-elevation myocardial infarction.","authors":"Luca Bergamaschi, Dimitri Arangalage, Niccolò Maurizi, Carmine Pizzi, Marco Valgimigli, Juan F Iglesias, Antonio Landi, Laura Anna Leo, Eric Eeckhout, Juerg Schwitter, Anna Giulia Pavon","doi":"10.1093/ehjci/jeae256","DOIUrl":"10.1093/ehjci/jeae256","url":null,"abstract":"<p><strong>Aims: </strong>The hepatic response after ST-elevation myocardial infarction (STEMI) may be associated with mortality and morbidity. We aimed to assess the cardio-hepatic axis post-STEMI using cardiovascular magnetic resonance (CMR).</p><p><strong>Methods and results: </strong>This prospective, observational, single-centre study included consecutive patients with STEMI who underwent CMR after primary angioplasty from January 2015 to January 2019. Standard infarct characteristics were analysed, and hepatic T1 and hepatic extracellular volume (ECV) were assessed using pre- and post-contrast T1 mapping sequences. The primary endpoint was the relationship between native hepatic T1 values and ischaemic right ventricular (RV) involvement, determined by RV ejection fraction (EF) dysfunction and/or the presence of RV acute myocardial infarction (AMI). The diagnostic performance of hepatic T1 values for detecting RV involvement was assessed using the area under the receiver operating characteristic curve (AUC). Of 177 consecutive patients with STEMI undergoing CMR, 142 were included. Patients with RV ischaemic involvement, compared with those without, had significantly higher native hepatic T1 (P < 0.001) and hepatic ECV (P = 0.016). Hepatic T1 values demonstrated a good diagnostic performance in detecting RV involvement (AUC 0.826, P < 0.001) and correlated positively with NT-proBNP values (r = 0.754, P < 0.001). Patients with high hepatic T1 values (> 605 ms) had significantly higher NT-proBNP levels (< 0.001), larger RV end-diastolic volume (P < 0.001), lower RVEF (P < 0.001), and a higher prevalence of RV AMI (P = 0.022) compared with those with hepatic T1 ≤ 605 ms, whereas left ventricular EF and infarct size were similar. Multivariable logistic regression analysis identified RVEF (P = 0.010) and NT-proBNP values (P < 0.001) as independent predictors of increased hepatic T1 values. Patients with increased hepatic T1 values had a higher rate of rehospitalization for heart failure at 17-month follow-up (12.1 vs. 2.0%, P = 0.046).</p><p><strong>Conclusion: </strong>Hepatic T1 mapping has emerged as a possible novel imaging biomarker of the cardio-hepatic axis in STEMI, being associated with RV involvement and increased NT-proBNP values.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"229-238"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of echocardiographic-derived stroke volume in severe primary mitral regurgitation.","authors":"Yoav Granot, Sheizaf Gefen, Daniel Karlsberg, Orly Ran Sapir, Michal Laufer Perl, David Zahler, Dana Viskin, Shmuel Banai, Yan Topilsky, Ofer Havakuk","doi":"10.1093/ehjci/jeae249","DOIUrl":"10.1093/ehjci/jeae249","url":null,"abstract":"<p><strong>Aims: </strong>Studies have demonstrated the importance of forward flow, and specifically of stroke volume (SV) and SV index (SVI), as prognostic markers in different cardiovascular diseases. In this study, we aim to evaluate the association between SV and SVI thresholds and prognosis in patients with severe primary mitral regurgitation (MR).</p><p><strong>Methods and results: </strong>The association between either SV (<55, 55-70, and >70 mL) or SVI (<30, 30-35, and >35 mL/m2) thresholds and all-cause mortality and heart failure (HF) hospitalizations was examined in a retrospective analysis of 283 patients [60% male, median age 70 years, interquartile range (IQR) 58-82] with severe primary MR, normal left ventricular size and systolic function, and no other significant left-sided valvular abnormalities. Compared with normal values, SV < 55 mL was found to be associated with worse outcomes (hazard ratio 1.8, IQR 1.1-2.8, P = 0.016), whereas SV between 55 and 70 mL was not. A non-significant trend for worse outcomes was noted for SVI < 35 mL/m2 compared with normal SVI.</p><p><strong>Conclusion: </strong>In patients with severe primary MR, SV < 55 mL was found to be associated with increased rates of HF hospitalization and all-cause mortality. This easily obtainable parameter may allow for better risk stratification of patients with primary MR.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"307-312"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study.","authors":"William Woodward, Casey L Johnson, Samuel Krasner, Jamie O'Driscoll, Annabelle McCourt, Cameron Dockerill, Katrin Balkhausen, Badrinathan Chandrasekaran, Soroosh Firoozan, Attila Kardos, Nikant Sabharwal, Rizwan Sarwar, Roxy Senior, Rajan Sharma, Kenneth Wong, Daniel X Augustine, Paul Leeson","doi":"10.1093/ehjci/jeae291","DOIUrl":"10.1093/ehjci/jeae291","url":null,"abstract":"<p><strong>Aims: </strong>Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result to inform on likely longer-term outcomes when applied in real-world practice across a healthcare system has not been previously reported.</p><p><strong>Methods and results: </strong>Five thousand five hundred and three patients recruited across 32 UK NHS hospitals between 2018 and 2022, participating in the EVAREST/BSE-NSTEP prospective cohort study, with data on medical outcomes up to 2023 available from NHS England were included in the analysis. Stress echocardiography results were related to outcomes, including death, procedures, hospital admissions, and relevant cardiovascular diagnoses, based on Kaplan-Meier analysis and Cox proportional hazard ratios (HRs). Median follow-up was 829 days (interquartile range 224-1434). A positive stress echocardiogram was associated with a greater risk of myocardial infarction [HR 2.71, 95% confidence interval (CI) 1.73-4.24, P < 0.001] and a composite endpoint of cardiac-related mortality and myocardial infarction (HR 2.03, 95% CI 1.41-2.93, P < 0.001). Hazard ratios increased with ischaemic burden. A negative stress echocardiogram identified an event-free 'warranty period' of at least 5 years in patients with no prior history of coronary artery disease and 4 years for those with disease.</p><p><strong>Conclusion: </strong>In real-world practice, the degree of myocardial ischaemia recorded by clinicians at stress echocardiography correctly categorizes risk of future events over the next 5 years. Reporting a stress echocardiogram as negative correctly identifies patients with no greater than a background risk of cardiovascular events over a similar time period.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"187-196"},"PeriodicalIF":6.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}