Journal of Cardiovascular Echography最新文献

{"title":"A Rare Case Study of Dextrocardia with Myocardial Infarction and Cerebrovascular accident in <i>Situs</i> Inversus Totalis.","authors":"Sanjay Thorat","doi":"10.4103/jcecho.jcecho_94_25","DOIUrl":"10.4103/jcecho.jcecho_94_25","url":null,"abstract":"<p><p>Situs inversus totalis (SIT) is a rare congenital condition, characterized by complete mirror-image transposition of the thoracic and abdominal organs. Although individual reports of myocardial infarction (MI) or cerebrovascular accidents in patients with SIT exist, the simultaneous occurrence of both is extremely rare and poses unique diagnostic and therapeutic challenges. We report the case of a 55-year-old female presenting with right-sided chest pain and later developing neurological deficits. Initial evaluation revealed dextrocardia and SIT on chest radiograph and abdominal ultrasound. Electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4, suggestive of anterior wall MI. The diagnosis was complicated due to reversed anatomical orientation. On day 3, the patient developed left-sided weakness and computed tomography of the brain confirmed an acute infarct in the right parietal lobe. Echocardiography revealed left ventricular apical clot with reduced ejection fraction. A coronary angiogram showed double-vessel disease involving the left anterior descending artery and ramus arteries and percutaneous coronary intervention was performed. This case highlights the clinical complexity and diagnostic uncertainty in managing cardiovascular and neurological events in patients with SIT. To our knowledge, this is one of the first reported cases of concomitant MI and stroke in a patient with SIT.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 1","pages":"62-65"},"PeriodicalIF":1.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015763","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":"Relationship between Epicardial Adipose Tissue Thickness Measured by Computed Tomography and Coronary Thrombus Burden in Patients with ST-elevation Myocardial Infarction.","authors":"Neveen Ibrahim Samy Agour, Mohammad Mahmoud Khallaf, Ahmed Mohamed Emara, Hend Mohamed Abdo Eldeeb","doi":"10.4103/jcecho.jcecho_147_25","DOIUrl":"10.4103/jcecho.jcecho_147_25","url":null,"abstract":"<p><strong>Background: </strong>Understanding the epicardial adipose tissue (EAT)-thrombus burden (TB) link in ST-segment elevation myocardial infarction (STEMI) may assist in singling out high-risk cases and guide therapies to reduce EAT or its activity, potentially improving outcomes.</p><p><strong>Aim: </strong>We aimed to study the EAT and coronary artery TB relationship in STEMI patients referred to primary percutaneous coronary intervention (PCI).</p><p><strong>Materials and methods: </strong>This prospective observational study included 32 patients diagnosed with ST-elevation myocardial infarction (STEMI)و aged 18 years old or more, both sexes. All participants underwent primary percutaneous coronary intervention (PCI) within 12 hours of symptom onset and subsequently had a non-contrast cardiac computed tomography (CT) scan performed during their hospital stay to assess epicardial adipose tissue (EAT) thickness. Patients were assigned to two groups: relying on their angiographic thrombolysis in myocardial infarction (TIMI) thrombus grade: Group I: with low TB (Grades 0-3) and Group II: with high TB (Grades 4-5).</p><p><strong>Results: </strong>A strong positive correlation between EAT in the right atrioventricular (AV) groove and TIMI thrombus score (<i>r</i> = 0.624, <i>P</i> < 0.001), indicating that enhanced thickness of epicardial fat in this region is significantly associated with higher TB. Conversely, the correlation between EAT in the anterior interventricular groove and thrombus score was weaker, and statistical significance was not attained (<i>r</i> = 0.336, <i>P</i> = 0.060).</p><p><strong>Conclusions: </strong>Increased right AV groove EAT is strongly linked to higher TB in STEMI and may serve as a noninvasive CT predictor for thrombus risk.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 1","pages":"38-45"},"PeriodicalIF":1.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015467","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":"Narrowing the QRS, Expanding the Function: Left Bundle Branch Pacing in Dilated Cardiomyopathy.","authors":"Fulvio Cacciapuoti, Ilaria Caso, Carlo Liguori, Salvatore Crispo, Antonio Torsi, Mario Volpicelli","doi":"10.4103/jcecho.jcecho_144_25","DOIUrl":"10.4103/jcecho.jcecho_144_25","url":null,"abstract":"<p><p>Left bundle branch block (LBBB) is a key driver of electrical and mechanical dyssynchrony in heart failure with reduced ejection fraction (HFrEF). Conventional cardiac resynchronization therapy improves outcomes, yet up to one-third of patients is non-responders, partly due to nonphysiological ventricular activation. Left bundle branch pacing (LBBP) has emerged as a physiological alternative by directly recruiting the His-Purkinje system. We describe the case of a 62-year-old woman with nonischemic dilated cardiomyopathy, severely reduced left ventricular ejection fraction (30%), and complete LBBB (QRS 162 ms) who remained symptomatic despite maximally tolerated guideline-directed therapy. Multimodality imaging was central to decision-making: echocardiography demonstrated severe mechanical dyssynchrony and impaired strain, while cardiac magnetic resonance (CMR) excluded ischemic scar and revealed diffuse interstitial fibrosis, supporting the indication for physiological pacing. LBBP was successfully achieved, resulting in QRS narrowing to 118 ms and stable electrical parameters. At a 6-month follow-up, the patient showed marked symptomatic improvement (New York Heart Association I-II) and significant reverse remodeling, with left ventricular ejection fraction rising to 54%, global longitudinal strain improving from -8.2% to -18.8%, reduced mechanical dispersion, and regression of functional mitral regurgitation. This case highlights the value of advanced imaging for candidate selection and for quantifying structural and functional recovery. Emerging translational data suggest that LBBP may also favorably influence molecular remodeling, including connexin-mediated gap-junction coupling. LBBP represents a promising strategy for physiological resynchronization in HFrEF with LBBB and warrants further prospective evaluation.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"36 1","pages":"78-83"},"PeriodicalIF":1.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015803","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":"Strengthening Echocardiographic Surveillance for Managing Long-term Cardiac Sequelae of COVID-19 Infection.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate, Prithvi Brahmanand Petkar","doi":"10.4103/jcecho.jcecho_65_25","DOIUrl":"10.4103/jcecho.jcecho_65_25","url":null,"abstract":"","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"423-424"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104824","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":"ECG Never Lies: A Case of Apical Hypertrophic Cardiomyopathy.","authors":"Francesco Briani, Ilaria Minnucci","doi":"10.4103/jcecho.jcecho_54_25","DOIUrl":"10.4103/jcecho.jcecho_54_25","url":null,"abstract":"<p><p>Apical hypertrophic cardiomyopathy (ApHCM) is a less common variant of hypertrophic cardiomyopathy, characterized by predominant thickening of the left ventricular apex. We describe a 64-year-old man presenting with dyspnea and T-wave inversions in the lateral precordial leads. Although initial echocardiography was reported as normal, further imaging revealed an \"ace of spades\" configuration on ventriculography and an anechoic apical area on off-axis views. Contrast echocardiography confirmed apical wall thickening with systolic obliteration. Cardiac magnetic resonance imaging showed patchy late gadolinium enhancement, and Holter monitoring excluded sustained arrhythmias. This case highlights the role of multimodality imaging in ApHCM.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"398-399"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105551","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":"Transcatheter Aortic Valve Replacement in a Patient with Ankylosing Spondylitis and Complex Valvulopathy: Managing Aortic Regurgitation, Mitral Regurgitation, and Ventricular Arrhythmias.","authors":"Songlin Peng, Fushun Liao, Yuanyuan Liao, Yuguang You","doi":"10.4103/jcecho.jcecho_75_25","DOIUrl":"10.4103/jcecho.jcecho_75_25","url":null,"abstract":"<p><p>Complex cardiac damage caused by ankylosing spondylitis (AS) is relatively rare in clinical practice. Although the first clear association between AS and aortic regurgitation (AR) was established in 1958, and subsequent case reports have been published, previous studies have not proposed effective, minimally invasive surgical treatment options. This report describes a patient with AS, AR, and mitral regurgitation who experienced frequent premature ventricular contractions, posing an extremely high risk of sudden death. We used a combination of multimodal imaging techniques to perform transcatheter aortic valve replacement on the patient. The patient recovered well after the procedure, with improved cardiac function. This case serves as a reference for treating patients with similar conditions.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"377-380"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104768","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":"Incorporating Echocardiographic Assessment in High-risk Pregnancies for Risk Stratification and Better Pregnancy Outcomes.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate","doi":"10.4103/jcecho.jcecho_108_25","DOIUrl":"10.4103/jcecho.jcecho_108_25","url":null,"abstract":"","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"425-426"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105538","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":"Beyond Echocardiography: The Evolving Role of Imaging in Left Atrial Appendage Closure in the Modern Era.","authors":"Alberto Cresti, Marco Solari, Riccardo Agostini, Mattia Alberti, Francesco Becherini, Elisa Cerone, Elisabetta Corsi, Maria Grazia D'Alfonso, Iacopo Fabiani, Giosuè Falcetta, Lorenzo Nesti, Maria Concetta Pastore, Valentina Barletta","doi":"10.4103/jcecho.jcecho_33_25","DOIUrl":"10.4103/jcecho.jcecho_33_25","url":null,"abstract":"<p><p>Left atrial appendage closure (LAAC) has emerged as a crucial alternative for stroke prevention in patients with atrial fibrillation ineligible for long-term anticoagulation. While echocardiography, particularly transesophageal echocardiography (TEE), remains fundamental for procedural planning and guidance, the integration of multimodal imaging is increasingly shaping contemporary practice. This review explores the evolving landscape of imaging for LAAC, highlighting their complementary roles, technological advancements, and future directions in optimizing procedural outcomes. TEE is the standard imaging modality for LAAC, providing comprehensive anatomical and functional assessment across all procedural phases. However, advanced cardiac imaging techniques, including cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR), are gaining prominence. CCT offers detailed anatomical characterization of the left atrial appendage (LAA) and surrounding structures, aiding in device sizing and excluding thrombus. CMR provides superior tissue characterization and can be an alternative when TEE is not feasible. Intracardiac echocardiography may be a valid alternative to TEE ti guide device deployment and assessment. This review critically evaluates the strengths and limitations of each imaging modality in the LAAC procedure, from pre-procedural planning and patient selection to intraprocedural guidance and post-procedural assessment for complications like device leaks and device-related thrombosis. The evolving role of three-dimensional imaging and potential future applications, such as artificial intelligence-assisted image analysis, are also considered. Understanding the complementary roles of these imaging modalities is crucial for optimizing patient care in the modern era of LAAC. LAAC has emerged as a crucial alternative for stroke prevention in patients with atrial fibrillation who are ineligible for long-term anticoagulation. While echocardiography remains the cornerstone of procedural planning and guidance, the expanding role of multimodal imaging is reshaping current practice. Advanced cardiac imaging techniques, including CCT and CMR, are increasingly integrated into patient selection, device sizing, and post-procedural assessment, enhancing safety and efficacy. This review explores the evolving landscape of imaging modalities in LAAC, highlighting their complementary roles, recent technological advances, and future directions in optimizing procedural outcomes.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"323-335"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105554","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":"Simplifying Left Ventricular Function Assessment: The Clinical Value of Mitral Annular Plane Systolic Excursion.","authors":"Vasavdatta Sharma, R Padmakumar, Kanhai Lalani","doi":"10.4103/jcecho.jcecho_67_25","DOIUrl":"10.4103/jcecho.jcecho_67_25","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) dysfunction is a critical global health concern, usually assessed using parameters such as global longitudinal strain (GLS) and LV ejection fraction (LVEF) by Simpson's method. However, these methods can be resource-intensive and reliant on high-quality imaging. Mitral annular plane systolic excursion (MAPSE) offers a simpler, more accessible bedside alternative for evaluating LV function.</p><p><strong>Objective: </strong>This study explored how MAPSE correlates with key echocardiographic parameters, such as GLS and LVEF, to establish its role as a practical and reliable tool for assessing LV systolic longitudinal function.</p><p><strong>Methods: </strong>We conducted a single-center cross-sectional study with 80 patients diagnosed with LV dysfunction (LVEF <50%). Echocardiographic assessments measured were MAPSE, GLS, and LVEF. Statistical analyses examined the relationships between these parameters.</p><p><strong>Results: </strong>MAPSE showed a strong correlation with GLS (<i>r</i> = 0.535, <i>P</i> < 0.0001) and a moderate correlation with LVEF (<i>r</i> = 0.324, <i>P</i> < 0.0001). Patients with more severe LV dysfunction (ejection fraction [EF] <40%) had lower mean MAPSE values (11.1 ± 0.4 mm) than those with milder dysfunction (EF >40%, MAPSE 12.4 ± 0.4 mm). MAPSE also correlated inversely with LV filling pressures (E/e' >14, <i>P</i> < 0.0001) and LV end-systolic dimensions (<i>r</i> = -0.254, <i>P</i> = 0.022). Interestingly, its positive association with tricuspid annular plane systolic excursion (<i>P</i> = 0.0046) highlighted its role in possibly reflecting biventricular function and ventricular interdependence.</p><p><strong>Conclusion: </strong>MAPSE is a simple yet powerful tool for assessing LV function, offering strong correlations with GLS and insights into systolic and diastolic performance. Even with suboptimal imaging, its ease of use makes it an invaluable option for cardiac evaluation, particularly in time-sensitive or resource-constrained clinical settings.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"372-376"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105620","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":"Mitral Mass after Mitral Transcatheter Edge-to-edge Repair: Diagnostic Dilemma between Infective Endocarditis and Nonbacterial Thrombotic Endocarditis in a Patient with Malignancy.","authors":"Giovanni Bellina, Francesca Casadei, Francesco Musca, Francesca Maria Spanò, Antonella Moreo","doi":"10.4103/jcecho.jcecho_82_25","DOIUrl":"10.4103/jcecho.jcecho_82_25","url":null,"abstract":"<p><p>Transcatheter mitral valve repair using the mitral transcatheter edge-to-edge repair (M-TEER) technique is a well-established therapeutic option for patients with severe mitral regurgitation. However, postprocedural complications can pose diagnostic and therapeutic challenges. We report the case of an 80-year-old woman with multiple comorbidities, including essential thrombocythemia, and a newly diagnosed bladder neoplasm, who recently underwent M-TEER. During routine follow-up, a mass was detected on the atrial surface of the mitral clip. The initial suspicion was thrombus. Transesophageal echocardiography confirmed a mass on the mitral clip. 18F-fluorodeoxyglucose positron emission tomography/computed tomography showed focal uptake at the mitral valve level. Based on the modified Duke criteria and European Society of Cardiology 2023 guidelines, the diagnosis was considered \"possible infective endocarditis.\" However, the concurrent neoplastic condition and lack of typical pathogens raised the alternative hypothesis of nonbacterial thrombotic endocarditis (NBTE). The patient was treated with intravenous anticoagulation and antibiotics. Serial imaging demonstrated a reduction in the size of the mass, but surgical intervention was precluded due to frailty. A definitive diagnosis could not be established.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"416-419"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105616","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}