Echo Research and Practice最新文献

{"title":"Determinants of outcome in atrial functional tricuspid regurgitation.","authors":"Jawza Aldakhil, Kush Patel, Sveeta Badiani, Steffen E Petersen, Guy Lloyd, Sanjeev Bhattacharyya","doi":"10.1186/s44156-026-00140-4","DOIUrl":"10.1186/s44156-026-00140-4","url":null,"abstract":"<p><strong>Background: </strong>Atrial functional tricuspid regurgitation (AFTR) is increasingly recognized as a result of atrial remodelling in patients with atrial fibrillation (AF). However, prognostic predictors in this population remain incompletely defined.</p><p><strong>Objectives: </strong>To evaluate echocardiographic characteristics and identify predictors of all-cause mortality in patients with AFTR.</p><p><strong>Methods: </strong>We retrospectively studied consecutive patients with AF who underwent transthoracic echocardiography between 2017 and 2025. Inclusion required significant right atrial remodelling, defined as a right atrial area > 25 cm². Patients with at least moderate functional tricuspid regurgitation comprised the AFTR cohort, while patients with mild/trivial/no tricuspid regurgitation served as controls. Patients with primary valvular disease, cardiomyopathy, congenital heart disease, device-related valve disease, RV dilatation, or more than mild RV systolic dysfunction were excluded. Cox proportional hazards regression was performed to identify predictors of mortality.</p><p><strong>Results: </strong>A total of 152 patients were included, comprising 120 patients with AFTR and 32 controls. Compared with controls, patients with AFTR demonstrated larger atrial dimensions, higher right-sided hemodynamic-burden, impaired RV longitudinal strain, and reduced reservoir RA strain. During a median follow-up of 6.3 years, 53 deaths (45%) occurred among patients with AFTR. In univariable Cox analysis, age (HR 1.02, 95% CI 1.00-1.04; p = 0.016), TR Vmax (HR 1.59, 95% CI 1.07-2.35; p = 0.020), and lower reservoir RA strain (HR 0.90, 95% CI 0.84-0.96; p = 0.003) were associated with mortality. In multivariable analysis, reservoir RA strain remained independently associated with mortality (adjusted HR 0.88, 95% CI 0.81-0.95; p < 0.001).</p><p><strong>Conclusion: </strong>AFTR is characterized by marked biatrial remodelling and impaired right atrial function. Reduced RA reservoir strain was independently associated with mortality, supporting a potential role for RA deformation imaging in risk stratification in AFTR.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220897","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":"The effect of different exercise modalities on the maximal left ventricular outflow tract gradient in patients with obstructive hypertrophic cardiomyopathy.","authors":"Maximilian Nicolas Möbius-Winkler, Andreas Hagendorff, Stephan Stöbe, Michael Gaier, Alexander Kogel, Marios Antoniadis, Ulrich Laufs, Michael Metze, Karsten Lenk, Joscha Kandels","doi":"10.1186/s44156-026-00141-3","DOIUrl":"10.1186/s44156-026-00141-3","url":null,"abstract":"<p><strong>Background: </strong>Assessment of maximally provoked LVOT obstruction (LVOTO) guides treatment decisions in obstructive hypertrophic cardiomyopathy (HCM). Guidelines recommend various maneuvers, with exercise stress echocardiography (ESE) as the preferred method if others fail. Comparative data are limited. Therefore, in this prospective study, 20 patients with obstructive HCM underwent transthoracic echocardiography (TTE) with continuous wave Doppler measuring LVOT gradients at rest, during the Valsalva maneuver, handgrip exercise at 30% and 50% of maximal hand force, squats, and bicycle ESE, with the aim of comparing commonly used maneuvers and evaluating handgrip exercise as a potential alternative for eliciting LVOTO.</p><p><strong>Results: </strong>The mean resting LVOT gradient was 38.9 ± 31.4 mmHg. Handgrip exercise caused no significant change of LVOT gradients. In contrast, gradients increased markedly during the Valsalva maneuver (98.9 ± 52.8 mmHg), squats (120.3 ± 68.8 mmHg), and bicycle ESE (83.4 ± 43.3 mmHg; p < 0.001 vs. rest). There was no significant difference between Valsalva, squats, and ESE (p = NS). Squats induced the maximal gradient in 50% of patients. Performance time was significantly shorter for the Valsalva maneuver (15 s) and squats (1 min 23 s ± 28 s) than for bicycle ESE (15 min 54 s ± 5 min 46 s; p < 0.01).</p><p><strong>Conclusion: </strong>The Valsalva maneuver, squats, and bicycle ESE are equally effective in provoking LVOTO, whereas handgrip exercise is not. Given their simplicity, low cost, and shorter testing time, squats may serve as a practical adjunct to the Valsalva maneuver for LVOT gradient provocation in routine clinical assessment of obstructive HCM.</p><p><strong>Clinical trial registration: </strong>German Clinical Trials Register (ID: DRKS00034473).</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170551","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":"Multi-valvular burden score and one-year mortality in ICU patients undergoing echocardiography: an exploratory cohort study.","authors":"Hasan Burak Isleyen, Sevil Tugrul Yavuz, Sercan Bulut, Fatih Kizkapan, Cevahir Alioglu, Ali Arda Sozen, Mahsa Khanmohammadi","doi":"10.1186/s44156-026-00139-x","DOIUrl":"https://doi.org/10.1186/s44156-026-00139-x","url":null,"abstract":"<p><strong>Background: </strong>Multiple regurgitant lesions coexist in critically ill patients, yet cohort-level analyses typically represent each valve separately. We evaluated whether a Multi-Valvular Burden (MVB) score could summarize regurgitant involvement and whether its prognostic information differed from models retaining individual valve grades.</p><p><strong>Methods: </strong>This retrospective cohort used MIMIC-IV v3.1 linked with MIMIC-IV-ECHO. Adults with an ICU admission and complete ordinal grading of tricuspid, mitral, and aortic regurgitation on an index echocardiogram within 72 h of ICU admission were included. MVB was the arithmetic sum of TR, MR, and AR grades (0-12). Cox models assessed 1-year all-cause mortality. Additional analyses compared MVB with separate valve-grade models, tested a high-burden definition requiring MVB > = 4 and at least two involved valves, used missing-aware AS/MS evidence proxies, and examined LVEF with structured RV-function classification.</p><p><strong>Results: </strong>The cohort included 5,362 patients; 1,979 (36.9%) died within 1 year. Mortality increased from 24.6% at MVB 0 to 47.4% at MVB > = 4. After clinical adjustment, continuous MVB remained associated with mortality (HR 1.07 per point, 95% CI 1.05-1.09; P < 0.001), and MVB > = 4 was associated with higher mortality (HR 1.35, 95% CI 1.22-1.48; P < 0.001). The high-burden category predominantly reflected multivalve involvement: 2,206 of 2,257 patients with MVB > = 4 had at least two affected valves. A model with separate TR, MR, and AR grades showed similar discrimination to the MVB model (C-index 0.7585 vs. 0.7582). Incremental discrimination over the clinical model was small (C-index 0.7543 to 0.7582; delta 0.0039), although likelihood-ratio improvement was statistically significant (chi-square 50.61; P < 0.001). MVB remained associated with mortality in the missing-aware AS/MS sensitivity model (HR 1.07, 95% CI 1.05-1.09) and the LVEF/structured RV-function subset (HR 1.05, 95% CI 1.03-1.08).</p><p><strong>Conclusions: </strong>MVB is an exploratory summary marker rather than an outcome-derived or mechanistic weighting system. Its near-identical discrimination to a model retaining individual valve grades and very modest incremental discrimination suggest that it is best viewed as a compact descriptive marker of broader cardiovascular burden within systemic critical illness, not as a stand-alone clinical decision tool or evidence of a causal pathway to mortality.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116330","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":"Echocardiographic assessment of pulmonary hypertension: a hierarchical interpretive framework for clinical decision-making and echo laboratory practice.","authors":"Aditya Shrivastav, Suhas Tivaskar, Anurag Luharia, Shantanu Gomase, Ranjana Lanjewar","doi":"10.1186/s44156-026-00138-y","DOIUrl":"10.1186/s44156-026-00138-y","url":null,"abstract":"<p><strong>Background: </strong>Echocardiography is central to the evaluation of pulmonary hypertension (PH), yet interpretation of echocardiographic findings remains challenging because non-invasive estimation of pulmonary pressures and right ventricular function is inherently imperfect. Although contemporary guidelines provide structured probability-based assessment, the growing number of available echocardiographic parameters has increased interpretive complexity, particularly in routine echocardiography laboratories where findings must be integrated within diverse clinical contexts.</p><p><strong>Main body: </strong>This narrative review synthesises contemporary echocardiographic parameters used in PH across key clinical applications, including screening, probability assessment, phenotyping, risk stratification, and longitudinal monitoring. Rather than cataloguing individual measurements, the review examines how pressure estimation, right ventricular structure and function, ventricular interaction, right atrial pressure surrogates, and integrative markers contribute differently according to the clinical question being addressed. Particular emphasis is placed on technical limitations, common sources of measurement uncertainty, and potential discordance with invasive haemodynamic assessment. Building on this synthesis, we propose a hierarchical, decision-oriented interpretive framework designed to support routine echocardiography laboratories by organising existing echocardiographic findings according to clinical purpose and interpretive confidence. The framework emphasises multiparametric integration, internal consistency, contextual interpretation, and transparent communication of uncertainty while complementing established guideline-based probability assessment.</p><p><strong>Conclusion: </strong>A hierarchical interpretive approach positions echocardiography as a staged component of the broader pulmonary hypertension diagnostic and monitoring pathway rather than as a standalone diagnostic test. By supporting structured reporting, contextual interpretation, and consistent communication of uncertainty, the proposed framework complements existing international guidelines and may facilitate more consistent application of echocardiographic findings within routine clinical practice.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070370","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":"Correction: Agitated Saline Contrast Echocardiography in the diagnosis of right to left shunts: Guidance and recommendations from the British Society of Echocardiography.","authors":"Bushra Rana, Shaun Robinson, Liam Ring, Dave Oxborough, Mark Belham, Jim Newton, Alfa Ali, Nilesh Sutaria, Nina Bual, Martin Swaans, Nina Wunderlich, Victoria Delgado, David Northridge, Dave Hildick-Smith, Neil Ruparelia, Mark Turner, Michael Mullen, Chris Baker, Brian Clapp, Mark Spence, Horst Sievert, Iqbal Malik, Roxy Senior, Anjana Siva","doi":"10.1186/s44156-026-00128-0","DOIUrl":"10.1186/s44156-026-00128-0","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064971","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 significance of resting and dobutamine stress myocardial work in cirrhotic cardiomyopathy.","authors":"Jeyamani Ramachandran, Purendra Kumar Pati, Fadak Mohammadi, Majo Jospeh, Teresa Hecker, Mohamed Asif Chinnaratha, James Gunton, Kate Muller, Matthew Chapman, Richard Woodman, Alan Wigg","doi":"10.1186/s44156-026-00136-0","DOIUrl":"10.1186/s44156-026-00136-0","url":null,"abstract":"<p><strong>Background: </strong>Myocardial work (MW), an emerging measure of cardiac function, has not been assessed in cirrhotic cardiomyopathy (CCM) unlike global longitudinal strain (GLS).</p><p><strong>Aims: </strong>To evaluate MW in cirrhosis with transthoracic echocardiography (TTE) and dobutamine stress echocardiography (DSE); to study association of MW and CCM with a composite study outcome (one or more of acute kidney injury/hepatorenal syndrome, refractory ascites, cardiac failure, death); to assess the utility of cardiac biomarkers (NT-pro-BNP and cardiac troponin T) in the diagnosis of CCM; and to re-assess cardiac function at 12 months of LT.</p><p><strong>Methods: </strong>Design: Prospective study.</p><p><strong>Participants: </strong>Decompensated liver cirrhotic patients with ascites and those undergoing liver transplant (LT) assessment from January 2021 to August 2022 with a 12-month follow-up.</p><p><strong>Study: </strong>TTE- and DSE-reported systolic and diastolic parameters as well as GLS and MW indices were calculated.</p><p><strong>Results: </strong>96 patients, mean ± SD age 56 ± 11 years (58% male; 59% alcohol misuse) with Model for End-stage Liver Disease Sodium (MELD-Na) 17 ± 7 were studied. During the follow-up, 16 underwent LT; 53 developed the study outcome. CCM was diagnosed in 26 (27%), and it had no association with study outcome. MW was decreased in patients with CCM, and there was no augmentation of GLS or MW on DSE. MELD-Na. GLS, MW indices and septal E/e' were higher in patients meeting the study outcome. MELD-Na and septal E/e' were independent predictors of the study outcome. There was no association between biomarkers and CCM. Ten patients evaluated post LT demonstrated significant reductions in GLS and MW.</p><p><strong>Conclusions: </strong>MW was decreased in patients with CCM. Neither MW indices nor a diagnosis of CCM was predictive of the study outcome. Liver disease severity measured by MELD-Na score and E/e' were independent predictors of the study outcome. Although MW is a load-independent measure, in this study, it did not add to the diagnosis CCM more than GLS. Further large-scale studies are required to establish the role of MW in evaluation of patients with liver cirrhosis.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963928","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":"Artificial intelligence-based prediction of procedural success in transcatheter mitral valve edge-to-edge repair.","authors":"Mathias Claeys, Neil Fam, Xiaojiao Xiao, Tejas Vyas, Mohsena Chowdhury, Gordon Moe, Sami Alnasser, Patrick Prud'homme, Anas Merdad, Akshay Bagai, Kim A Connelly, Jeremy Edwards, Guanghui Wang, Géraldine Ong","doi":"10.1186/s44156-026-00134-2","DOIUrl":"10.1186/s44156-026-00134-2","url":null,"abstract":"<p><strong>Background: </strong>Patient selection for transcatheter mitral valve edge-to-edge repair (MTEER) remains challenging, particularly in individuals with complex mitral valve anatomy. Conventional risk scores incorporate limited clinical variables and do not adequately account for detailed echocardiographic features, resulting in suboptimal prediction of procedural success.</p><p><strong>Objectives: </strong>To develop and evaluate machine learning (ML) and deep learning (DL) models integrating clinical and echocardiographic data to predict procedural success following MTEER.</p><p><strong>Methods: </strong>Consecutive patients undergoing MTEER at a single tertiary center between 2014 and 2022 were retrospectively analyzed. Procedural success was defined as residual mitral regurgitation ≤ mild and mean mitral valve gradient < 5 mmHg at the end of the procedure. Pre-procedural transesophageal echocardiographic (TEE) videoclips were used to generate image datasets for ML and DL model training. Machine Learning algorithms (Decision Tree, Random Forrest, Gradient Boosting, k-Nearest Neighbors, Support Vector Machines) were used to predict the primary outcome from patient demographics and baseline TEE measurements. Inception, Xception, and MobileNet architectures were evaluated using 10-fold cross-validation with strict patient-level data separation. Model performance was assessed using accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among 467 included patients, procedural success was achieved in 90.7%. Deep learning models demonstrated superior performance compared with logistic regression and ML. The Xception architecture achieved the highest discriminatory ability (AUC 0.76), with favorable accuracy and sensitivity for predicting procedural success.</p><p><strong>Conclusions: </strong>Artificial intelligence has the potential to improve prediction of procedural outcomes following MTEER. Deep learning models that integrate echocardiographic imaging and clinical data can accurately predict procedural success and may enhance pre-procedural risk stratification, patient selection, and Heart Team decision-making.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901384","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":"First we feast: a narrative review of postprandial assessment of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.","authors":"Mahesh Chandrasekhar, Carolyn Park, Pamela Burgess, Richard Brandon Stacey","doi":"10.1186/s44156-026-00135-1","DOIUrl":"10.1186/s44156-026-00135-1","url":null,"abstract":"<p><strong>Background: </strong>Dynamic left ventricular outflow tract (LVOT) obstruction is a common and consequential feature of hypertrophic cardiomyopathy (HCM), present in a majority of patients at rest or with provocation, and it directly influences symptom burden and eligibility for therapy. When obstruction is absent at rest it can be provoked by physiologic stimuli, including the ingestion of a meal, a phenomenon patients have reported for decades. Whether postprandial assessment improves detection of obstructive physiology over conventional provocative testing has not been systematically examined.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Embase, the Cochrane Library, and Web of Science from inception through June 2025. Study quality was assessed with the Newcastle-Ottawa Scale. Because of substantial heterogeneity in study protocols and outcome definitions, we performed a narrative synthesis rather than a meta-analysis.</p><p><strong>Results: </strong>Seven studies met inclusion criteria, published between 1991 and 2024 across three countries. Across these studies, postprandial assessment consistently provoked higher LVOT gradients than fasting measurement and identified obstructive physiology in patients with no obstruction on conventional testing. In the most rigorous comparative study, postprandial echocardiography identified gradients ≥ 30 mmHg in 74% of patients with no resting obstruction, compared with 23% by Valsalva maneuver (p < 0.001). In the largest cohort (n = 252), postprandial testing identified gradients ≥ 50 mmHg in an additional 35.7% of patients who did not reach that threshold under routine conditions. Invasive hemodynamic data provide a mechanistic basis: meal ingestion reduced systemic vascular resistance and raised cardiac filling pressures, conditions that favor dynamic obstruction.</p><p><strong>Conclusions: </strong>Postprandial LVOT assessment identifies obstructive physiology that conventional provocative maneuvers miss. As approved medical therapies targeting LVOT obstruction reshape HCM management, accurate identification of the obstructive phenotype carries direct therapeutic consequences. Standardized multicenter validation is needed, but existing evidence supports consideration of postprandial testing in symptomatic patients who remain without obstruction on conventional assessment.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867170","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":"Echocardiographic characteristics of new-onset methamphetamine-associated heart failure: a retrospective cohort study.","authors":"Joey Chiang, Danelle Hidano, Heather Herren, Christopher T Longenecker, Mrinal Yadava, Cooper B Kersey","doi":"10.1186/s44156-026-00133-3","DOIUrl":"10.1186/s44156-026-00133-3","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine-associated heart failure (MAHF) is a growing cause of healthcare burden, yet the echocardiographic phenotype at the time of initial diagnosis is poorly characterized. We tested the hypothesis that new-onset MAHF exhibits a distinct echocardiographic phenotype that could aid in early disease identification.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study comparing echocardiographic parameters in patients with new-onset MAHF versus controls with non-ischemic cardiomyopathy unrelated to methamphetamine use. Patients with MAHF (n = 75) were identified by positive urine drug screen, ICD-10 codes for incident heart failure, and confirmed active methamphetamine use at index hospitalization. Controls were matched 1:1 by age, sex, and race. Pre-specified echocardiographic endpoints included left and right ventricular size and function, left ventricular thrombi, valvular dysfunction, and pulmonary artery systolic pressure.</p><p><strong>Results: </strong>The two groups showed no significant differences in echocardiographic parameters. Left ventricular ejection fraction (28%, 20-36% vs. 25%, 19-35%), left ventricular indexed end-diastolic volume (103 ml/m2, 79-130 ml/m2 vs. 94 ml/m2, 73-118 ml/m2), left atrial size, right ventricular size and function, diastolic parameters, pulmonary artery pressures, and prevalence of ventricular thrombi were all similar between groups.</p><p><strong>Conclusions: </strong>At the time of initial heart failure diagnosis, MAHF is indistinguishable by traditional echocardiographic parameters from other non-ischemic cardiomyopathies. The findings of this study differ from prior research into the echocardiographic phenotype of MAHF by focusing on the time of initial heart failure diagnosis, presumably when less adverse remodeling has occurred. These negative findings underscore that MAHF is a diagnosis of exclusion and a full work-up to assess for alternative etiologies of cardiomyopathy is paramount.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809197","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":"A structured 5-question approach for echocardiographic evaluation of undifferentiated shock.","authors":"Claire Colebourn, Richard Fisher","doi":"10.1186/s44156-026-00129-z","DOIUrl":"10.1186/s44156-026-00129-z","url":null,"abstract":"<p><p>Shock is the clinical state whereby the patient's circulation fails to meet the body's metabolic demands. Both acute illnesses that lead to shock and therapies employed to support the shocked patient (including intravenous fluids, vasoactive infusions and ventilatory support) may result in changes to the normal function of the heart. The conventional approach to interpretation of echocardiography in the steady physiological state needs modification when this test is applied to the shocked patient. In this paper we explain when and why modifications are required, and provide echocardiographers already established in outpatient practice with a practical approach to performing and reporting echocardiograms in shocked patients.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766398","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}