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Echocardiographic assessment of aortic regurgitation: a practical guideline from the British Society of Echocardiography.
IF 3.2
Echo Research and Practice Pub Date : 2025-01-27 DOI: 10.1186/s44156-024-00067-8
Kelly Victor, Liam Ring, Vasiliki Tsampasian, David Oxborough, Sanjeev Bhattacharyya, Rebecca T Hahn
{"title":"Echocardiographic assessment of aortic regurgitation: a practical guideline from the British Society of Echocardiography.","authors":"Kelly Victor, Liam Ring, Vasiliki Tsampasian, David Oxborough, Sanjeev Bhattacharyya, Rebecca T Hahn","doi":"10.1186/s44156-024-00067-8","DOIUrl":"10.1186/s44156-024-00067-8","url":null,"abstract":"<p><p>Aortic regurgitation is the third most common valve lesion with increasing prevalence secondary to an ageing population. Transthoracic echocardiography plays a vital role in the identification and assessment of aortic regurgitation and proves essential in monitoring severity and determining the timing of intervention. Building on the foundations of previous British Society of Echocardiography (BSE) recommendations, this BSE guideline presents an update on how to approach an echocardiographic assessment of aortic regurgitation. It provides a practical, step-by-step guide to facilitate a comprehensive, high-quality echocardiographic assessment of aortic regurgitation. It discusses commonly encountered echocardiography-based challenges with suggestions regarding how this information is relevant in the interpretation and grading of regurgitation severity. Additionally, the value of other cardiac imaging modalities is discussed. The guideline concludes with an overview of aortic regurgitation in the clinical context, addressing chronic versus acute aortic regurgitation, which features prompt referral for intervention, and the consequences of combined valve disease.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"3"},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053815","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}
引用次数: 0
Sex differences in ventricular-vascular interactions associated with aerobic capacity. 与有氧能力相关的心室-血管相互作用的性别差异。
IF 3.2
Echo Research and Practice Pub Date : 2025-01-20 DOI: 10.1186/s44156-024-00066-9
Barbara N Morrison, Peter M Mittermaier, Garth R Lester, Michael E Bodner, Anita T Cote
{"title":"Sex differences in ventricular-vascular interactions associated with aerobic capacity.","authors":"Barbara N Morrison, Peter M Mittermaier, Garth R Lester, Michael E Bodner, Anita T Cote","doi":"10.1186/s44156-024-00066-9","DOIUrl":"10.1186/s44156-024-00066-9","url":null,"abstract":"<p><strong>Background: </strong>Aerobic capacity measured by maximal oxygen uptake (VO<sub>2</sub>max) is related to functional capacity and is a strong independent predictor of all-cause and disease-specific mortality. Sex-specific cardiac and vascular responses to endurance training have been observed, however, their relative contributions to VO<sub>2</sub>max are less understood. The purpose of this study was to evaluate sex-specific ventricular-vascular interactions associated with VO<sub>2</sub>max in healthy males and females.</p><p><strong>Methods: </strong>Sixty-eight males and females (38% females, 35 ± 10y) characterised as recreational exercisers to highly trained endurance athletes, and free of chronic disease underwent a cycle ergometer to assess VO<sub>2</sub>max. Resting arterial compliance and echocardiographic evaluation of left ventricular (LV) structure and function were measured and indexed to body surface area.</p><p><strong>Results: </strong>VO<sub>2</sub>max was similar between groups (54 ± 6 vs. 50 ± 7 ml/kg/min, p = 0.049). Indexed LV mass (LVMi) was higher (96 ± 15 vs. 81 ± 11, p = 0.001) in males versus females, respectively. Linear regression analysis revealed two models that were significantly associated with VO<sub>2</sub>max in males and females. In males, the two models included (1) longitudinal diastolic strain rate and LVMi (r<sup>2</sup> = 0.31, p = 0.003) and (2) indexed end-diastolic volume (EDVi) and longitudinal diastolic strain rate (r<sup>2</sup> = 0.34, p < 0.001). In females, the linear regression models included (1) LVMi, large arterial compliance, longitudinal systolic strain rate, and age (r<sup>2</sup> = 0.69, p < 0.001) and (2) EDVi, large arterial compliance, longitudinal systolic strain rate, and age (r<sup>2</sup> = 0.52, p = 0.003).</p><p><strong>Conclusion: </strong>These findings reveal that while in both sexes, LVMi and LVEDVi are associated with VO<sub>2</sub>max, arterial compliance was also found to contribute to the variance in VO<sub>2</sub> max in females, but not in males. Further, ventricular relaxation was a significant factor in aerobic capacity in males, while in females ventricular contraction was a significant factor.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013812","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}
引用次数: 0
Diagnostic value of selected fetal echocardiographic parameters in the prenatally suspected bicuspid aortic valve. 胎儿超声心动图参数对产前怀疑为二尖瓣主动脉瓣的诊断价值。
IF 3.2
Echo Research and Practice Pub Date : 2025-01-06 DOI: 10.1186/s44156-024-00065-w
Min Zheng, Yanping Ruan, Lin Sun, Xiaowei Liu, Jiancheng Han, Yihua He
{"title":"Diagnostic value of selected fetal echocardiographic parameters in the prenatally suspected bicuspid aortic valve.","authors":"Min Zheng, Yanping Ruan, Lin Sun, Xiaowei Liu, Jiancheng Han, Yihua He","doi":"10.1186/s44156-024-00065-w","DOIUrl":"https://doi.org/10.1186/s44156-024-00065-w","url":null,"abstract":"<p><strong>Objective: </strong>To explore the diagnostic value of crucial parameters of echocardiography for fetal bicuspid aortic valve (BAV) and improve diagnostic accuracy.</p><p><strong>Methods: </strong>Fetuses with a prenatal suspected diagnosis of BAV were followed, and confirmed and misdiagnosed cases were obtained. Prenatal echocardiography was reviewed and analyzed. ROC curves were plotted to evaluate the diagnostic capabilities of different echo signs.</p><p><strong>Results: </strong>14 cases were confirmed, and 7 patients were misdiagnosed. Some abnormal ultrasound signs were observed in both groups, including direct ultrasound signs of the aortic valve: Two commissures and a \"fish-mouth\" opening; Thickening, hyperechogenicity, or the presence of a raphe; Restricted motion or opening; Eccentric or a-linear valve leaflet closure line and indirect ultrasound signs: Increased supra-aortic valve velocity; Post-stenotic widening of the ascending aorta. The combination of \"Increased supra-aortic valve velocity\" and \"Two commissures and a 'fish-mouth' opening\" had the highest AUC (AUC: 0.893, 95%CI: 0.752-1.000, Sensitivity: 0.786, Specificity: 1.000).</p><p><strong>Conclusions: </strong>We first found that the combination of \"Increased supra-aortic valve velocity\" and \"Two commissures and a 'fish-mouth' opening\" had the best diagnostic capability and could reduce the rate of misdiagnosis. Fetuses with BAV should be followed up prenatally for the aortic valve and ascending aorta as they progressively deteriorate with gestational age.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933098","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}
引用次数: 0
Feasibility of three dimensional and strain transthoracic echocardiography in a single-centre dedicated NHS cardio-oncology clinic. 三维和应变经胸超声心动图在英国国家医疗服务系统(NHS)心脏肿瘤专科门诊单中心的可行性。
IF 3.2
Echo Research and Practice Pub Date : 2024-12-16 DOI: 10.1186/s44156-024-00063-y
Patrick O'Driscoll, David Gent, Liam Corbett, Rod Stables, Rebecca Dobson
{"title":"Feasibility of three dimensional and strain transthoracic echocardiography in a single-centre dedicated NHS cardio-oncology clinic.","authors":"Patrick O'Driscoll, David Gent, Liam Corbett, Rod Stables, Rebecca Dobson","doi":"10.1186/s44156-024-00063-y","DOIUrl":"10.1186/s44156-024-00063-y","url":null,"abstract":"<p><strong>Background: </strong>Following the publication of international cardio-oncology (CO) imaging guidelines, standard echocardiographic monitoring parameters of left ventricular systolic function have been endorsed. Recommendations highlight that either two-dimensional (2D) or three-dimensional (3D) left ventricular ejection fraction (LVEF), alongside global longitudinal strain (GLS) should be routinely performed for surveillance of patients at risk of cancer therapy-related cardiac dysfunction (CTRCD). We studied the feasibility of 3D-LVEF, 2D-GLS and 2D-LVEF in a dedicated CO service.</p><p><strong>Methods: </strong>This was a single-centre prospective analysis of consecutive all-comer patients (n = 105) referred to an NHS CO clinic. Using a dedicated Philips EPIQ CVx v7.0, with X5-1 3D-transducer and 3DQA software, we sought to acquire and analyse 2D- and 3D-LVEF and 2D-GLS, adhering to the British Society of Echocardiography (BSE) and British Cardio-Oncology Society (BCOS) transthoracic echocardiography protocol.</p><p><strong>Results: </strong>A total of 105 patients were enrolled in the study; 5 were excluded due to carcinoid heart disease (n = 5). Calculation of 3D-LVEF was achieved in 40% (n = 40), 2D-GLS in 73% (n = 73), and 2D-LVEF in 81% (n = 81). LV quantification was not possible in 19% (n = 19) due to poor myocardial border definition. Strong correlation existed between 2D-LVEF and 3D-LVEF (r = 0.94, p < 0.0001). Bland-Altman plot demonstrated no statistical differences in that the mean deviation between 2D-LVEF and 3D-LVEF were consistent throughout a range of LVEF values. The most persistent obstacle to 3D-LVEF acquisition was insufficient myocardial border tracking (n = 30, 50%).</p><p><strong>Conclusion: </strong>This study demonstrates the high feasibility of 2D-GLS and 2D-LVEF, even in those with challenging echocardiographic windows. The lower feasibility of 3D-LVEF limits its real-world clinical application, even though only a small difference in agreement with 2D-LVEF calculation was found when successfully performed.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"27"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830242","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}
引用次数: 0
The implementation of speckle tracking echocardiography for cardiac resynchronization therapy optimisation. A rotational myocardial mechanics interpretation. 斑点跟踪超声心动图在心脏再同步化治疗优化中的应用。旋转心肌力学解释。
IF 3.2
Echo Research and Practice Pub Date : 2024-12-02 DOI: 10.1186/s44156-024-00062-z
Alexandros Stefanidis, Paraskevi Korlou, Panagiotis Margos, Ignatios Ikonomidis, Ioannis Paraskevaidis, Konstantinos Gatzoulis, Evmorfia Aivalioti, Konstantinos Kostopoulos
{"title":"The implementation of speckle tracking echocardiography for cardiac resynchronization therapy optimisation. A rotational myocardial mechanics interpretation.","authors":"Alexandros Stefanidis, Paraskevi Korlou, Panagiotis Margos, Ignatios Ikonomidis, Ioannis Paraskevaidis, Konstantinos Gatzoulis, Evmorfia Aivalioti, Konstantinos Kostopoulos","doi":"10.1186/s44156-024-00062-z","DOIUrl":"https://doi.org/10.1186/s44156-024-00062-z","url":null,"abstract":"<p><strong>Background: </strong>Cardiac resynchronization therapy (CRT) has an additive therapeutic influence on left ventricular function in heart failure patients, but the underlying mechanisms through which it works are not completely explained. Our aim was to further elucidate the role of this intervention via rotational mechanics using 2D speckle tracking echocardiography (2D-STE).</p><p><strong>Results: </strong>We investigated 46 patients (65 ± 9 years) who received CRT. All enrolled patients were assessed on admission by 2D-STE and 6 min walk test (6 min WT) and followed in the outpatient device clinic by 2D-STE (at 1 week and 6 months post-implantation) and 6 min WT (at 6 months post-implantation). On their first appointment all biventricular systems were optimised by atrioventricular delay optimisation and by changing the temporal activation of ventricular electrodes aiming to reach the highest left ventricular effective stroke volume across all activation options. A new 2D-STE based index (twist integral) targeting to assess the rotational mechanics of the whole cardiac cycle was also measured to further explain the CRT response. Twenty-two (48%) patients were responders at 6-month follow-up and most of them had dilated cardiomyopathy. The commonest selected mode that was related with the greatest left ventricular performance response was the simultaneous activation of the 2 ventricular leads (39%). The strongest predictor of CRT response was the improvement of effective stroke volume between admission and first appointment at clinic, followed by the improvement of twist integral, the absence of coronary artery disease, and the improvement of peak systolic twist.</p><p><strong>Conclusions: </strong>Additional CRT optimisation via changing the temporal activation of ventricular electrodes is beneficial for left ventricular performance in heart failure patients. The success of biventricular pacing may also be explained by the improvement of left ventricular rotational mechanics.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"28"},"PeriodicalIF":3.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773407","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}
引用次数: 0
Visual grading of valvular regurgitation is inferior to measurement - results from the VIAVA-study (VIsual Assessment of VAlvular Regurgitation). 瓣膜返流的视觉分级不如测量--VIAVA(瓣膜返流的视觉评估)研究的结果。
IF 3.2
Echo Research and Practice Pub Date : 2024-11-11 DOI: 10.1186/s44156-024-00061-0
Ozan Demirel, Paolo Di Stefano, Elke Boxhammer, Thomas Wuppinger, Christina Granitz, Björn Goebel, Uta C Hoppe, Michael Lichtenauer, Moritz Mirna
{"title":"Visual grading of valvular regurgitation is inferior to measurement - results from the VIAVA-study (VIsual Assessment of VAlvular Regurgitation).","authors":"Ozan Demirel, Paolo Di Stefano, Elke Boxhammer, Thomas Wuppinger, Christina Granitz, Björn Goebel, Uta C Hoppe, Michael Lichtenauer, Moritz Mirna","doi":"10.1186/s44156-024-00061-0","DOIUrl":"10.1186/s44156-024-00061-0","url":null,"abstract":"<p><p>While the visual estimation of systolic left ventricular function by experienced examiners closely aligns with quantitative methodologies, the accuracy of visual estimation in determining the severity of valvular regurgitation using colour flow Doppler assessment of native heart valves remains largely unexplored. This study analysed the ability of 262 physicians to visually estimate the severity of 12 native valve regurgitations by grading colour Doppler transthoracic echocardiography loops in an online questionnaire. The assessments of the participants were compared to standardized quantitative evaluations conducted by certified echocardiography experts. Of the three valves to assess, evaluations by the participants showed the best correlation (Rs = 0.75, p < 0.0001) and agreement (percent agreement: 66.4%) with those of the experts in mitral valve regurgitation (MR). High agreement was observed for mild regurgitation across all valves (MR 94.5%, AR 80.3% and TR 88.7%), while consensus diminished in moderate (MR 55.9%, AR 49.5% and TR 55.0%) and severe regurgitation (MR 57.6%, AR 67.4%, TR 14.6%). The study underscores the potential utility of visual estimation of valvular regurgitation in clinical settings for identifying clinically relevant regurgitations. However, our findings also highlight the importance of integrating visual estimation with quantitative methods, particularly in moderate and severe cases of regurgitation.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"26"},"PeriodicalIF":3.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630017","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}
引用次数: 0
A proposal of a simplified grading and echo-based staging of aortic valve stenosis to streamline management. 建议对主动脉瓣狭窄进行简化分级和基于回声的分期,以简化管理。
IF 3.2
Echo Research and Practice Pub Date : 2024-11-04 DOI: 10.1186/s44156-024-00064-x
Attila Kardos, Mani A Vannan
{"title":"A proposal of a simplified grading and echo-based staging of aortic valve stenosis to streamline management.","authors":"Attila Kardos, Mani A Vannan","doi":"10.1186/s44156-024-00064-x","DOIUrl":"10.1186/s44156-024-00064-x","url":null,"abstract":"<p><p>In this paper we discuss the relevance of continuity equation based aortic valve area (AVA) calculation as a robust parameter suitable for accurate grading of aortic stenosis (AS) irrespective of flow conditions. Combining the AVA-based grading and echocardiography-based staging, can provide with the most comprehensive clinical assessment of patients with AS and preserved left ventricular systolic function to streamline management decisions.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"29"},"PeriodicalIF":3.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569531","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}
引用次数: 0
Left atrial volume assessed by echocardiography identifies patients with high risk of adverse outcome after acute myocardial infarction. 通过超声心动图评估左心房容积,确定急性心肌梗死后不良预后风险高的患者。
IF 3.2
Echo Research and Practice Pub Date : 2024-10-21 DOI: 10.1186/s44156-024-00060-1
Jorun Tangen, Thuy Mi Nguyen, Daniela Melichova, Lars Gunnar Klaeboe, Marianne Forsa, Kristoffer Andresen, Adrien Al Wazzan, Oyvind Lie, Fatih Kizilaslan, Kristina Haugaa, Helge Skulstad, Harald Brunvand, Thor Edvardsen
{"title":"Left atrial volume assessed by echocardiography identifies patients with high risk of adverse outcome after acute myocardial infarction.","authors":"Jorun Tangen, Thuy Mi Nguyen, Daniela Melichova, Lars Gunnar Klaeboe, Marianne Forsa, Kristoffer Andresen, Adrien Al Wazzan, Oyvind Lie, Fatih Kizilaslan, Kristina Haugaa, Helge Skulstad, Harald Brunvand, Thor Edvardsen","doi":"10.1186/s44156-024-00060-1","DOIUrl":"10.1186/s44156-024-00060-1","url":null,"abstract":"<p><strong>Background: </strong>The left atrial (LA) volume has been demonstrated to be an important predictor of adverse outcome in patients with various cardiac conditions, including acute myocardial infarction (AMI). However, new treatment strategies in patients with AMI have led to better patient outcomes. We hypothesised that increased LA size could still predict mortality in patients with AMI despite improved treatment strategies.</p><p><strong>Methods: </strong>We included patients with AMI in a prospective multicenter cohort study and the study patients were enrolled from 2014 to 2022. We recorded echocardiographic and clinical data during their index hospitalisation. Indexed LA volume (LAVi) was assessed in all patients and was used as a continuous variable in the univariate and multivariate Cox regression analysis. The study took place over a period of five years and median follow-up time was 3.8 years (range 3.1 to 5.0 years). The primary study outcomes were all-cause mortality and major adverse cardiac events (MACE). MACE was defined as hospital readmission due to myocardial infarction, cardiac arrest, stroke, heart failure, or onset of new atrial fibrillation.</p><p><strong>Results: </strong>We included 487 patients (69 ± 12 years old, 26% female) with AMI. During the follow-up period all-cause mortality was 50 (10.3%) and patients who reached the primary outcomes were 153 (31.4%). The deceased patients had higher LAVi compared to survivors (40.0 ± 12.9 mL/m<sup>2</sup> vs. 29.7 ± 11.2 mL/m<sup>2</sup>, p < 0.001). Factors associated with all-cause mortality and MACE were age, year of enrollment, left ventricular (LV) ejection fraction, LV global longitudinal strain (GLS), LV filling pressure, moderate or severe mitral regurgitation and LAVi. GLS and EF were segregated into two distinct models due to their moderately high correlation (r = 0.57, p < 0.001). LAVi remained as an independent echocardiographic predictor of primary outcomes after adjusting for the covariates above in two separates multivariable Cox regression models (hazard ratio 1.02/1.02 mL/m<sup>2</sup> [95% CI 1.01-1.03/1.01-1.03], p = 0.006/0.003).</p><p><strong>Conclusions: </strong>Our study demonstrated that LA dilatation is an independent echocardiographic predictor of mortality and MACE in patients with AMI despite improved treatment strategies. This finding highlights the potential of using LAVi as a marker for prognostication in these patients.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"24"},"PeriodicalIF":3.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477266","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}
引用次数: 0
Deep learning of echocardiography distinguishes between presence and absence of late gadolinium enhancement on cardiac magnetic resonance in patients with hypertrophic cardiomyopathy. 超声心动图深度学习可区分肥厚型心肌病患者心脏磁共振上是否出现晚期钆增强。
IF 3.2
Echo Research and Practice Pub Date : 2024-10-14 DOI: 10.1186/s44156-024-00059-8
Keitaro Akita, Kenya Kusunose, Akihiro Haga, Taisei Shimomura, Yoshitaka Kosaka, Katsunori Ishiyama, Kohei Hasegawa, Michael A Fifer, Mathew S Maurer, Yuichi J Shimada
{"title":"Deep learning of echocardiography distinguishes between presence and absence of late gadolinium enhancement on cardiac magnetic resonance in patients with hypertrophic cardiomyopathy.","authors":"Keitaro Akita, Kenya Kusunose, Akihiro Haga, Taisei Shimomura, Yoshitaka Kosaka, Katsunori Ishiyama, Kohei Hasegawa, Michael A Fifer, Mathew S Maurer, Yuichi J Shimada","doi":"10.1186/s44156-024-00059-8","DOIUrl":"https://doi.org/10.1186/s44156-024-00059-8","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) can cause myocardial fibrosis, which can be a substrate for fatal ventricular arrhythmias and subsequent sudden cardiac death. Although late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) represents myocardial fibrosis and is associated with sudden cardiac death in patients with HCM, CMR is resource-intensive, can carry an economic burden, and is sometimes contraindicated. In this study for patients with HCM, we aimed to distinguish between patients with positive and negative LGE on CMR using deep learning of echocardiographic images.</p><p><strong>Methods: </strong>In the cross-sectional study of patients with HCM, we enrolled patients who underwent both echocardiography and CMR. The outcome was positive LGE on CMR. Among the 323 samples, we randomly selected 273 samples (training set) and employed deep convolutional neural network (DCNN) of echocardiographic 5-chamber view to discriminate positive LGE on CMR. We also developed a reference model using clinical parameters with significant differences between patients with positive and negative LGE. In the remaining 50 samples (test set), we compared the area under the receiver-operating-characteristic curve (AUC) between a combined model using the reference model plus the DCNN-derived probability and the reference model.</p><p><strong>Results: </strong>Among the 323 CMR studies, positive LGE was detected in 160 (50%). The reference model was constructed using the following 7 clinical parameters: family history of HCM, maximum left ventricular (LV) wall thickness, LV end-diastolic diameter, LV end-systolic volume, LV ejection fraction < 50%, left atrial diameter, and LV outflow tract pressure gradient at rest. The discriminant model combining the reference model with DCNN-derived probability significantly outperformed the reference model in the test set (AUC 0.86 [95% confidence interval 0.76-0.96] vs. 0.72 [0.57-0.86], P = 0.04). The sensitivity, specificity, positive predictive value, and negative predictive value of the combined model were 0.84, 0.76, 0.78, and 0.83, respectively.</p><p><strong>Conclusion: </strong>Compared to the reference model solely based on clinical parameters, our new model integrating the reference model and deep learning-based analysis of echocardiographic images demonstrated superiority in distinguishing LGE on CMR in patients with HCM. The novel deep learning-based method can be used as an assistive technology to facilitate the decision-making process of performing CMR with gadolinium enhancement.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"11 1","pages":"23"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477265","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}
引用次数: 0
Improvements of right ventricular function after intervention with CPAP in patients with obstructive sleep apnoea. 使用 CPAP 对阻塞性睡眠呼吸暂停患者进行干预后,右心室功能得到改善。
IF 3.2
Echo Research and Practice Pub Date : 2024-10-01 DOI: 10.1186/s44156-024-00058-9
Greg Murphy, Peter Coss, Gerard King, Mark Coyle, Anne-Marie McLaughlin, Ross Murphy
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