Journal of Echocardiography最新文献

{"title":"Role of preoperative echocardiography in 639 pectus excavatum: structural and functional cardiac alterations in a large cohort.","authors":"Cecilia Villa Etchegoyen, Juan M Farina, Nour Odeh, Rawan M Zeineddine, Justin Shipman, Said Alsidawi, Chadi Ayoub, David S Majdalany, Reza Arsanjani, Dawn E Jaroszewski","doi":"10.1007/s12574-026-00747-w","DOIUrl":"https://doi.org/10.1007/s12574-026-00747-w","url":null,"abstract":"<p><strong>Aims: </strong>Pectus excavatum (PE) can mechanically displace and compress the heart, often altering right ventricular (RV) geometry and function. Comprehensive preoperative echocardiographic characterization in large adult cohorts is limited. This study describes structural and functional cardiac findings in a large cohort of adults with PE evaluated by transthoracic echocardiography (TTE) prior to surgical repair.</p><p><strong>Methods and results: </strong>We retrospectively reviewed adult patients undergoing primary minimally invasive repair of PE (MIRPE) at a single tertiary center between January 2016 and July 2024 who had at least one preoperative TTE. Echocardiographic measurements followed scientific guidelines and included anatomical, functional, and hemodynamic assessment of the cardiac chambers, evaluation of valvular morphology, and visual assessment of cardiac compression. Among 639 adults (median age 28 years), cardiac compression was identified in 64% of cases on preoperative TTE. An additional 21% (increased to 85%) had compression subsequently seen on intraoperative echocardiography. Despite preserved conventional systolic parameters such as tricuspid annular plane systolic excursion, a high prevalence of RV functional abnormalities was observed, including reduced tissue Doppler S' velocity in 61.9%, reduced RV fractional area change in 62.4%, impaired RV free-wall longitudinal strain in 70.6%, and reduced RV stroke volume index in 54.7% of patients. Septal motion abnormalities were present in 24%. Mitral valve morphological abnormalities were frequent, with elongated anterior mitral valve leaflets observed in 76.9% of patients and mitral valve prolapse or bowing in 24%.</p><p><strong>Conclusion: </strong>In this large adult PE cohort, cardiac compression, subclinical RV systolic dysfunction, reduced stroke volume, and mitral valve morphological abnormalities were common, often despite preserved conventional echocardiographic parameters. These findings highlight the importance of a standardized and comprehensive echocardiographic evaluation to detect clinically relevant cardiac involvement in PE.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implications of left anterior fascicular block for cardiac remodeling in hypertensive patients.","authors":"Mucahit Yetim, Muhammet Cihat Çelik, Lütfü Bekar, Macit Kalçık, Mehmet Mustafa Yılmaz, Abdullah Sarıhan, Abdülmelik Birgün, Yusuf Karavelioğlu","doi":"10.1007/s12574-026-00745-y","DOIUrl":"https://doi.org/10.1007/s12574-026-00745-y","url":null,"abstract":"<p><strong>Background: </strong>Left anterior fascicular block (LAFB) has traditionally been regarded as a benign electrocardiographic finding; however, growing evidence suggests that it may reflect underlying myocardial remodeling. Hypertension is a major driver of structural and functional cardiac changes, particularly left ventricular hypertrophy (LVH) and left atrial enlargement. This study aimed to investigate the association between LAFB and detailed echocardiographic markers of cardiac remodeling, including chamber volumes and diastolic function, in patients with essential hypertension.</p><p><strong>Methods: </strong>We prospectively enrolled 225 consecutive patients with essential hypertension (mean age 61.9 ± 7.8 years; 42.7% male). All patients underwent transthoracic echocardiography and 12-lead electrocardiography. LAFB was diagnosed using standard electrocardiographic criteria. Conventional echocardiographic measurements, left atrial and left ventricular volumes, tissue Doppler parameters, and indices of diastolic function were compared between patients with and without LAFB. Multivariate logistic regression analysis was performed to identify independent predictors of LAFB.</p><p><strong>Results: </strong>LAFB was present in 50 patients (22.2%). Compared with patients without LAFB, those with LAFB exhibited significantly larger left atrial diameter, left atrial volume and higher left atrial volume index (38.9 ± 8.1 vs. 30.6 ± 7.6 mL/m², p < 0.001), increased interventricular septal and posterior wall thickness, and greater left ventricular mass and mass index (all p < 0.01). Left ventricular systolic function and ventricular volumes were similar between groups. Patients with LAFB showed more pronounced diastolic dysfunction, characterized by lower e' velocities, higher E/e' ratio, and a higher prevalence of grade II diastolic dysfunction. In multivariate analysis, left atrial diameter, left atrial volume index, left ventricular mass index, and the presence of LVH emerged as independent predictors of LAFB.</p><p><strong>Conclusion: </strong>In patients with essential hypertension, LAFB is independently associated with left atrial enlargement, increased LV mass, and impaired diastolic function, supporting its association with advanced hypertensive cardiac remodeling.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of left atrial reservoir strain for major adverse cardiovascular events in coronary artery disease.","authors":"Thitiphan Srikulmontri, Phuuwadith Wattanachayakul, Suchanart Pantarote, Chanokporn Puchongmart, Pojsakorn Danpanichkul, Thanathip Suenghataiphorn, Danich Qadir, Sahil Banka, Aman Amanullah","doi":"10.1007/s12574-026-00742-1","DOIUrl":"https://doi.org/10.1007/s12574-026-00742-1","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is associated with a high burden of long-term adverse cardiovascular events. Traditional risk stratification relies primarily on left ventricular ejection fraction, a measure limited to systolic function; however, myocardial ischemia affects both systolic and diastolic mechanics. Left atrial reservoir strain (LASr) is an integrated marker of left atrial-left ventricular function with potential prognostic relevance in CAD. We conducted a systematic review and meta-analysis of studies evaluating LASr in patients with CAD. PubMed and Embase were searched from inception through November 2, 2025. Hazard ratios (HRs) for major adverse cardiovascular events (MACE) were pooled using random-effects models, with prespecified subgroup analyses, meta-regression, sensitivity analyses, and publication bias analyses. Seventeen studies comprising 9,404 patients were included. Fifteen studies enrolled acute coronary syndrome (ACS) populations, whereas two enrolled chronic coronary syndrome/stable CAD populations. In the primary ACS analysis using adjusted HRs, higher LASr was significantly associated with a lower risk of MACE (pooled HR per 1% increase = 0.94; 95% CI, 0.92-0.95; I² = 27%). This association was consistent across imaging modalities and timing of LASr assessment. A separate pooled analysis for chronic coronary syndrome/stable CAD was not performed because only two studies were available. Higher LASr was associated with a lower risk of MACE in patients with ACS, supporting its potential value as a prognostic marker in this population. Further studies are needed to clarify its role value in routine clinical practice.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated increases in tricuspid regurgitation velocity during exercise in dyspneic patients without risks for pulmonary hypertension.","authors":"Tomoaki Ishii, Yuta Tani, Kazuki Kagami, Naoki Yuasa, Tomonari Harada, Tsukasa Murakami, Takahiro Okuno, Naoki Wada, Hideki Ishii, Masaru Obokata","doi":"10.1007/s12574-026-00743-0","DOIUrl":"https://doi.org/10.1007/s12574-026-00743-0","url":null,"abstract":"<p><strong>Background: </strong>An isolated increase in tricuspid regurgitation velocity (TRV) during exercise stress echocardiography is frequently observed in patients with dyspnea, even in the absence of E/e' elevation. However, the pathophysiological and prognostic significance of this finding, particularly in patients without risk factors for pulmonary hypertension (PH), remains uncertain.</p><p><strong>Methods: </strong>Patients who underwent bicycle exercise stress echocardiography with simultaneous expired gas analysis for the evaluation of exertional dyspnea were retrospectively identified. After excluding patients with risk factors for PH, participants were categorized into three groups: controls (exercise TRV ≤ 3.2 m/s and exercise E/e' <15; n = 360), isolated exercise-induced increase in TRV (isolated Ei-TRV, exercise TRV > 3.2 m/s and exercise E/e' <15; n = 83), and heart failure with preserved ejection fraction (HFpEF, exercise E/e' ≥15; n = 211).</p><p><strong>Results: </strong>Peak oxygen consumption was comparable between isolated Ei-TRV and controls, but significantly reduced in HFpEF. Over a median follow-up of 595 days, HFpEF patients had a two-fold higher risk of all-cause death and worsening HF events compared with controls whereas outcomes in isolated Ei-TRV did not significantly differ from controls. Nearly all patients with isolated Ei-TRV exhibited an abnormally elevated mean pulmonary artery pressure/cardiac output slope (mPAP/CO > 3 mmHg/L/min), and those with slopes > 5.2 mmHg/L/min had reduced peak oxygen consumption compared with those with slope ≤ 5.2 mmHg/L/min.</p><p><strong>Conclusions: </strong>In dyspneic patients without apparent risks for PH, isolated Ei-TRV was associated with preserved exercise capacity, without increased adverse outcomes compared with controls. Assessment of mPAP/CO slope may help refine risk stratification compared to exercise TRV alone in this population.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline remodeling-dependent changes in left atrial strain after catheter ablation for paroxysmal atrial fibrillation.","authors":"Yuki Hasegawa, Hiroko Kobayashi, Minori Sakurazawa, Hironori Furuse, Yuka Sekiya, Rie Akagawa, Naomasa Suzuki, Yasuhiro Ikami, Sou Otsuki, Takeshi Kashimura, Masaomi Chinushi, Takayuki Inomata","doi":"10.1007/s12574-026-00740-3","DOIUrl":"https://doi.org/10.1007/s12574-026-00740-3","url":null,"abstract":"<p><strong>Background: </strong>Left atrial (LA) mechanical function may change after catheter ablation for atrial fibrillation (AF); however, the determinants of follow-up LA function remain unclear. We aimed to characterize 6-month changes in LA strain and identify baseline determinants of follow-up LA strain after ablation for paroxysmal AF.</p><p><strong>Methods: </strong>This prospective study enrolled consecutive patients undergoing first-time pulmonary vein isolation for paroxysmal AF. Two-dimensional speckle-tracking echocardiography from apical four- and two-chamber views was performed at baseline and 6 months to assess LA reservoir strain (LASr) and contraction strain (LASct). Factors associated with 6-month LASr and ΔLASr (6-month minus baseline) were examined using multivariable linear regression.</p><p><strong>Results: </strong>Of 167 enrolled patients, 121 without structural heart disease and with analyzable echocardiograms in sinus rhythm at baseline and 6 months were included (67 ± 11 years; 68% men). LASr decreased (25.9 ± 7.9% to 23.1 ± 6.4%, p < 0.001) and LASct declined (11.8 ± 5.5% to 10.4 ± 4.8%, p = 0.007), while LA volume index (LAVI) was unchanged. Baseline LAVI was independently associated with 6-month LASr (standardized β = 0.32, p < 0.001), and higher baseline LAVI was associated with greater ΔLASr (standardized β = 0.33, p < 0.001). These associations were unchanged after adjustment for ablation modality (pulsed-field ablation vs thermal ablation).</p><p><strong>Conclusions: </strong>Post-ablation changes in LA strain were continuously associated with baseline LA remodeling; lower baseline LAVI was independently associated with a less favorable change in LASr. Post-ablation LA function should be interpreted in conjunction with baseline remodeling.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in echocardiographic left ventricular remodeling and clinical outcomes following transcatheter aortic valve implantation.","authors":"Jocelyn Chai, Matthew Cheung, Joshua Yoon, Brandon Park, Bianca Zaidel, Cameron Andres, Jaclyn Lam, Eric C Sayre, David A Wood, Scott D Lim, Janarthanan Sathananthan, John G Webb, Christina Luong, Darwin F Yeung, Parvathy Nair, John Jue, Kenneth Gin, Teresa S M Tsang, Michael Y C Tsang","doi":"10.1007/s12574-026-00741-2","DOIUrl":"https://doi.org/10.1007/s12574-026-00741-2","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in left ventricular (LV) remodeling in response to severe aortic stenosis (AS) and post-transcatheter aortic valve implantation (TAVI) remain unclear. Previous studies have demonstrated inconsistent and discordant findings regarding the relationships between LV remodeling and clinical endpoints across sexes following TAVI. More importantly, it has been shown that females with severe AS are often diagnosed later and less likely to be referred for TAVI.</p><p><strong>Objectives: </strong>We sought to evaluate sex-based differences in LV remodeling prior to and after TAVI, and to assess whether these differences were associated with long-term clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective study of 977 patients with severe AS undergoing TAVI (2013-2020). Serial echocardiograms were performed at baseline (before TAVI) and at various timepoints post-TAVI. Echocardiographic parameters related to LV remodeling were extracted. Clinical outcomes (myocardial infarction [MI], heart failure hospitalization [HFH], stroke, and survival) were tracked over 10 years.</p><p><strong>Results: </strong>Compared with males, females had larger baseline indexed LV end-diastolic dimension (26.5 ± 4.0 mm/m² vs. 25.3 ± 3.5; p < 0.001), lower LV mass index[LVMI] (101.5 ± 28.0 vs. 111.5 ± 30.1 g/m²; p < 0.001), higher left ventricular ejection fraction (59.5 ± 11.13 vs. 53.8 ± 13.5%; p < 0.001), and higher LV filling pressures as indicated by a higher E/e' (18.7 ± 6.9 vs. 15.6 ± 6.2, p < 0.001). However, changes in LVMI, LV chamber size, and diastolic parameters post-TAVI were similar across sexes. Within-group analyses demonstrated that both males and females experienced favorable reverse remodeling in LV mass, LVMI, and wall thicknesses post-TAVI. No significant sex differences were observed in MI, HFH, stroke, or survival post-TAVI.</p><p><strong>Conclusion: </strong>Our results support that males and females present with distinct baseline cardiac phenotypes in the setting of severe AS, but both sexes experience comparable LV reverse remodeling and clinical outcomes post-TAVI. This reinforces the structural and prognostic benefit from TAVI across sexes, underscoring the importance of equitable referral and access to this intervention.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of cardiac reverse remodeling with prognosis after transcatheter aortic valve replacement in patients with mixed aortic valve disease.","authors":"Akihiro Tani, Yoshihito Saijo, Kenya Kusunose, Tomonori Takahashi, Hirotsugu Yamada, Masataka Sata, Kimi Sato, Noor Albakaa, Tomoko Ishizu, Yoshihiro Seo","doi":"10.1007/s12574-025-00709-8","DOIUrl":"10.1007/s12574-025-00709-8","url":null,"abstract":"<p><p>BACKGROUND: Mixed aortic valve disease (MAVD), characterized by concurrent presence of aortic stenosis (AS) and aortic regurgitation (AR), exhibits distinct cardiac structural and functional characteristics compared to isolated aortic valve disease. The aim of the present study was to elucidate the impact of cardiac reverse remodeling after transcatheter aortic valve replacement (TAVR) on prognosis in MAVD. METHODS: The present study included patients with severe symptomatic AS and moderate or greater AR who underwent TAVR and both preoperative and one-year follow-up echocardiography. Reverse remodeling after TAVR was defined as the change of each left ventricular end-systolic volume index (LVESVi), end-diastolic volume index or mass index from baseline to one-year follow-up. The primary outcome was a composite of cardiac death and hospitalization due to heart failure. Internal validation was performed bootstrap resampling methods. RESULTS: A total of 143 patients was enrolled (83.4 ± 6.0 years, 46.9% male). During a median follow-up period of 519 days, 17 patients achieved the primary outcome. Decrease of LVESVi with a cut-off value of 36% was optimal at identifying favorable prognosis (area under the curve: 0.65, sensitivity: 35%, specificity:100%, P = 0.045). Patients with ≥ 36% reduction of LVESVi after TAVR had significantly better prognosis than those without it (P = 0.004). Preoperative larger LVESVi and higher LV mass index were predictors of ≥ 36% decrease of LVESVi following TAVR. CONCLUSION: Greater decrease of LVESVi following TAVR was associated with improved postoperative prognosis in MAVD. Patients with more advanced preoperative cardiac remodeling exhibited greater postoperative reverse remodeling. </p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":"92-100"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical guidance for echocardiography for cancer therapy-related cardiac dysfunction: 2026 focused update.","authors":"Hidekazu Tanaka, Yuko Fukuda, Hirotsugu Yamada, Sakiko Miyazaki, Jiro Sakamoto, Masao Daimon","doi":"10.1007/s12574-026-00731-4","DOIUrl":"10.1007/s12574-026-00731-4","url":null,"abstract":"<p><strong>Background: </strong>Cancer therapy-related cardiac dysfunction (CTRCD) has become an important clinical issue with advances in cancer treatment and improved patient survival. The Japanese Society of Echocardiography previously published practice guidance in 2020. The present document provides an updated revision reflecting recent developments in cardio-oncology.</p><p><strong>Methods: </strong>This guidance was developed based on contemporary evidence, including the 2022 European Society of Cardiology cardio-oncology guidelines, recent clinical studies, and advances in echocardiographic and multimodality imaging technologies.</p><p><strong>Results: </strong>Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) are emphasized as essential parameters for diagnosing and monitoring CTRCD. The document provides standardized protocols for echocardiographic evaluation before, during, and after cancer drug therapy, as well as recommendations for long-term surveillance following radiotherapy. It also addresses cardiovascular complications associated with immune checkpoint inhibitors, particularly myocarditis, and highlights the importance of measurement accuracy, quality control, artificial intelligence, and three-dimensional echocardiography in clinical practice.</p><p><strong>Conclusions: </strong>This updated guidance offers practical and evidence-based recommendations for echocardiographic assessment in cardio-oncology, aiming to facilitate early detection of cardiotoxicity and optimize multidisciplinary management.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":"123-140"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821822","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":"Reverse remodeling after aortic valve intervention in patients with aortic stenosis: echocardiographic assessments and prognostic implications.","authors":"Naoki Taniguchi, Yoko Miyasaka, Yuta Watanabe, Tohru Ishimine, Toshiho Tengan, Kentaro Hayashida","doi":"10.1007/s12574-026-00727-0","DOIUrl":"10.1007/s12574-026-00727-0","url":null,"abstract":"<p><p>Aortic stenosis (AS) is the most prevalent valvular heart disease among the elderly, often leading to chronic left ventricular (LV) pressure overload, myocardial hypertrophy, and fibrosis. Following surgical or transcatheter aortic valve replacement (SAVR/TAVI), relief of afterload can induce reverse remodeling - characterized by reductions in LV size, LV mass index (LVMI), improvements in LV ejection fraction (LVEF), global longitudinal strain (GLS), and left atrial (LA) parameters. The extent of reverse remodeling varies significantly among patients and is closely associated with prognosis. Greater regression in LVMI and improvements in LVEF or GLS have been linked to reduced cardiovascular events and mortality. Conversely, persistent LV hypertrophy, lack of LVEF improvement, or impaired GLS recovery are associated with adverse outcomes. Factors influencing reverse remodeling include underlying myocardial conditions such as advanced fibrosis, or comorbidities like hypertension and diabetes, and/or residual hemodynamic burden [ e.g., elevated blood pressure, prosthesis-patient mismatch, residual aortic regurgitation (AR)]. Echocardiographic assessment of LVMI, LVEF, GLS, and LA indices enables clinicians to evaluate reverse remodeling, stratify risk, and guide post-operative management. Emerging evidence suggests GLS and LA strain may provide prognostic information beyond conventional LVEF. Optimizing hemodynamic conditions and considering early intervention before irreversible myocardial damage could help promote reverse remodeling and may improve long-term outcomes. Comprehensive echocardiographic follow-up is essential for identifying patients at higher residual risk and support its role in risk stratification following valve intervention.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":"80-91"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic evaluation and clinical implications of cardiac remodeling in obesity.","authors":"Yuichiro Okushi, Tomonori Takahashi, Kenya Kusunose","doi":"10.1007/s12574-026-00721-6","DOIUrl":"10.1007/s12574-026-00721-6","url":null,"abstract":"<p><p>The global prevalence of obesity continues to rise. Obesity impacts left ventricular (LV) structure and function through both hemodynamic and metabolic changes and increases the risk of many cardiovascular diseases. Obesity is a significant risk factor for heart failure, particularly HFpEF, and is closely associated with its increasing prevalence, making it a major clinical challenge. Echocardiography, one of the most widely used non-invasive tools for assessing cardiac structure and function, is highly valuable in evaluating cardiovascular complications caused by obesity. Some parameters begin to change already in the overweight stage and allow early detection of cardiac remodeling. Major treatments for obesity include diets, physical activity, bariatric surgery, and pharmacological therapies. Bariatric surgery results in substantial weight loss and improvements in LV structure and function. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have recently been used in obesity treatment, with reports indicating improvements in diastolic function in obese patients. Early and appropriate obesity treatments may help prevent the development of heart failure. This review focuses on the impact of obesity on the heart, the role of advanced echocardiographic evaluation, and the therapeutic effects of bariatric surgery and GLP-1 RAs in improving obesity-related cardiac dysfunction.</p>","PeriodicalId":44837,"journal":{"name":"Journal of Echocardiography","volume":" ","pages":"69-79"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}