Journal of Cardiovascular Imaging最新文献

{"title":"Aortic valve leaflet motion for diagnosis and classification of aortic stenosis using single view echocardiography.","authors":"Thomas Meredith, Farhan Mohammed, Amy Pomeroy, Sebastiano Barbieri, Erik Meijering, Louisa Jorm, David Roy, Christopher Hayward, Jason C Kovacic, David W M Muller, Michael P Feneley, Mayooran Namasivayam","doi":"10.1186/s44348-025-00051-8","DOIUrl":"10.1186/s44348-025-00051-8","url":null,"abstract":"<p><strong>Background: </strong>Accurate classification of aortic stenosis (AS) severity remains challenging despite detailed echocardiographic assessment. Adjudication of severity is informed by subjective interpretation of aortic leaflet motion from the first image parasternal long axis (PLAX) view, but quantitative metrics of leaflet motion currently do not exist. The objectives of the study were to echocardiographically quantify aortic leaflet motion using the PLAX view and correlate motion data with Doppler-derived hemodynamic indices of disease severity, and predict significant AS using these isolated motion data.</p><p><strong>Methods: </strong>PLAX loops from 200 patients with and without significant AS were analyzed. Linear and angular motion of the anterior (right coronary) leaflet were quantified and compared between severity grades. Three simple supervised machine learning classifiers were then trained to distinguish significant (moderate or worse) from nonsignificant AS and individual severity grades.</p><p><strong>Results: </strong>Linear and angular displacement demonstrated strong correlation with aortic valve area (r = 0.81 and r = 0.74, respectively). Severe AS cases demonstrated global leaflet motion of 2.1 mm, compared with 3.6 mm for moderate cases (P < 0.01) and 9.2 mm for control cases (P < 0.01). Severe cases demonstrated mean global angular rotation of 11°, significantly less than moderate (18°, P < 0.01) and normal cases (47°, P < 0.01). Using these novel metrics, a simple supervised machine learning model predicted significant AS with an accuracy of 90% and area under the receiver operator characteristics curve (AUC) of 0.96. Prediction of individual severity class was achieved with an accuracy of 72.5% and AUC of 0.88.</p><p><strong>Conclusions: </strong>Advancing severity of AS is associated with significantly reduced linear and angular leaflet displacement. Leaflet motion data can accurately classify AS using a single parasternal long axis view, without the need for hemodynamic or Doppler assessment. Our model, grounded in biological plausibility, simple linear algebra, and supervised machine learning, provides a highly explainable approach to disease identification and may hold significant clinical utility for the diagnosis and classification of AS.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591334","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":"Cardiac myosin inhibitors in hypertrophic cardiomyopathy.","authors":"Jaehyun Lim, Hyung-Kwan Kim","doi":"10.1186/s44348-025-00052-7","DOIUrl":"10.1186/s44348-025-00052-7","url":null,"abstract":"<p><p>Mavacamten, the first selective and reversible cardiac myosin inhibitor (CMI), has been introduced to the clinical arena for the treatment of obstructive hypertrophic cardiomyopathy (HCM). By reducing excessive actin-myosin cross-bridging, this agent decreases myocardial contractility and alleviates the dynamic left ventricular outflow tract (LVOT) obstruction in obstructive HCM. In the EXPLORER-HCM trial, mavacamten significantly improved exercise capacity, symptoms, and LVOT pressure gradients, while the VALOR-HCM trial proved it can obviate the need for septal reduction therapy in patients who were deemed to be candidates for septal reduction therapy. Notably, long-term data (MAVA-LTE study) has demonstrated sustained benefits up to 180 weeks, with < 10% experiencing transient reductions in left ventricular ejection fraction < 50% and only 1.3% of permanent discontinuation rate. Aficamten, a next-generation CMI with a shorter half-life, has also demonstrated comparable efficacy. Reverse remodeling following treatment was noted in both agents. In nonobstructive HCM, preliminary studies (MAVERICK-HCM trial and cohort 4 of REDWOOD-HCM trial) have reported improvements in cardiac serum biomarkers and symptoms. However, the preliminary results from phase 3 trials (ODYSSEY-HCM trial) revealed that primary endpoints were not met in nonobstructive HCM. Regarding safety, both were generally well tolerated. Although an LVEF reduction occurred in some patients, it was reversible with a dose reduction or a short-term drug cessation. These results emphasize careful dosing strategy with regular echocardiographic monitoring. Real-world data have also demonstrated consistent efficacy and safety across varying ethnic groups without new safety signals. CMI is a major advance in HCM management. However, future studies must provide data on hard clinical outcomes, such as heart failure hospitalization or death. Ongoing trials comparing CMI to traditional first-line therapies, such as β-blockers, will clarify their potential role as an initial therapeutic option.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584020","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":"Update on left ventricular outflow tract obstruction.","authors":"Jae-Kwan Song, Byung Joo Sun, Dae-Hee Kim, Sung Ho Jung","doi":"10.1186/s44348-025-00049-2","DOIUrl":"10.1186/s44348-025-00049-2","url":null,"abstract":"<p><p>The diagnosis and management of left ventricular outflow tract obstruction have evolved substantially since its initial characterization by invasive cardiac catheterization nearly 70 years ago. This review traces the historical progression of our understanding of left ventricular outflow tract obstruction, with a particular focus on the pivotal role of echocardiography in redefining its detection, hemodynamic assessment, and clinical relevance, especially as its prevalence is expected to increase along with the growing aging population.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540354","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":"Diagnostic performance of cardiovascular magnetic resonance parametric mapping as per modified Lake Louise Criteria in acute myocarditis: an updated systematic review and meta-analysis.","authors":"Latika Giri, Roshan Singh, Ahmed Marey, Yupeng Li, Bharath Ambale Venkatesh, Jawdat Abdulla, Stefan Zimmerman, Muhammad Umair","doi":"10.1186/s44348-025-00048-3","DOIUrl":"10.1186/s44348-025-00048-3","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance mapping parameters-native T1 mapping, T2 mapping, and extracellular volume (ECV)-are key for diagnosing acute myocarditis under the modified 2018 Lake Louise Criteria (mLLC). This systematic review and meta-analysis evaluated their diagnostic performance and established optimal thresholds for acute myocarditis.</p><p><strong>Methods: </strong>We reviewed articles published in the past decade utilizing parametric mapping for myocarditis diagnosis. Data on sensitivity, specificity, and area under the curve (AUC) were extracted. Quality assessment was conducted using the QUADAS-2 tool by two independent reviewers.</p><p><strong>Results: </strong>Eleven studies with 677 patients were included. Native T1 mapping showed sensitivity of 83%, specificity of 86%, diagnostic odds ratio (DOR) of 39, and an AUC of 0.91. T2 mapping had sensitivity of 81%, specificity of 86%, DOR of 25, and an AUC of 0.89. ECV demonstrated sensitivity of 71%, specificity of 81%, DOR of 13, and an AUC of 0.83. Mean control values were 1,039 ± 39.23 ms for native T1 mapping, 57 ± 5.18 ms for T2 mapping, and 31% ± 5.60% for ECV. Optimal thresholds were 1,021 ms for native T1 mapping, 52 ms for T2 mapping, and 28% for ECV based on receiver operating characteristic curves analysis based on 1.5-T scanner value. Native T1 mapping showed the highest diagnostic accuracy. Subgroup analysis found no significant sensitivity differences based on biopsy or clinical criteria.</p><p><strong>Conclusions: </strong>Parametric mapping, particularly native T1, demonstrated strong diagnostic performance for acute myocarditis compared to T2 mapping and ECV within the modified 2018 Lake Louise Criteria framework. Incorporating these cardiovascular magnetic resonance parameters may improve diagnostic accuracy. Further research is recommended to refine these findings and optimize diagnostic strategies.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215943","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":"Speckle-tracking echocardiographic abnormalities in chronic obstructive pulmonary disease: a systematic review and meta-analysis.","authors":"Ranjini N V, Sunil Kumar S, Nagaraj Desai, Mahesh P A, Chaithra N, Sri Harsha Chalasani, Nikita Pal, Syed Abdul Hafeez, Chaya S K","doi":"10.1186/s44348-025-00046-5","DOIUrl":"https://doi.org/10.1186/s44348-025-00046-5","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is known to be associated with cardiovascular disease due to shared risk factors and its impact on the cardiopulmonary vasculature. Speckle-tracking echocardiography (STE) is an effective tool for identifying subclinical, COPD-associated right ventricular (RV) and left ventricular (LV) dysfunction before conventional echocardiography can detect it. A systematic review and meta-analysis of the literature on STE in COPD are presented. A systematic search was conducted of PubMed, Scopus, Cochrane Library, and Science Direct for papers published between 2011 and March 2023, and bias was assessed using the STROBE tool. Eleven studies were included in the two-stage meta-analysis: first among 742 COPD cases, and then a case-control design with 507 COPD cases and 259 healthy controls. Of the 11 studies analyzed, 6 were dedicated to the assessment of RV strain, and 5 studies examined LV global longitudinal strain (GLS). Significant heterogeneity was observed in the STE parameters of COPD patients (I² = 95%; mean effect size: -17.055 for LV GLS and -19.098 for RV free wall strain; Z = -35.809; P < 0.001) and between COPD patients and controls (I² = 92%; mean effect size, 2.100; Z = 8.433; P < 0.0001). LV and RV STE parameters were lower in the COPD group than in the healthy control group. The two-dimensional STE parameters correlated with disease severity metrices such as the BODE (body mass index, airflow obstruction, dyspnea, and exercise) index and Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, and they predicted mortality, hospitalization rates, and exercise tolerance in COPD patients. STE abnormalities are prevalent in COPD patients and can help identify subclinical LV and RV dysfunction. The presence of STE abnormalities helps in prognostication for COPD patients.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020208","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":"Utilizing deep learning for accurate assessment of aortic valve stenosis: case series for clinical applications.","authors":"Jiesuck Park, Jiyeon Kim, Jaeik Jeon, Yeonyee E Yoon","doi":"10.1186/s44348-025-00047-4","DOIUrl":"https://doi.org/10.1186/s44348-025-00047-4","url":null,"abstract":"","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036535","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":"Differential impact of ventricular-arterial coupling on left ventricular function in patients with acute myocardial infarction: a comparison between preserved and reduced ejection fraction.","authors":"Hae Eun Yun, Seung-Jae Joo, Geum Ko, Ki Yung Boo, Jae-Geun Lee, Joon-Hyouk Choi, Song-Yi Kim","doi":"10.1186/s44348-025-00045-6","DOIUrl":"10.1186/s44348-025-00045-6","url":null,"abstract":"<p><strong>Background: </strong>Ventricular-arterial coupling (VAC) plays a crucial role in the initiation and progression of heart failure in patients with coronary artery disease. The influence of VAC on left ventricular (LV) function may vary depending on LV systolic function. This study investigated the relationship between VAC and LV function in patients with acute myocardial infarction (AMI), stratified by ejection fraction (EF).</p><p><strong>Methods: </strong>Echocardiographic indices of LV volumes, systolic function, and diastolic function were measured using standard techniques. Effective arterial elastance (E_A) was calculated based on stroke volume derived from the LV outflow waveform. Effective LV end-systolic elastance was determined using the single-beat method. The central aortic pressure waveform was recorded via applanation tonometry. Characteristic impedance (Zc) of the aortic root was calculated using Fourier transformation of both aortic pressure and flow waveforms.</p><p><strong>Results: </strong>A total of 85 patients (mean age, 58.5 ± 10.6 years) with AMI were enrolled. They were classified into two groups: those with reduced EF (< 50%, 27 patients) and those with preserved EF (≥ 50%, 58 PATIENTS). In the adjusted linear regression analysis, E' velocity was significantly associated with VAC (β = -0.310, P = 0.008) in the preserved EF group but not in the reduced EF group. LV global longitudinal strain showed significant positive associations with VAC (β = 0.505, P < 0.001), E_A index (β = 0.536, P < 0.001), and Zc (β = 0.344, P = 0.018) exclusively in the preserved EF group.</p><p><strong>Conclusions: </strong>The distinct influence of EF status on the relationships between hemodynamic parameters and LV diastolic and systolic functions suggests a differential interplay between arterial and ventricular dynamics depending on LV systolic function.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811532","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":"Is early use of sodium-glucose cotransporter type 2 inhibitor (SGLT2i) necessary even in diabetic patients without cardiovascular disease: a prospective study regarding the effect of SGLT2i on left ventricular diastolic function.","authors":"Kina Jeon, Shin Yi Jang, You-Bin Lee, Jihoon Kim, Darae Kim, Sung-A Chang, Sung-Ji Park, Sang-Chol Lee, Seung Woo Park, Moon-Kyu Lee, Eun Kyoung Kim, Kyu Yeon Hur","doi":"10.1186/s44348-024-00043-0","DOIUrl":"10.1186/s44348-024-00043-0","url":null,"abstract":"<p><strong>Background: </strong>There are insufficient studies to determine whether sodium-glucose cotransporter type 2 inhibitors (SGLT2i) will help reduce early diabetic cardiomyopathy, especially in patients without documented cardiovascular disease.</p><p><strong>Methods: </strong>We performed a single center, prospective observation study. A total of 90 patients with type 2 diabetes patients without established heart failure or atherosclerotic cardiovascular disease were enrolled. Echocardiography, cardiac enzyme, and glucose-control data were examined before and 3 months after the administration of SGLT2i (dapagliflozin 10 mg per day). Cardiovascular risk factors included hypertension, smoking, obesity, dyslipidemia, and old age. The primary end point was the change of E/e' before and after administration of SGLT2i.</p><p><strong>Results: </strong>Most patients (86.7%) had three or more cardiovascular risk factors, and about 32% had all five risk factors. Although the decrease in E/e' after the administration of SGLT2i was observed in 20% of enrolled patients, there was no significant difference in average E/e' value or left atrial volume index before and after the SGLT2i medication. Even in patients with all known risk factors including old age, E/e' value did not decrease after adding SGLT2i (8.9 ± 2.4 vs. 8.7 ± 3.2). There was a statistically significant difference in E/e' change after the SGLT2i administration between patients younger than 60 years and those older than 60 years (-0.7 ± 2.2 vs. 1.1 ± 2.8, P = 0.002).</p><p><strong>Conclusions: </strong>In type 2 diabetes patients without documented cardiovascular disease including heart failure, administration of SGLT2i showed no improvement in diastolic function profile. Further large-scale randomized studies are needed to determine who will benefit from potential cardiovascular events with early addition of SGLT2i.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"33 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978519","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":"Real-time three-dimensional transthoracic echocardiographic segmental volume analysis: a quantitative and objective tool for assessing regional left ventricle wall motion in patients with ischemic heart disease.","authors":"Jin-Hwan Kwak, Kang-Un Choi, Jong-Il Park, Jong-Ho Nam, Chan-Hee Lee, Ung Kim, Jong-Seon Park, Jang-Won Son","doi":"10.1186/s44348-024-00040-3","DOIUrl":"10.1186/s44348-024-00040-3","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of regional left ventricle function using two-dimensional echocardiography (2DE) in patients with ischemic heart disease has limitations due to its low objectivity and qualitative nature. In addition, 2DE is limited because multiple acoustic windows are used to obtain the image, whereas three-dimensional echocardiography (3DE) uses a single window. This study aims to demonstrate the clinical utility of 3DE segmental volume analysis for evaluating regional wall motion abnormality (RWMA).</p><p><strong>Methods: </strong>This retrospective study included 33 patients with ischemic heart disease and single-vessel territory RWMA confirmed on coronary angiography. RWMA was visually assessed using 2DE, generating 17-segment bull's-eye polar maps, and 3DE. In the 3DE study, two independent observers analyzed segmental volumes and segmental volume ejection fractions (SVEFs) using QLAB 3D quantification software. The optimal SVEF cutoff value differentiating normal from abnormal was determined using receiver operating curve analysis. The accuracy of 3DE in predicting culprit coronary arteries was compared with that of 2DE using Cohen κ coefficients, which also were used for interobserver and intraobserver variability assessments.</p><p><strong>Results: </strong>Mean 3DE SVEFs were significantly lower in segments showing RWMA on 2DE. The optimal SVEF cutoff value was 44%, with sensitivity of 75.0% and specificity of 73.9% (area under the curve, 0.801; 95% CI, 0.763-0.838; P < 0.001). The reliability of 3DE-derived bull's-eye predictions of culprit coronary arteries was 81.8% (κ = 0.672; 95% CI, 0.555-0.789; P < 0.001). Interobserver and intraobserver variabilities were 97.0% (κ = 0.947; 95% CI, 0.894-1.00; P < 0.001) and 93.9% (κ = 0.897; 95% CI, 0.827-0.967; P < 0.001), respectively.</p><p><strong>Conclusions: </strong>The 3DE segmental volume analysis effectively quantified regional left ventricle function and aligned well with 2DE and coronary angiography findings in predicting culprit coronary arteries. Thus, 3DE segmental volume analysis can serve as a quantitative and objective tool for RWMA assessment in patients with ischemic heart disease.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"32 1","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882149","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":"Aortic valve sclerosis is not a benign finding but progressive disease associated with poor cardiovascular outcomes.","authors":"Jeong Hun Seo, Kwang Jin Chun, Bong-Ki Lee, Byung-Ryul Cho, Dong Ryeol Ryu","doi":"10.1186/s44348-024-00037-y","DOIUrl":"10.1186/s44348-024-00037-y","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve sclerosis (AVS) shares risk factors with atherosclerosis. However, the relationship between AVS progression with cardiovascular (CV) risk has not been researched. This study investigates CV outcomes according to progression of AVS.</p><p><strong>Methods: </strong>This study included 2,901 patients with AVS (irregular leaflet thickening and peak aortic jet velocity < 2 m/sec) who underwent serial echocardiograms at least 1 year apart during 2011-2020. The primary outcome was defined as CV death, myocardial infarction, stroke, or revascularization.</p><p><strong>Results: </strong>During a median follow-up period of 3.9 years, 439 of 2,901 AVS patients (15.1%) progressed to mild or greater aortic stenosis. Patients with progression were older and more likely to have atrial fibrillation than those without. In a stepwise regression, age (odds ratio [OR] per 1-year increase, 1.04; 95% confidence interval [CI], 1.01-1.07), peripheral artery disease (OR, 9.07; 95% CI, 3.12-26.4), and left ventricular mass index (OR per 1-g/m² increase, 1.01; 95% CI, 1.00-1.02) were associated with AVS progression. Over a median of 6.3 years, the primary outcome occurred in 858 of 2,901 patients (29.6%). Patients with progression had higher frequency of CV death, myocardial infarction, stroke, or revascularization than those without progression (P < 0.0001). In Cox proportional hazards regression, AVS progression (hazard ratio, 1.33; 95% CI, 1.10-1.61) was a significant determinant of CV mortality.</p><p><strong>Conclusions: </strong>The progression to aortic stenosis in AVS patients is an independent risk factor for CV mortality. These findings suggest that patients with AVS progression may benefit from stricter CV risk monitoring.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"32 1","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728302","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}