Echo Research and Practice最新文献

{"title":"Tracking progression of aortic stenosis with echocardiography.","authors":"Clay Sherrill, Jenna Port, Mohamad Wahoud, Ben Koethe, Sharanya Mohanty, Brian C Downey, Ayan Patel, Benjamin S Wessler","doi":"10.1186/s44156-025-00086-z","DOIUrl":"https://doi.org/10.1186/s44156-025-00086-z","url":null,"abstract":"<p><strong>Background: </strong>Transthoracic echocardiography (TTE) is used to assess aortic stenosis (AS) severity and track disease progression. As the field moves to study medical therapies to halt disease progression, reliable non-invasive imaging markers that are sensitive to small changes in disease progression are needed to enable efficient trial designs. The signal-to-noise ratio of commonly obtained TTE-based measures of progressive (non-severe) AS severity is unknown.</p><p><strong>Methods: </strong>This is a retrospective study of TTEs done at a tertiary referral centre (Tufts Medical Center, Boston MA). A cohort of patients with progressive AS who had two TTEs done within 30 days (in the absence of valve intervention) and a cohort of progressive AS patients with TTEs ≥ 1 year apart, also without valvular intervention, were assembled. Limits of agreement (LOA) and intraclass correlation (ICC) were calculated for aortic valve area (AVA) by continuity equation, peak velocity, and mean gradient. Cohen's d-statistic (d) was calculated for each hemodynamic assessment and a composite marker to assess sensitivity for detecting disease progression normalised to measurement variability.</p><p><strong>Results: </strong>The reproducibility cohort included 24 patients. The progression cohort included 35 patients. The median age was 70 years (interquartile range [IQR] 13). 22 patients (37.3%) were female. In the progression cohort, the median time between TTEs was 2.2 years (IQR 3.1 years). In the reproducibility cohort, AVA LOA were -0.7 to 0.8, ICC = 0.61; peak velocity LOA were -149.0 to + 126.7, ICC = 0.29; and mean gradient LOA were -16.2 to 12.2, ICC = 0.06. The d-statistic for annualised change in AVA was -0.29, the d-statistic for annualised change in maximum velocity was 0.46, the d-statistic for mean gradient was 0.55. The d-statistic for a composite, including all three hemodynamic markers, was 0.45.</p><p><strong>Conclusions: </strong>Standard TTE markers of AS severity have variable sensitivity for detecting AS progression. For patients with progressive (non-severe) AS, mean gradient has the highest signal-to-noise ratio and may be the most reliable TTE-based assessment of disease progression.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"19"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776447","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":"BSEcho 2024 Conference Report.","authors":"","doi":"10.1186/s44156-025-00079-y","DOIUrl":"10.1186/s44156-025-00079-y","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 Suppl 1","pages":"23"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733817","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":"Epicardial fat thickness predicts severe coronary artery disease and high mortality risk among ST-elevation myocardial infarction patients.","authors":"Heba M El-Naggar, Jacqueline G Abdel-Maseh, Hosam Hasan-Ali, Shimaa S Khidr","doi":"10.1186/s44156-025-00087-y","DOIUrl":"10.1186/s44156-025-00087-y","url":null,"abstract":"<p><strong>Background: </strong>Epicardial adipose tissue has been identified as a significant marker in the assessment of coronary artery disease (CAD), with a possible impact on the development of acute coronary events including ST-elevation myocardial infarction (STEMI).</p><p><strong>Aim: </strong>To assess the association and predictability of echocardiographic-measured epicardial fat thickness (EFT) for the severity of CAD and mortality risk among STEMI patients.</p><p><strong>Methods: </strong>This study included 159 STEMI patients who underwent primary percutaneous coronary intervention (PPCI) and survived the in-hospital duration. Anthropometric measurements, lipid profiles, and angiographic data were recorded. The correlations between echo-measured EFT and CAD severity indicated by the syntax score (SS) were assessed. In-hospital and 6-month major adverse cardiovascular events (MACE) were reported, and mortality risk was evaluated using the Grace score.</p><p><strong>Results: </strong>Among the study population, 104 patients (65.4%) had low SS, 45 patients (28.3%) had moderate SS, and 10 patients (6.3%) had high SS. STEMI patients with moderate/high SS had significantly larger EFT. EFT showed a significant correlation with BMI (r = 0.57), fat mass (kg) (r = 0.44), LDL (r = 0.40), the syntax score (r = 0.74), and the Grace score (r = 0.68), (p < 0.001 for all). Our ROC-derived cutoff value of EFT ≥ 5.45 mm significantly discriminated STEMI patients with moderate/high-SS, high coronary thrombus burden, 6-months high mortality risk, and 6-months MACE with reasonable respective sensitivity and specificity. Increased EFT independently predicted moderate/high-SS and high mortality risk on multivariable regression analysis.</p><p><strong>Conclusion: </strong>Echo-measured EFT ≥ 5.45 mm might be a reliable non-invasive marker for predicting CAD severity, high coronary thrombus burden, 6-months high mortality risk, and 6-months MACE among STEMI patients.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"17"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676026","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 function and mechanics in systemic sclerosis: a systematic review and meta-analysis.","authors":"Mihnea Casian, Alina Dima, Ciprian Jurcuț, Laura Andrei, Jamie Edwards, Jamie O'Driscoll, Bogdan A Popescu, Ruxandra Jurcuț","doi":"10.1186/s44156-025-00081-4","DOIUrl":"10.1186/s44156-025-00081-4","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to evaluate differences in conventional, tissue Doppler imaging (TDI) and speckle-tracking echocardiographic (STE) parameters of all cardiac chambers between SSc patients and healthy controls.</p><p><strong>Methods: </strong>A study search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. MEDLINE, Scopus and Web of Science were searched using the following keywords: \"speckle tracking\", \"global strain\", \"longitudinal strain\", \"circumferential strain\", \"radial strain\", \"atrial strain\", \"right ventricular strain\", or \"left ventricular strain\" and \"systemic sclerosis\". Primary pooled analyses were performed on each cardiac parameter independently to determine the weighted mean difference (WMD) between SSc and controls. Further independent subgroup analyses were performed to compare symptomatic vs asymptomatic SSc and diffuse vs limited SSc.</p><p><strong>Results: </strong>The systematic review and meta-analysis included 41 case-control eligible reports studies with a pooled sample size of 2497 SSc cases and 1439 controls. Significant weighted mean differences (WMD) between SSc patients and healthy controls were identified in septal S' wave (WMD 0.343 cm/s, CI [- 0.540-0.145], I²: 36%, p = 0.001), lateral S' wave (WMD 0.795 cm/s, CI [- 1.394-0.197], I²: 0%, p = 0.009), tricuspid S' wave (WMD 1.137 cm/s, CI [- 1.784-0.489], I²: 84%, p = 0.001), septal e' wave (WMD 1.398 cm/s, CI [- 2.272-0.523], I²: 82%, p = 0.002) and lateral e' wave (WMD 3.545 cm/s, CI [- 4.990-2.100], I²: 71%, p < 0.001) velocities. STE parameters were attenuated in patients with SSc, with impairment of left ventricular global longitudinal (WMD 2.765%, CI [- 3.482-2.049], I²: 91%, p < 0.001), circumferential (WMD 3.145%, CI [- 4.181-2.109], I²: 79%, p < 0.001), and radial (WMD 4.044%, CI [- 6.199-1.889], I²: 0%, p < 0.001) strain, right ventricular free wall (WMD 4.492%, CI [- 6.048-2.937], I²: 76%, p < 0.001) and right ventricular global longitudinal strain (WMD 2.843%, CI [- 3.290-2.396], I²: 32%, p < 0.001), as well as left (WMD - 8.317%, CI [- 11.873-4.761], I²: 82%, p < 0.001) and right (WMD 7.346%, CI [- 10.536-4.156], I²: 26%, p < 0.001) atrial reservoir strain.</p><p><strong>Conclusion: </strong>SSc is associated with significantly impaired cardiac function and mechanics compared to healthy individuals, even in the absence of symptoms or pulmonary hypertension.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"18"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627390","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":"Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction?","authors":"Mame Madjiguene Ka, Serigne Cheikh Tidiane Ndao, Waly Niang Mboup, Mariama Barry, Rabab Yassine, Pape Momar Guissé, Demba Waré Baldé, Tacko Niang, Djibril Marie Ba, Khadidiatou Dia, El Hadji Mbacké Sarr, Ibrahima Bara Diop, Mouhamed Chérif Mboup","doi":"10.1186/s44156-025-00084-1","DOIUrl":"10.1186/s44156-025-00084-1","url":null,"abstract":"<p><strong>Background: </strong>GLS is a non-invasive imaging test that can be useful in the selection of patients highly suspected of CCS for coronary angiogram.</p><p><strong>Aims: </strong>This study aimed to evaluate the diagnostic performance of rest 2D speckle tracking echocardiography (2D-STE) for detecting obstructive coronary artery disease (CAD) in patients with high clinical probability of chronic coronary syndrome (CCS) and preserved left ventricular ejection fraction (LVEF).</p><p><strong>Methods: </strong>A prospective study enrolled 52 patients referred for coronary angiography due to highly suspected CCS. Participants were divided into CAD+ (significant stenosis) and CAD- (normal or non-significant stenosis). Transthoracic echocardiography (TTE), exercise EKG, 2D-STE, and coronary angiography were performed. Global longitudinal peak systolic strain (GLS) was calculated using 2D-STE, with a cut-off value of -18% for normal GLS. Reproducibility was assessed with intraclass correlation.</p><p><strong>Results: </strong>The mean age of participants was 62.5 ± 11.9 years, and 63.5% were male. The CAD + group (51.9%) had significantly higher rates of hypertension, diabetes, dyslipidemia, and typical angina. GLS was significantly lower in the CAD + group (-15.89 ± 2.07%) compared to the CAD- group (-18.99 ± 2.37%, p = 0.0001). The optimal GLS cut-off for detecting significant coronary lesions was - 16.9%, with 74% sensitivity, 76% specificity, and an area under the curve (AUC) of 0.83 (95% CI 0.73-0.94). GLS correlated with the number of diseased vessels (p = 0.0001) but not with lesion complexity (SYNTAX score, p = 0.18). Regional strain was significantly reduced in patients with obstructive lesions in the left anterior descending (LAD) and circumflex arteries (CX), with optimal cut-offs at -19.2% and - 15.8%, respectively. GLS showed excellent inter-operator reproducibility (ICC = 0.94, p < 0.0001).</p><p><strong>Conclusion: </strong>GLS demonstrates good diagnostic performance in detecting obstructive CAD in patients with a high pre-test probability of CCS and preserved LVEF. It serves as a reliable, reproducible indicator of significant coronary lesions, with promising clinical utility for non-invasive CAD assessment, particularly in resource-limited settings.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"16"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530305","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":"Can automation and artificial intelligence reduce echocardiography scan time and ultrasound system interaction?","authors":"Kylie J Hollitt, Steven Milanese, Majo Joseph, Rebecca Perry","doi":"10.1186/s44156-025-00077-0","DOIUrl":"10.1186/s44156-025-00077-0","url":null,"abstract":"<p><strong>Background: </strong>The number of patients referred for and requiring a transthoracic echocardiogram (TTE) has increased over the years resulting in more cardiac sonographers reporting work related musculoskeletal pain. We sought to determine if a scanning protocol that replaced conventional workflows with advanced technologies such as multiplane imaging, artificial intelligence (AI) and automation could be used to optimise conventional workflows and potentially reduce ergonomic risk for cardiac sonographers. The aim was to assess whether this alternate protocol could reduce active scanning time as well as interaction with the ultrasound machine compared to a standard echocardiogram without a reduction in image quality and interpretability.</p><p><strong>Method and results: </strong>Volunteer participants were recruited for a study that comprised of two TTE's with separate protocols. Both were clinically complete, but Protocol A combined automation, AI assisted acquisition and measurement, simultaneous and multiplane imaging whilst Protocol B reflected a standard scanning protocol without these additional technologies. Keystrokes were significantly reduced with the advanced protocol as compared to the typical protocol (230.9 ± 24.2 vs. 502.8 ± 56.2; difference 271.9 ± 61.3, p < 0.001). Furthermore, there was a reduction in scan time with protocol A compared to protocol B the standard TTE protocol (13.4 ± 2.3 min vs. 18.0 ± 2.6 min; difference 4.6 ± 2.9 min, p < 0.001) as well as a decrease of approximately 27% in the time the sonographers were required to reach beyond a neutral position on the ultrasound console.</p><p><strong>Conclusions: </strong>A TTE protocol that embraces modern technologies such as AI, automation, and multiplane imaging shows potential for a reduction in ultrasound keystrokes and scan time without a reduction in quality and interpretability. This may aid a reduction in ergonomic workload as compared to a standard TTE.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"11"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303255","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":"British Society of Echocardiography guideline for the transthoracic echocardiographic assessment of adult patients with obstructive hypertrophic cardiomyopathy receiving myosin-inhibitor therapy.","authors":"Clare M Culshaw, Daniel Augustine, Caroline J Coats, Ivo Andrade, Keith Pearce, Antonis Pantazis, William Bradlow, Lauren Turvey, William Moody, Lynne Williams, Rachel Bastianen, Jane Draper, David L Oxborough, Robert M Cooper","doi":"10.1186/s44156-025-00078-z","DOIUrl":"10.1186/s44156-025-00078-z","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"15"},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200393","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":"Risk factors for early radiation-induced heart damage in patients undergoing pulmonary SBRT.","authors":"Tingcui Li, Dan Zhu, Ming Cui","doi":"10.1186/s44156-025-00076-1","DOIUrl":"10.1186/s44156-025-00076-1","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic body radiotherapy (SBRT) is superior to conventional radiotherapy for the treatment of lung tumors but can lead to radiation-induced heart damage (RIHD). Its risk factors have not been clarified. The purpose of our study was to determine the risk factors for early RIHD in patients undergoing pulmonary SBRT.</p><p><strong>Methods: </strong>We prospectively included patients who planned to receive pulmonary SBRT at our center from January 2020 to May 2021. Two-dimensional speckle tracking echocardiography was performed within 2 months after radiotherapy. The diagnostic criterion for early RIHD was a decrease in global longitudinal strain by ≥ 15% from baseline. Logistic regression was used to explore the risk factors for early RIHD.</p><p><strong>Results: </strong>A total of 108 patients were included in the study. The overall incidence of early RIHD in the cohort was 41.7%. Significant risk factors, including maximum heart dose, anthracycline use and hypertension, were independently associated with early RIHD, with ORs of 1.058 (95% CI: 1.028-1.089; p < 0.001), 3.524 (95% CI: 1.296-9.577; p = 0.014), and 4.284 (95% CI: 1.424-12.890; p = 0.010), respectively. The cutoff of the maximum heart dose was 27.0 Gy in patients who received anthracycline and 29.3 Gy in those who did not.</p><p><strong>Conclusions: </strong>Among patients receiving pulmonary SBRT, the maximum heart radiation dose, the use of anthracycline drugs and hypertension are independently associated with the occurrence of early RIHD. These findings could be applied to predict early RIHD and screen for high-risk patients. Individualized cardiac dose limitations may be helpful in improving the long-term prognosis of pulmonary SBRT patients.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"14"},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200394","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":"Prognostic significance of right ventricular dysfunction in heart failure with preserved ejection fraction: a meta-analysis of reconstructed time-to-event data.","authors":"Roozbeh Narimani-Javid, Mehrdad Mahalleh, Kiyarash Behboodi, Kasra Izadpanahi, Alireza Arzhangzadeh, Reza Nikfar, Seyed Ali Hosseini, Ehsan Amini-Salehi, Sasan Shafiei, Hamed Vahidi, Kaveh Hosseini, Hamidreza Soleimani","doi":"10.1186/s44156-025-00080-5","DOIUrl":"10.1186/s44156-025-00080-5","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of Heart failure with preserved ejection fraction (HFpEF) is significantly impacted by the existence and severity of comorbidities. Recent studies highlight the right ventricle (RV) as a crucial player in heart failure pathophysiology. However, there are still gaps in understanding how right ventricular dysfunction (RVD) affects long-term outcomes in patients with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Materials and methods: </strong>In this systematic review and meta-analysis, a comprehensive search was conducted to identify studies investigating RVD as the predictor of the composite outcome of All-cause death, cardiac death, and hospitalization for HF in patients with HFpEF published until October 2024. RVD was defined as the deviation of at least one measurement of RV function from the recommended normal range based on modality and the normal ranges established in each study. Time and survival probability were extracted for each Group (HFpEF patients with and without RVD) in each of the Kaplan-Meier curves. Individual patient data were reconstructed by processing the extracted time points, survival probabilities, and the number of patients at risk in a two-stage approach. The restricted mean survival time (RMST) was also calculated as the area under the survival curve for each group.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria, comprising 1936 individuals, of which 555 patients had RVD. The pooled prevalence of RVD among HFpEF was 41.2% (95% CI: 36.5; 45.9). Patients with RVD had a significantly higher risk of adverse outcomes compared to those without RVD, with an HR of 2.28 (95% CI, 1.95; 2.68, p-value < 0.001) in the eight-year follow-up after the RVD diagnosis. The one-year landmark analysis revealed that the majority of the event-free survival disparity between patients with RVD and those without arises from the first year after an RVD diagnosis. Patients with RVD also had shorter event-free survival. (ΔRMST = -2.127 years, 95% CI, -2.383; -1.872, p-value < 0.001).</p><p><strong>Conclusion: </strong>The development of RVD in HFpEF is linked to significantly increased composite outcomes of all-cause death and HF hospitalization and shorter event-free survival.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"13"},"PeriodicalIF":3.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174071","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":"Standing transthoracic echocardiography: a feasibility study.","authors":"Stephen P Juraschek, Noelle Ojo, Janet Monroe, Jordan B Strom, Jessica Stout, Warren J Manning, Ruth-Alma N Turkson-Ocran, Gabrielle Kolaci, Kaitlynn Geier, Carla Baptista, Araina Picanzo, Kenneth J Mukamal, Jason D Matos","doi":"10.1186/s44156-025-00075-2","DOIUrl":"10.1186/s44156-025-00075-2","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) is associated with cardiovascular disease, particularly among older adults. While a standing transthoracic echocardiogram (TTE) could theoretically identify changes in cardiac output to diagnose cardiogenic OH, there are no established protocols for orthostatic TTEs and their feasibility is unknown.</p><p><strong>Methods and results: </strong>We recruited 115 patients scheduled for elective outpatient TTE. Consenting participants, who were able to stand safely, underwent their scheduled recumbent TTE, followed by a standing TTE, performed within 1-2 minutes of standing. The focused TTE used the apical window to measure velocity time integral across the aortic valve to assess cardiac output. Blood pressure (BP) was measured in the supine and standing positions and patients were asked about symptoms of dizziness and lightheadedness. OH was defined as a change in standing minus supine systolic BP ≤-20 mm Hg or in diastolic BP of ≤-10 mm Hg. Of the 115 enrolled participants, 102 (89%) completed the standing echocardiogram protocol. Among those completing, mean age was 63.4 (SD, 14.8) years (38% were ≥ 70 years), 48% women, and 34% had a BMI ≥ 30 kg/m². There were 21% with OH. Upon standing, systolic BP changed by -5.9 mm Hg (95% CI: -9.5, -2.2), diastolic BP by 2.4 mm Hg (-0.1, 4.8), and cardiac output by -0.4 L/min (95% CI: -0.7, -0.1). Change in cardiac output (per 1 L/min) was associated with a higher odds of systolic OH (OR: 1.60; 95% CI: 1.05, 2.42), but not diastolic OH (OR: 1.21; 95% CI: 0.63, 2.32).</p><p><strong>Conclusions: </strong>Standing TTE is safe, well-tolerated, and feasible in the ambulatory setting. Moreover, TTE changes in cardiac output are associated with systolic OH. This clinical assessment shows promise for distinguishing OH etiologies and could inform further research on treatments to prevent OH.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"12"},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102984","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}