Journal of Cardiovascular Echography最新文献

{"title":"Age-Creatinine-Ejection Fraction Score in Infective Endocarditis: Integrated Clinical and Echocardiographic Score for Surgically and Medically Treated Patients.","authors":"Sara Hana Weisz, Nicolina Capoluongo, Chiara Sordelli, Nunzia Fele, Angela Guarino, Raffaele Verde, Alessandro Perrella, Paolo Golino, Emilio Di Lorenzo","doi":"10.4103/jcecho.jcecho_181_25","DOIUrl":"10.4103/jcecho.jcecho_181_25","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is associated with high morbidity, therefore the identification of high risk patients is crucial. Age-creatinine-ejection fraction (ACEF) score is a risk stratification tool already used in different clinical settings. The aims of our study is to evaluate its ability to identify IE patients with worst prognosis.</p><p><strong>Methods: </strong>Consecutive patients hospitalized in our infectious diseases hospital for IE were retrospectively included (January 2023 - February 2025). Clinical, laboratory, echocardiographic data and ACEF score were recorded at admission.</p><p><strong>Results: </strong>One hundred forty-three patients were included. Mean age was 65±14 years (69% males). Native valve was involved in 48% and Staphylococcus aureus was responsible in 16% patients. Thirty patients died during follow up. At adjusted Cox regression model, higher ACEF score (AdjHR= 2.944; CI 1.153-7.513; p= 0.024), diabetes mellitus (AdjHR= 4.842; CI 1.017-4.322; p 0.022), cardiac surgery indicated but not performed (AdjHR 5.695; CI 1.503-21.574; p= 0.010) and Staphylococcus aureus infection (AdjHR 1.058; CI 1.012-1.280; p <0.001) were associated with worst outcome. In Kaplan-Meier analysis, these populations had significantly higher in-hospital and early mortality (P-log-rank= 0.024; 0.022; 0.010 and <0.001).</p><p><strong>Conclusions: </strong>ACEF score is a simple risk score, integrating clinical and echocardiographic informations, that can be easily calculated in IE. High ACEF score ≥1.30 was associated to worst prognosis in terms of higher mortality during follow up, in both surgically or medically treated subjects. Our results suggest the possible use of ACEF score to stratify risk in newly diagnosed IE, representing a quick tool for clinicians in everyday practice.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"387-394"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between Epicardial Fat Thickness and Left Atrial Mechanics in Type 2 Diabetes Patients: Strain Imaging Study.","authors":"Asmaa Abdelkarim Kenawy, Morad Beshay Mena, Moustafa Mahmoud Taha Mohamed, Tarek Mohamed Ahmed Aly, Hend Mohammed Abdo Eldeeb","doi":"10.4103/jcecho.jcecho_48_26","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_48_26","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is linked to early myocardial dysfunction, particularly diastolic impairment and atrial remodeling. Epicardial adipose tissue may contribute to subclinical cardiac dysfunction through mechanical and inflammatory effects. This study evaluated the relationship between epicardial fat thickness (EFT) and left atrial (LA) strain measured by speckle-tracking echocardiography in patients with T2DM compared with non-diabetic controls.</p><p><strong>Methods: </strong>This case-control study at Menoufia University Hospitals included 78 participants equally divided into two groups: 39 healthy controls and 39 patients with T2DM diagnosed according to the American Diabetes Association criteria. Participants underwent clinical evaluation, laboratory investigations, conventional echocardiography, Doppler assessment, and speckle-tracking echocardiography to measure LA reservoir (LASr), conduit (LAScd), and contractile (LASct) strain. EFT was measured from the parasternal long-axis view.</p><p><strong>Results: </strong>Patients with T2DM had higher body mass index, waist circumference, fasting glucose, glycosylated hemoglobin, and lipid levels than controls (<i>P</i> < 0.05). Left ventricular ejection fraction was similar between groups. However, diastolic parameters were impaired in the diabetic group, with lower E/A ratio and e' velocities and higher E/e' ratio (<i>P</i> < 0.001). EFT was greater in T2DM patients (<i>P</i> < 0.001). LASr, LAScd, and LASct strain values were reduced (<i>P</i> < 0.001). EFT correlated negatively with LASr (<i>r</i> = -0.341, <i>P</i> = 0.034) and LAScd (<i>r</i> = -0.322, <i>P</i> = 0.046).</p><p><strong>Conclusion: </strong>Increased EFT in T2DM is associated with impaired LA strain, suggesting early atrial dysfunction before structural remodeling.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"237-243"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiography versus Bioimpedance in Evaluating Volume Status in Patients with Chronic Cardiorenal Syndrome: A Preliminary Study.","authors":"Fatemeh Omidi, Amir Ahmad Nassiri, Mohammad Parsa Mahjoob, Mohammad Haji Aghajani, Roxana Sadeghi, Minoo Heidari Almasi, Fahimeh Safari","doi":"10.4103/jcecho.jcecho_99_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_99_25","url":null,"abstract":"<p><strong>Background and aim: </strong>Assessment of volume status plays a critical role in the therapeutic management of patients with heart failure (HF) and chronic kidney disease (CKD). Echocardiography and bioelectrical impedance analysis (BIA) are two noninvasive methods frequently used to evaluate body fluid distribution. This study aimed to investigate the correlation between parameters obtained from these two methods in hospitalized patients.</p><p><strong>Methods: </strong>In this cross-sectional study, 40 patients with concurrent HF and CKD admitted to a tertiary hospital were evaluated. Demographic data, medical history, medication usage, and echocardiographic and BIA parameters were collected. Associations between variables were analyzed using correlation and regression models, with statistical significance defined as <i>P</i> < 0.05.</p><p><strong>Results: </strong>A significant correlation was found between inferior vena cava diameter and total body water (TBW) (ρ = 0.332, <i>P</i> = 0.037). Reduced left ventricular ejection fraction (EF) was associated with increased left atrial volume (LAV) and LAV index (<i>P</i> < 0.001). Among echocardiographic indices, right ventricular diameter showed strong positive correlations with TBW (ρ = 0.610, <i>P</i> < 0.001), intracellular water (ρ = 0.597, <i>P</i> < 0.001), and extracellular water (ECW) (ρ = 0.571, <i>P</i> < 0.001). E-wave velocity correlated positively with ECW ratio (ρ = 0.434, <i>P</i> = 0.005) and negatively with segmental phase angle (ρ = -0.398, <i>P</i> = 0.011). Patients with pulmonary congestion on computed tomography had lower segmental phase angle values (<i>P</i> = 0.027), and those with pleural effusion showed higher ECW ratios (<i>P</i> = 0.047). However, no significant correlations were observed between systolic pulmonary artery pressure (SPAP), tricuspid regurgitation gradient, and BIA-derived indices. Among laboratory markers, serum creatinine was significantly associated with the body cell mass index (<i>P</i> = 0.049), whereas NT-proBNP and CA125 were not. Clinically, patients with lower limb edema had higher ECW ratios (<i>P</i> = 0.045), and those with pulmonary rales exhibited lower stroke volume index (SVI) values (<i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>The findings suggest that echocardiography and BIA provide complementary insights into volume assessment in patients with HF and CKD. Significant correlations between selected parameters indicate that combining these modalities may enhance diagnostic accuracy. However, further large-scale studies are warranted to validate the clinical utility of these findings.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"250-260"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrium Function Study Affection and Myocardial Deformations before and after Ventricular Septal Defect Surgical Closure.","authors":"Sahar S Sheta, Mohamed Samir, Mohamed Eltoukhy, Baher M Hanna, Ahmed Behairy","doi":"10.4103/jcecho.jcecho_56_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_56_25","url":null,"abstract":"<p><strong>Background: </strong>Ventricular septal defect (VSD) is the most prevalent form of congenital heart disease (CHD) in children and the second-most prevalent form of CHD in adults, following a bicuspid aortic valve. Large VSDs can lead to significant complications, including heart failure and ventricular dysfunction. Assessing cardiac function in patients with VSD is an essential component of clinical evaluation both before and following surgery. The left atrium (LA) is a critical structure in cardiac physiology, serving as a dynamic chamber that plays a pivotal role in left ventricular filling by actively contributing during various phases of the cardiac cycle through its mechanical functions. Our aim is to validate alterations in LA function and myocardial deformation before and after surgical closure of VSD using speckle-tracking echocardiography.</p><p><strong>Patients and methods: </strong>A prospective observational study with paired comparisons included 40 VSD patients who were assessed preoperatively and had short-term follow-up after 3 months at a tertiary university-based pediatric hospital.</p><p><strong>Results: </strong>Infants with hemodynamically significant VSD show impaired growth. Postsurgery, VSD cases demonstrated a significant elevation in weight and body surface area (<i>P</i> < 0.001). LA function assessment with speckle-tracking echocardiography showed a decrease in LA reservoir, LA conduit (CD), and LA contractile (CT) strain (<i>P</i> < 0.001, <i>P</i> = 0.026 and < 0.001, respectively). VSD cases showed that E/E' and MV E/A ratios decreased postsurgery (<i>P</i> < 0.001 and 0.045), whereas deceleration time increased (<i>P</i> < 0.001), indicating improved diastolic dysfunction. VSD cases showed a systolic function decline in septal S' (<i>P</i> = 0.034), and both two-dimensional (2D) and 3D echocardiography revealed significant drops in left ventricle (LV) volumes, whereas 3D echocardiography showed decreased ejection fraction postsurgery (<i>P</i> < 0.024 and <i>P</i> < 0.001, respectively). LV global longitudinal strain significantly decreased postoperatively (<i>P</i> < 0.001). Both left ventricular end-diastolic diameter and left ventricle end diastolic volume (LVEDV) by 2D and 3D LVEDV and LV end-systolic volume decreased significantly with surgery by 2D and 3D (<i>P</i> < 0.05). Right ventricle (RV) volumes by 3D conversely increased postoperatively as 3D right ventricle end diastolic volume (RVEDV) and right ventricle end systolic volume (RVESD) increased (<i>P</i> = 0.003 and 0.002, respectively).</p><p><strong>Conclusion: </strong>Preoperative VSD cases demonstrated higher LA R, CD, and CT function compared to postoperative cases.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"244-249"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Pseudoaneurysm Following Anterior Myocardial Infarction.","authors":"Lorenzo Bazan, Mattia Alberti, Paolo Caravelli, Maria Grazia Delle Donne, Laura Besola, Michele Celiento, Gerardo Anastasio, Doralisa Morrone, Andrea Colli, Giovanni Donato Aquaro, Raffaele De Caterina","doi":"10.4103/jcecho.jcecho_161_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_161_25","url":null,"abstract":"<p><p>Left ventricular pseudoaneurysm (LVP) is a rare but severe mechanical complication of myocardial infarction (MI), associated with high risk of rupture and mortality. Accurate diagnosis relies on multimodality imaging, and timely surgical repair remains the mainstay of treatment. We report the case of a 78-year-old man, a former heavy smoker, who presented with progressive exertional dyspnea and bilateral lower limb edema. The electrocardiogram showed sequelae of a prior anterior MI with suspected aneurysmal evolution. Transthoracic echocardiography revealed a dilated left ventricle with severely impaired systolic function (left ventricular ejection fraction [LVEF] -20%) and a dyskinetic, aneurysmal apex. Coronary angiography showed two-vessel disease, while cardiac magnetic resonance confirmed a nonacute transmural infarction of the anterior and septal walls complicated by a large pseudoaneurysm with mural and extramural thrombus. Because of the high risk of progression and embolic complications, the patient underwent elective surgical repair with an endoventricular circular patch plasty (Dor procedure). The postoperative recovery was uneventful. At 2-weeks, echocardiography showed a favorable left ventricular (LV) remodeling, with an important reduction in end-diastolic volume (from 230 to 150 mL), and a marked improvement in systolic function (LVEF from 20% to 39%). This case highlights the critical role of imaging in diagnosing and characterizing LVP, as well as the therapeutic efficacy of surgical ventricular reconstruction. Early surgical intervention can prevent catastrophic rupture and restore LV geometry, improving global systolic performance. Multidisciplinary evaluation is essential to guide management, and less invasive percutaneous approaches may represent future alternatives in high-risk surgical candidates.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"330-334"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging-based Demonstration of Reverse Left Heart Remodeling after Sodium-Glucose Co-transporter 2 Inhibitors in Heart Failure: A Systematic Review and Meta-analysis.","authors":"Federico Giannino, Luigi Colarusso, Matteo Mancuso, Maurizio Cusmà Piccione, Gianluca Di Bella, Antonio Micari, Concetta Zito","doi":"10.4103/jcecho.jcecho_11_26","DOIUrl":"10.4103/jcecho.jcecho_11_26","url":null,"abstract":"<p><strong>Background: </strong>Several studies have demonstrated the safety and efficacy of sodium-glucose co-transporter 2 inhibitors (SGLT2i), but there is little evidence on how these drugs improve cardiac remodeling parameters in patients with heart failure (HF). We performed a meta-analysis of RCTs to evaluate the effect of SGLT2i on cardiac remodeling in patients with HF. The study protocol was registered in June 2025 (PROSPERO: CRD420251055562).</p><p><strong>Methods: </strong>The Medline, Scopus, and Cochrane Central databases were searched for RCTs that compared SGLT2i with placebo in patients ≥18 years of age with a diagnosis of HF. Eleven outcomes were analyzed, including left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVES), left ventricular mass (LVM), left ventricular ejection fraction (LVEF), left atrial volume indexed (LAVi), left ventricular global longitudinal Strain, stroke volume, and E/e'. Statistical analyses were performed using R version 4.3.2.</p><p><strong>Results: </strong>We included 13 RCTs with 1181 patients, 592 of whom received SGLT2i as the intervention. LVEDV (MD: -8.41 mL; 95% CI: -13.07 to - 3.75, <i>P</i> = 0.004), LVES (MD: -8.11 mL; 95% CI: -13.95 to -2.28, <i>P</i> = 0,006), left ventricular end-systolic volume indexed (LVESVi) (MD: -3.71 mL/m², 95% CI: -6.84 to - 0.58, <i>P</i> = 0.02), LVM (MD: -7.65 g; 95% CI: -13.79 to -1.51, <i>P</i> = 0.01), and LAVi (MD: -2.04 ml/m²; 95% CI: -3.21 to - 0.86, <i>P</i> = 0.0007) were significantly lower in patients treated with SGLT2i compared to placebo. In addition, this treatment led to a significant increase in LVEF (MD: +2.59%, 95% CI: 1.76 to 3.43, <i>P</i> < 0.00001) compared to placebo.</p><p><strong>Conclusion: </strong>Our results suggest that in patients with HF, SGLT2i have a positive influence on cardiac remodeling since they lead to a significant decrease in LVEDV, LVES, LVESVi, LVM, left ventricular mass indexed, and LAVi compared to placebo and a significant increase in EF.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"395-407"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelium-dependent Coronary Microvascular Dysfunction - A Diagnosis by Integrated Non-invasive Imaging.","authors":"Nicola Gaibazzi, Jiri Sklenar, Attila Kardos, Benedetta Albiani, Sergio Suma, Rebecca Navacchi","doi":"10.4103/jcecho.jcecho_25_26","DOIUrl":"10.4103/jcecho.jcecho_25_26","url":null,"abstract":"<p><p>Coronary microvascular dysfunction (CMD) is a common but often underdiagnosed cause of ischemia and angina in patients with angina and no obstructive coronary artery disease (ANOCA). The reliance on invasive testing contributes to delayed or missed diagnosis. Exercise-induced ST-segment abnormalities in ANOCA patients may serve as a non-invasive marker, particularly reflecting impaired endothelium-dependent vasodilation. We report the case of a middle-aged man undergoing a treadmill exercise test for competitive sports eligibility. The patient developed atypical chest pain with significant (>2 mm) down-sloping ST depression in precordial and inferior leads during exertion. Coronary computed tomography angiography revealed normal coronary arteries, raising suspicion for CMD. Further assessment with dipyridamole stress echocardiography demonstrated normal coronary flow velocity reserve (CFVR) in the left anterior descending artery = 3.2, indicating preserved endothelium-independent vasodilation. However, contrast myocardial perfusion imaging revealed patchy areas of delayed replenishment-indicative of CMD and suggestive of impaired endothelium-dependent function. Exercise-induced ST depression was reproducible during stress echocardiography. In patients with ANOCA, patchy perfusion abnormalities during vasodilator stress and preserved CFVR may reflect CMD due to endothelium-dependent dysfunction. Ecostress may offer valuable diagnostic insights and support early identification and management of CMD.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"460-461"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Profile of Cardiac Resynchronization Therapy Recipients in a Saudi Tertiary Center: A Descriptive Single-Center Study.","authors":"Alhanouf Muneer Alotaibi, Jamilah S AlRahimi, Amjad Amjed SaemalDahar","doi":"10.4103/jcecho.jcecho_156_25","DOIUrl":"10.4103/jcecho.jcecho_156_25","url":null,"abstract":"<p><strong>Objective: </strong>Women remain underrepresented in landmark cardiac resynchronization therapy (CRT) trials, despite evidence suggesting they may derive substantial clinical benefit. Age at implantation also influences outcomes and long-term management. However, demographic and clinical data on CRT recipients in Saudi Arabia remain limited. This study aimed to describe the sex distribution and age profile of CRT recipients in a tertiary Saudi center and to contextualize these findings within international CRT trial and registry data.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed consecutive CRT implantations performed between January 2017 and December 2021 at a tertiary cardiac center in Jeddah, Saudi Arabia. Demographic and clinical variables, including age and sex, underlying cardiomyopathy, New York Heart Association (NYHA) class, conduction morphology, atrial fibrillation, and baseline echocardiographic parameters, were collected. Descriptive statistics were summarized and compared narratively with published data from major CRT randomized controlled trials (RCTs) and large international registries.</p><p><strong>Results: </strong>Among 53 CRT recipients, 18 (34.0%) were women (95% confidence interval [CI]: 22.7-47.4). Mean age was 65.5 ± 10.5 years (95% CI: 62.6-68.4). Ischemic cardiomyopathy accounted for 54.7% of cases, left bundle branch block morphology was present in 69.8%, and the mean left ventricular ejection fraction was 27% ±6%. Most patients (67.9%) were in NYHA Class III. Female proportion was broadly similar to that reported in large international registries (≈30%-36%) and higher than landmark RCTs (≈20%-25%). Age distribution was comparable to global CRT cohorts. Most patients received CRT-D devices (94.3%).</p><p><strong>Conclusion: </strong>CRT recipients in this Saudi cohort exhibited demographic and clinical characteristics comparable to international real-world CRT populations. These findings provide much-needed foundational data on CRT utilization in Saudi Arabia and highlight the importance of establishing multicenter national CRT registries to better characterize access patterns and identify potential sex- or age-related disparities in advanced heart failure therapy.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"375-379"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cocaine Induced Cardiomyopathy Presenting with Cardiac Arrest: Insights from Cardiac Magnetic Resonance.","authors":"Francesco Mori, Mattia Alberti, Simona Chiusolo, Gabriele Masini, Valentina Barletta, Emanuele Neri, Lorenzo Faggioni, Doralisa Morrone, Raffaele De Caterina, Giovanni Donato Aquaro","doi":"10.4103/jcecho.jcecho_146_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_146_25","url":null,"abstract":"<p><p>Cocaine abuse is associated with a broad spectrum of cardiovascular complications, including myocardial ischemia, arrhythmias, and cardiomyopathy. However, chronic myocardial injury may remain subclinical, delaying diagnosis until an acute event occurs. We present the case of a 49-year-old man with a history of chronic cocaine use who was admitted following an out-of-hospital cardiac arrest. A post-Return of Spontaneous Circulation Point-of-Care Ultrasound revealed mildly reduced left ventricular systolic function, while coronary angiography excluded obstructive coronary artery disease. Cardiac magnetic resonance (CMR) imaging demonstrated mid-wall late gadolinium enhancement and patchy T1 elevation, consistent with nonischemic myocardial fibrosis and edema. A subcutaneous implantable cardioverter-defibrillator was placed for secondary prevention, and beta-blocker therapy was initiated. Genetic testing for inherited arrhythmogenic and cardiomyopathic conditions was also undertaken. This case underscores the potential for clinically silent cocaine-induced cardiomyopathy and highlights the value of CMR in detecting subclinical myocardial injury.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"313-318"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transesophageal Echocardiography and Clinical Significance of Giant Eustachian Valve during Cardiac Surgery: A Narrative Review.","authors":"Abhijeet B Shitole, Gananjay G Salve, Anushri Pradip Patil, Sharanagouda S Patil, Rajesh Munigial, Anand Ghorpade, T Surya Sravanti","doi":"10.4103/jcecho.jcecho_58_26","DOIUrl":"10.4103/jcecho.jcecho_58_26","url":null,"abstract":"<p><p>The Eustachian valve (EV), an embryologic remnant of the right valve of the sinus venosus located at the inferior vena cava (IVC)-right atrial (RA) junction, is typically a small and clinically insignificant structure. However, a prominent, large, or giant EV can present important challenges during cardiac surgery and cardiopulmonary bypass (CPB). This review summarizes the perioperative implications, echocardiographic identification, and management strategies associated with large EVs in adult cardiac surgical patients. A narrative literature review was conducted using PubMed, Scopus, and Embase databases from inception to March 2026. Available evidence indicates that large EVs may obstruct IVC cannula flow, resulting in inadequate venous drainage and suboptimal CPB performance. The increasing adoption of minimally invasive cardiac surgery (MICS) has further highlighted the importance of EV recognition, as prominent valves may impede guidewire passage and femoral venous cannula positioning, compromising venous return during CPB. Large EVs may also increase the risk of right atrial or IVC injury during cannulation and facilitate paradoxical embolism by directing venous blood flow toward a patent foramen ovale. In addition, prominent EVs are frequently misidentified on transesophageal echocardiography (TEE) as right atrial thrombi, tumors, vegetations, or intracardiac devices, potentially leading to diagnostic confusion and inappropriate interventions. Intraoperative two-dimensional and three-dimensional TEE, particularly the mid-esophageal bicaval view, remains the most reliable modality for identification. Real-time TEE-guided cannulation, careful surgical planning, selective prophylactic resection, and meticulous de-airing strategies can minimize associated complications. Routine pre-CPB TEE assessment and standardized management algorithms may improve procedural safety and perioperative outcomes in this uncommon but clinically significant anatomical variant.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"366-374"},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}