Journal of Cardiovascular Echography最新文献

{"title":"High Incidence of Short-term Subsequent Atrial Fibrillation Following Restrictive Filling Mitral Flow Profile in Patients without Structural Heart Disease.","authors":"Tomoo Nagai, Hitomi Horinouchi, Yuji Ikari","doi":"10.4103/jcecho.jcecho_8_26","DOIUrl":"10.4103/jcecho.jcecho_8_26","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the implications of a restrictive filling (RF) mitral flow profile on the frequency of short-term subsequent atrial fibrillation (AF) in cases without thrombotic conditions during routine transthoracic echocardiography (TTE).</p><p><strong>Methods: </strong>A TTE database was retrospectively analyzed from 2015 to 2023 (<i>n</i> = 123,210). We enrolled middle-aged and older adults (≥50 years) with RF mitral flow (the ratio of the early to atrial mitral inflow peak velocities [E/A ratio] ≥2), normal sinus rhythm during the TTE study, and a large left atrial (LA) dimension (≥40 mm) excluding those with structural heart disease and depressed left ventricular ejection fraction. <i>Ad hoc</i> analyses of LA emptying fraction (LAEF) and LA longitudinal strain during the reservoir phase (LASr) were performed. We calculated the ratio of LASr to LAEF (LASr/LAEF) for the discrepancy between LAEF and LASr.</p><p><strong>Results: </strong>The cohort comprised 163 cases (0.13%, 163/123,210) recruited from 3788 cases with RF mitral flow profile (3.1%, 3788/123,210). Subsequent AF was frequently confirmed in this cohort (14.7%, 24/163). LAEF ≤25.9% was selected as a predictor (<i>P</i> = 0.023, odds ratio: 5.547) in a logistic model, while LASr/LAEF ≥0.65 was a predictor in another model (<i>P</i> = 0.020, OR: 3.68).</p><p><strong>Conclusions: </strong>The RF mitral flow profile is rare but may indicate short-term subsequent AF. Among TTE parameters, low LAEF and increased LASr/LAEF were the predictors. Atrial stunning might play a significant role.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"438-445"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038652","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":"Challenging Pacemaker Implant in Sinus Node Dysfunction and Cardiac Involvement in Erdheim-Chester Disease: A Multimodality Imaging-guided Procedure.","authors":"Stefano Maffè, Paola Paffoni, Eleonora Prenna, Pierfranco Dellavesa","doi":"10.4103/jcecho.jcecho_163_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_163_25","url":null,"abstract":"<p><p>Erdheim-Chester disease (ECD) is a rare systemic non-Langerhans cell histiocytosis of unknown etiology characterized by multiorgan xanthomatous infiltration by foamy histiocytes. Cardiovascular involvement in ECD is frequent at the level of the right atrium and superior vena cava. We present the case of a 67-year-old woman with a history of ECD and cardiac involvement, referred to our attention following syncopal episodes and paroxysmal atrial fibrillation alternating with phases of marked sinus bradycardia and asystolic pauses. Transesophageal echocardiogram and cardiac magnetic resonance imaging confirmed the increased wall thickness and the marked reduction of the internal diameter of the superior vena cava and of the right atrium. This can be a major obstacle to the implantation of a bicameral pacemaker, necessary for the sick sinus syndrome. Despite this problem, we decided to try an implant with a traditional approach from the left axillary vein; we followed the procedure with fluoroscopic and ultrasound guidance that was very useful in crossing the stenotic superior vena cava and in the positioning of the active fixation electrode in the right atrial appendage. This case confirms how a multimedial imaging approach is crucial to organize and best perform electrostimulation procedures in particular anatomical contexts such as in ECD with cardiac involvement, minimizing the risks.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"322-324"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793514","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":"A rare case of Papillary Fibroelastoma Involving the Pulmonic Valve.","authors":"Aibek E Mirrakhimov, Erinn A Ogburn","doi":"10.4103/jcecho.jcecho_174_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_174_25","url":null,"abstract":"<p><p>Papillary fibroelastomas involving the pulmonic valve are rare and may present incidentally or with nonspecific cardiopulmonary symptoms. We report a 75-year-old woman with an incidentally discovered right ventricular outflow tract mass ultimately identified as a papillary fibroelastoma arising from the ventricular aspect of the left pulmonic valve cusp. Multimodality imaging, including transthoracic and transesophageal echocardiography (TEE) and cardiac magnetic resonance imaging, confirmed a mobile, pedunculated lesion without associated valve dysfunction. The mass was excised on cardiopulmonary bypass through a pulmonary arteriotomy without aortic cross-clamping. Post-resection TEE confirmed preserved pulmonic valve morphology and function. Histopathologic analysis confirmed the lesion to be a papillary fibroelastoma. The patient recovered uneventfully and was discharged home on postoperative day 4. This case underscores the pivotal role of TEE in defining pulmonic valve mass morphology and providing real-time intraoperative guidance.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"319-321"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793704","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":"An Elusive Cause of Syncope: The Case of a Right Ventricular Myxoma.","authors":"Rijul Kulkarni, Sriram Easwaran, Siddhant Yadav, Pratap Nathani, Milind Phadke","doi":"10.4103/jcecho.jcecho_166_25","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_166_25","url":null,"abstract":"<p><p>Cardiac myxomas, the most common primary cardiac tumors, are benign tumors that arise from cardiac connective tissue. The most common site of origin is the left atrium, and occurrence at other sites is relatively rare. We present a case of a 19-year-old male, with a history of multiple episodes of syncope. The electrocardiogram showed right axis deviation, right ventricular hypertrophy with a strain pattern, and right bundle branch block. Echocardiography revealed multiple masses in the right atrium (RA) and right ventricle (RV) extending into the RV outflow tract (RVOT) and main pulmonary artery. The masses resulted in severe RVOT obstruction, which was the likely cause of recurrent syncope. The patient was referred for surgical excision. On histopathological examination, the mass was found to be a myxoma. The syncopal attacks resolved completely after resection of the mass, and he is asymptomatic on follow-up at 14 months. Cardiac myxomas arising in the right-sided cardiac chambers, though rare, can occur. When present, they may be multiple and may present with syncope due to RVOT obstruction. An early diagnosis and surgical excision are crucial for symptom relief and may be lifesaving. Histopathological examination is important in confirming the benign nature, for prognostication and for guiding further therapy.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"325-329"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793126","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":"Bifid Cardiac Apex in Noonan Syndrome: An Unusual Cardiac Morphology Associated with a RAF1 Pathogenic Variant.","authors":"Maria Elisa Martini Albrecht, Elssi Espinosa Quintero, Flavia Miagusuku Samos, Juliana Torres Pacheco, Mauricio Leonardo da Silva Paiva, Gustavo Yano Callado, Edward Araujo Júnior, Stevan Krieger Martins","doi":"10.4103/jcecho.jcecho_26_26","DOIUrl":"10.4103/jcecho.jcecho_26_26","url":null,"abstract":"<p><p>In this report, we describe the case of a 4-month-old infant diagnosed after birth with severe pulmonary stenosis and Noonan syndrome (NS) carrying a heterozygous pathogenic variant in the RAF1 gene. The patient was admitted for surgical correction, and during preoperative evaluation, severe biventricular hypertrophic cardiomyopathy, severe valvular pulmonary stenosis, and a bifid cardiac apex (BCA) were identified. The surgical procedure was performed without complications; however, due to postoperative hemodynamic instability, extracorporeal membrane oxygenation (ECMO) support was initiated. The patient initially showed satisfactory clinical evolution, allowing ECMO weaning; nevertheless, the patient subsequently developed cardiac arrest and died. It is known that the right ventricle and left ventricle develop independently and later fuse during embryogenesis. Disruption of this developmental process may result in a bifid apex. The GTPase Rac1 plays a regulatory role in embryonic cardiac development and cardiomyocyte differentiation. Cardiomyocyte-specific deletion of Rac1 (Rac1^Nkx2.5^) during cardiac development has been shown to result in a bifid apex, in addition to hypertrabeculation and a thin compact myocardium. NS caused by RAF1 mutations, as observed in this case, is associated with cardiac malformations in approximately 5%-10% of cases. Hypertrophic cardiomyopathy has an incidence of up to 95%, which may significantly worsen prognosis. Although this morphological finding is rare, when isolated it is usually associated with a favorable prognosis. However, BCA has been described in association with congenital heart disease, requiring careful evaluation. When associated with congenital cardiac malformations and genetic syndromes, particularly hypertrophic cardiomyopathy, the prognosis may be guarded.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 4","pages":"481-484"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038552","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":"Trend and Linearity Determination of Left Ventricular Mechanics in Cardiovascular Risk Factor Population with Preserved Ejection Fraction.","authors":"Akhil Mehrotra, Mohammad Shaban, Shubham Kacker, Mohammad Shadab, Naveen Chandra","doi":"10.4103/jcecho.jcecho_101_25","DOIUrl":"10.4103/jcecho.jcecho_101_25","url":null,"abstract":"<p><strong>Background: </strong>4-Dimensional XStrain speckle tracking echocardiography (4DXStrainSTE) is an advanced cardiac imaging technique that synthesizes speckle tracking echocardiography (STE) data obtained from the apical three-chamber (3CH), four-chamber (4CH), and two-chamber (2CH) views, thereby enabling a comprehensive evaluation of multiple left ventricular strain parameters (MLVSP) within a three-dimensional framework.</p><p><strong>Methods: </strong>This study aimed to evaluate the impact of cardiovascular risk factors (CVRFs) on MLVSP using 4DXStrainSTE. Nine strain parameters were analyzed: global circumferential strain (GCS), global circumferential strain rate (GCSR), global radial strain (GRS), and global radial strain rate (GRSR) at the mitral valve (mv) and papillary muscle (pap) levels, along with global longitudinal strain (GLS). A total of 500 Indian adults (aged 18-60 years; both sexes) were enrolled. Participants were categorized into four CVRF Risk Categories (1, 2, 3, and 4) according to the cumulative number of risk factors. The inclusion criterion was a 4-dimensional left ventricular ejection fraction (4D-LVEF) ≥50%.</p><p><strong>Results: </strong>The impact of CVRFs on LV strain parameters displayed a significant decline in GLS, GCS at pap level, GCSR at mv and pap level, substantiated by trend analysis. Mild-to-moderate linear association across MLVSP was identified. Multivariate regression illustrated significant associations of GLS and GCSR at mv level with GLS across the risk categories.</p><p><strong>Conclusions: </strong>This study illustrates a comprehensive evaluation of the consequences of CVRFs on MLVSP in individuals with preserved ejection fraction.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"131-147"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368498","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":"Diastolic Dysfunction in Mitral Stenosis: Invasive Versus Noninvasive Methods.","authors":"Khadije Mohammadi, Amin Mahdavi, Mohammad Masoumi, Mohammad Nabavi, Mina Mohseni","doi":"10.4103/jcecho.jcecho_105_25","DOIUrl":"10.4103/jcecho.jcecho_105_25","url":null,"abstract":"<p><strong>Introduction: </strong>Evaluating left ventricular (LV) diastolic function in patients with severe mitral stenosis (MS), is challenging. This study aimed to assess the value of noninvasive imaging methods for detecting elevated LV end-diastolic pressure (LVEDP) in patients with MS, using invasive measurements as the reference.</p><p><strong>Methods: </strong>This study assessed diastolic function in 63 severe mitral stenosis patients undergoing Percutaneous Transluminal Mitral Commissurotomy using various echocardiographic techniques and invasive LVEDP measurements.</p><p><strong>Results: </strong>The mean age of the patients was 49.9 ± 10.0 years, and 84.1% were women. In patients with atrial fibrillation and sinus rhythm, LVEDP was correlated with isovolumic relaxation time (IVRT), IVRT/T_E-e', and diastolic strain rate. In addition, in patients with sinus rhythm, LVEDP was correlated with LV ejection fraction, LV global longitudinal strain, pulmonary vein diastolic deceleration time, and Myocardial Performance Index. IVRT, IVRT/T_E-e', and diastolic strain rate were the best-performing parameters for assessing elevated LVEDP in patients with severe mitral stenosis.</p><p><strong>Conclusion: </strong>Noninvasive imaging parameters, especially IVRT, IVRT/TE-e', and diastolic strain rate, effectively identify elevated LVEDP in patients with severe mitral stenosis.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"124-130"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368389","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":"Adult Coarctation of Aorta - A Classic Presentation Successfully Managed by Endovascular Stenting.","authors":"Arun Shriram Amudhan, K V Logavengatesh, Vishal Venugopal, S Sanjith, C Ramya Shri, R Rajesh Kumar, T R Muralidharan","doi":"10.4103/jcecho.jcecho_117_25","DOIUrl":"10.4103/jcecho.jcecho_117_25","url":null,"abstract":"<p><p>This report presents the case of a 24-year-old woman with a 4-year history of unexplained headaches, vomiting, and fatigue, ultimately diagnosed with postductal coarctation of the aorta (CoA) and a bicuspid aortic valve. These conditions, often challenging to diagnose in adults, were revealed through significant upper-lower extremity blood pressure differences, rib notching on imaging, and extensive collateral vessel formation. Transcatheter coarctoplasty with bare-metal stent placement successfully resolved the pressure gradient and restored blood flow, leading to symptom relief and improved quality of life. This case emphasizes the importance of considering congenital cardiovascular conditions in adults and highlights advances in minimally invasive interventions and long-term management strategies.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"186-189"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368316","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":"An Unusual Case of Ischemic Stroke.","authors":"Vincenzo Lavanco, Ornella Rapisarda, Carolina Vitale, Salvatore Felis","doi":"10.4103/jcecho.jcecho_131_25","DOIUrl":"10.4103/jcecho.jcecho_131_25","url":null,"abstract":"<p><p>Left atrial appendage closure (LAAC) represents an alternative to anticoagulation therapy for stroke prevention in selected patients with atrial fibrillation (AF). Mitral valve repair with the MitraClip system is nowadays a specific therapy for patients who are not eligible for surgery. G. G. 71 years old, F, admitted to the neurology ward of our hospital with a diagnosis of ischemic stroke. Recent discharge from the cardiology unit after mitral valve repair with the MitraClip system and LAAC with the Amplatzer device. A transoesophageal echocardiography (TEE) was performed. The TEE showed good position of the LAAC device with no leaks and the presence of a thrombotic formation (0.9 cm × 0.7 cm) on the atrial surface of the LAAC device [Figure 1a arrows and Video 1]. Anticoagulant therapy with LMWH 6000 UI X2 was started. A follow-up TEE was performed 1 month postdischarge, showing the complete resolution of the thrombotic formation [Figure 1b and Video 2]. LAAC is a safe and effective procedure with a low rate of complications. Device-related thrombosis occurred in a minority of cases (2.8%). Combined MitraClip and LAAC is deemed feasible and safe, even though there are no large specific trials on this topic. In our case, we assume that the rapid reduction in mitral regurgitation and the rapid increase of aortic valve gradient, even if of little entity, could have caused a prothrombotic state that has caused the LAA device thrombosis. a device-related thrombosis must be taken into account in patients presenting with ischemic stroke without a clear cause.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 2","pages":"199-201"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368305","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":"Inferior Hypertrophic Cardiomyopathy: An Unusual and Insidious Site.","authors":"Diego Pancaldo, Enrico Armando, Sarah Dogliani, Michele de Benedictis","doi":"10.4103/jcecho.jcecho_12_26","DOIUrl":"https://doi.org/10.4103/jcecho.jcecho_12_26","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy is a heart muscle disease, characterized by increased left ventricular wall thickness that is not explained only by abnormal loading conditions. Hypertrophy preferentially involves the interventricular septum in the basal segments of the left ventricle, but often extends to the lateral wall, posterior septum, and apex of the left ventricle. A substantially isolated inferior wall hypertrophy is quite rare and diagnostically insidious. We present a clinical case in which diagnosis and therapeutic management were decisively guided by cardiac magnetic resonance.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 3","pages":"344-346"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793557","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}