Echo Research and Practice最新文献

{"title":"Contemporary review of stress echocardiography workforce within the UK: an EVAREST/BSE NSTEP study.","authors":"James Willis, Casey L Johnson, Samuel Krasner, William Woodward, Annabelle McCourt, Cameron Dockerill, Katrin Balkhausen, Badrinathan Chandrasekaran, Attila Kardos, Nikant Sabharwal, Soroosh Firoozan, Rizwan Sarwar, Roxy Senior, Rajan Sharma, Kenneth Wong, Maria Paton, Jamie O'Driscoll, David Oxborough, Keith Pearce, Shaun Robinson, Adora Mo Wah Yau, Daniel X Augustine, Paul Leeson","doi":"10.1186/s44156-025-00088-x","DOIUrl":"10.1186/s44156-025-00088-x","url":null,"abstract":"<p><strong>Background: </strong>Stress echocardiography is a key imaging modality for assessing coronary artery disease in the UK. Traditionally, stress echo services were led by consultant cardiologists, but evolving workforce models have increased the involvement of cardiac physiologists and scientists. This study, as part of the National Review of Stress Echocardiography Practice (BSE N-STEP), aimed to evaluate current stress echo workforce structures and test outcomes across a group of UK hospitals to inform future workforce planning.</p><p><strong>Results: </strong>Data were analysed from 8506 stress echocardiograms, conducted between September 2020 and June 2023 across 34 UK hospitals. Based on the supervising workforce, stress echocardiograms were allocated into either a doctor-led (DL) or cardiac physiologist/scientist and nurse-led (CNL) model. 56.9% of stress echocardiograms were DL, while 42.7% were conducted under a CNL model. Physiologists/scientists were the most frequently involved staff (81.9%). The primary indication for stress echocardiography was ischaemia evaluation (89.4%). Dobutamine stress echocardiography was more common in DL services (63.0 vs. 56.3%, p < 0.001), while CNL services performed more exercise stress echocardiography (42.8 vs. 36.4%, p < 0.001). Test positivity rates were similar between DL and CNL models (17.1 vs. 17.7%, p = ns), though the CNL group had a lower complication rate (2.2 vs. 5.3%, p < 0.001). Reporting of stress echocardiograms remained consultant-led in 82% of cases, but physiologist/scientist-led reporting showed an increase over time. Training was primarily provided to registrars/fellows (60.2%), with physiologist/scientist trainees accounting for 32.4%.</p><p><strong>Conclusions: </strong>This study provides a contemporary overview of stress echocardiography workforce models in the UK, highlighting the increasing role of cardiac physiologists and scientists in supervising and reporting stress echocardiography. Despite these shifts, consultant cardiologists remain central to stress echo reporting. The findings support the integration of multidisciplinary workforce models to enhance service efficiency. These insights will aid in future workforce planning and training strategies to optimise stress echocardiography service provision across the NHS.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"22"},"PeriodicalIF":2.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259618","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":"Enhancing heart valve disease surveillance: a quality improvement project demonstrating cost-effective triaging and Clinical Scientist-led services to improve patient care.","authors":"Emily King, Richard Clements, Nathan Proudlove","doi":"10.1186/s44156-025-00096-x","DOIUrl":"10.1186/s44156-025-00096-x","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"30"},"PeriodicalIF":2.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259613","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":"Inter-technique agreement of left atrial and ventricular deformation analysis: a comparison between transthoracic echocardiography and cardiovascular magnetic resonance imaging.","authors":"Aseel Alfuhied, Jian L Yeo, Gaurav S Gulsin, Abhishek Dattani, Kelly Parke, Christopher D Steadman, Manjit Sian, Anna-Marie Marsh, Gerry P McCann, Anvesha Singh","doi":"10.1186/s44156-025-00090-3","DOIUrl":"10.1186/s44156-025-00090-3","url":null,"abstract":"<p><strong>Background: </strong>Myocardial strain measurements are increasingly used in research and clinical practice. However, there are limited data on inter-modality agreement and reproducibility. We aimed to investigate the inter-technique agreement of transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging derived left atrial (LA) and left ventricular (LV) deformation parameters.</p><p><strong>Methods: </strong>Subjects with or without cardiovascular disease were prospectively recruited and had TTE and CMR on the same day. Ten subjects with type 2 diabetes (T2D) had both scans repeated within two weeks for test-retest reproducibility assessment. Myocardial deformation analyses were undertaken including LA strain (LAS) corresponding to LA reservoir, conduit and booster pump phases, LV global longitudinal strain (GLS) and peak early/late diastolic strain rate (PE/PLDSR) and LV mid-circumferential strain (Mid-CS) and strain rates.</p><p><strong>Results: </strong>222 participants (T2D (n = 87); severe aortic stenosis (n = 78) and healthy volunteers (n = 57)) were included. There were no significant differences between TTE and CMR measured LAS parameters, with moderate agreement between imaging modalities (ICC = 0.55-0.69). LV parameters were significantly higher on CMR except for Mid-CS which was higher on TTE (-19.3 ± 3.19 vs. -23.0 ± 4.37; p < 0.001). Inter-technique agreement was poor for all LV deformation parameters, except PLDSR with modest agreement (ICC = 0.52-0.66). CMR test-retest reproducibility was good to excellent for LAS and LV strain rate parameters (ICC = 0.73-0.90). TTE test-retest reproducibility was good for conduit LAS and LV_PEDSR (ICC = 0.80).</p><p><strong>Conclusion: </strong>There is modest agreement between TTE and CMR for LAS and poor agreement for LV strain assessment, suggesting that these techniques cannot be used inter-changeably. In a small subset of participants CMR test-retest reproducibility was overall better than TTE.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"24"},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233801","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":"The value of evaluating cardiac damage in patients with aortic stenosis: a systematic review and meta-analysis.","authors":"Sadie Bennett, Eric Holroyd, Maria F Paton, Paul Leeson, Bjorn Redfors, Philippe Pibarot, Philippe Généreux, Chun Shing Kwok","doi":"10.1186/s44156-025-00089-w","DOIUrl":"10.1186/s44156-025-00089-w","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) is a common valvular heart disease where aortic valve replacement (AVR) is the only treatment. A novel staging system based on cardiac damage was developed to assess the pathophysiological consequence of AS and this has been shown to be associated with outcomes post AVR.</p><p><strong>Methods: </strong>We conducted a systematic review of studies which evaluated cardiac damage in patients with AS. A search of MEDLINE and EMBASE was performed with data being extracted from relevant studies. The main outcome of interest were proportion of AS patients with signs of cardiac damage, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events.</p><p><strong>Results: </strong>A total of 18 studies were included with 21,876 patients (mean age 79 years, 52.7% males). Pooled analysis indicated 76% of symptomatic severe AS patients and 88% of asymptomatic moderate/severe AS patients had signs of cardiac damage, with stage two being the most commonly reported (25.1% and 32.3% respectively). For symptomatic severe AS patients, the pooled all-cause mortality and cardiovascular mortality rates increased along an increase in cardiac damage stage from 9.4% to 2.0% respectively for stage 0 to 24.2% and 36.1% respectively for stage 4. In patients with asymptomatic moderate / severe AS, all-cause mortality ranged from 30.0% in stage 0 to 51.2% in stage 3/4. In patients with symptomatic severe AS undergoing AVR, meta-analysis indicated an increase in odds of cardiovascular related mortality for stage 4 cardiac damage only (OR 6.89, 95% CI: 3.04,15.61, p = 0.003). An increased odds of all-cause mortality was seen in for cardiac damage stages 1, 3 and 4 (OR 1.4, 95%CI: 1.10,1.77, p = 0.01, OR 2.27, 95%CI: 1.76,2.92, p = 0.0002 and OR 2.94, 95%CI: 1.97,4.38, p = 0.0006 respectively).</p><p><strong>Conclusions: </strong>Cardiac damage is a common finding amongst patients with AS irrespective of AS severity or symptomatic status. Mortality rates appear to increase alongside an increase in cardiac damage staging. Cardiac damage may provide prognostic valve when considering the timing of AVR with left ventricular and right ventricular abnormalities being associated with increased odds of mortality.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"29"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193541","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":"Left ventricular myocardial strain in neonates is influenced by the definition of the basal region of interest.","authors":"Tom Roar Omdal, Umael Khan, Britt Engan, Lars Sandve Oppedal, Jörg Kessler, Cathrine Ebbing, Knut Matre, Elisabeth Leirgul, Gottfried Greve","doi":"10.1186/s44156-025-00093-0","DOIUrl":"10.1186/s44156-025-00093-0","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"28"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187035","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":"Imaging application in ventricular arrhythmia of ischemic cardiomyopathy: diagnosis, treatment and prognosis.","authors":"Fengli Hu, Ting Tang, Pengfei Wang, Guoqiang Gu, Ling Xue","doi":"10.1186/s44156-025-00082-3","DOIUrl":"10.1186/s44156-025-00082-3","url":null,"abstract":"<p><p>Ventricular arrhythmia (VA) is one of the common complications of many heart diseases in clinical practice, even some of its clinical symptoms are mild and non-specific, but the other may lead to sudden cardiac death (SCD) and most life-threatening VA is associated with ischemic cardiomyopathy (ICM). Nowadays, the developments in imaging techniques have provided clues to identify these highly variable VAs, which make clinicians identify patients with VA early and effectively who may have fatal consequences. Thereafter, it is beneficial to manage the risk stratification of patients, optimize their follow-up treatment, and improve clinical outcomes. This article reviews current ultrasound and magnetic resonance imaging techniques that can aid in diagnosis, treatment and prognosis, and provides clinicians with practical imaging and analytical recommendations to further identify patients with ICM who may develop VA. Clinical trial number Not applicable.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"27"},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114519","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":"Pathological post-systolic shortening as a prognostic marker for major cardiovascular events in patients with type 2 diabetes.","authors":"Lina Hult, David Kylhammar, Jan Engvall, Carl Johan Östgren, Fredrik Nyström, Peter Blomstrand, Kristofer Hedman","doi":"10.1186/s44156-025-00085-0","DOIUrl":"10.1186/s44156-025-00085-0","url":null,"abstract":"<p><strong>Background: </strong>Post-systolic shortening (PSS) has emerged as a method for evaluating left ventricular dysfunction. We aimed to determine whether pathological PSS, alone or in combination with global longitudinal strain (GLS), is a prognostic factor for major adverse cardiovascular events (MACEs) in patients with type 2 diabetes. We prospectively investigated 364 patients with type 2 diabetes aged 55-65 years in the CARDIPP study. All patients underwent echocardiography between 2005 and 2009. PSS, measured by speckle tracking echocardiography, was defined as myocardial contraction after aortic valve closure. Pathological PSS was defined as a post-systolic index > 5% and was calculated as follows: [(maximum longitudinal strain - peak systolic longitudinal strain)/(maximum longitudinal strain)]. The endpoint was any MACE, defined as hospitalization or death due to heart failure, myocardial infarction, or stroke. Cox proportional hazard ratios (HR) with 95% confidence intervals (CI) were calculated and adjusted for sex, age, body mass index, hypertension, smoking, previous cardiovascular events, and HbA1c level. The mean follow-up time was 11.2 ± 2.3 years.</p><p><strong>Results: </strong>Pathological PSS was associated with an increased risk of MACEs after adjustment for other cardiovascular risk factors (HR 2.20, 95% CI 1.11-4.37). Subjects with reduced GLS, PSS and GLS combined in a risk prediction model, had an adjusted HR for MACEs of 2.94 (95% CI 1.33-6.52).</p><p><strong>Conclusions: </strong>Our results suggest that PSS may provide additional prognostic information for patients with T2D when used alone or in combination with GLS.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"21"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973550","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":"Clinical research and trials in echocardiography: rationale, requirements and future opportunities.","authors":"Casey L Johnson, Ross Upton, Samuel Krasner, Sadie Bennett, Ashley Ackerman, Xing Liu, Daniel X Augustine, Maria F Paton, Paul Leeson","doi":"10.1186/s44156-025-00083-2","DOIUrl":"10.1186/s44156-025-00083-2","url":null,"abstract":"<p><p>Echocardiography has established itself as a vital component in the diagnosis and management of cardiovascular disease, evolving alongside advancements in imaging technology and clinical research methodologies. Since its inception in the 1950s, echocardiographic research has progressed from small-scale, observational studies to large cohort investigations and randomised controlled trials. This evolution has paralleled advancements in disease diagnosis and facilitated the use of echocardiography as an important player in other disciplines such as cardio-oncology and interventional cardiology. Echocardiography research has made great progress, with new developments rapidly shaping the field. This continued innovation underscores the singular focus of improving patient care. As digital and technological advancements accelerate, the potential for research in echocardiography to enhance diagnostic precision, guide personalised treatment, and improve outcomes on a global scale is greater than ever. Collaborative efforts and sustained investment in research will be key to realising these goals and advancing the care of patients with cardiovascular disease. This review explores the historical and ongoing contributions of echocardiography research to better understanding cardiac disease, emphasising the pivotal roles of early feasibility studies and large-scale trials in refining techniques and establishing clinical utility. Key infrastructure requirements for advancing echocardiography research are identified, including workforce development, academic and healthcare collaborations, clinical trial support, and access to big data and computational expertise. Emerging technologies, such as advanced imaging techniques, handheld devices, and AI-driven analytics, are highlighted as transformative tools poised to address current limitations in clinical practice.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"20"},"PeriodicalIF":2.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817836","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776447","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":"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}