Echo Research and Practice最新文献

{"title":"British Society of Echocardiography guideline for the transthoracic echocardiographic assessment of cardiac amyloidosis.","authors":"William E Moody, Lauren Turvey-Haigh, Daniel Knight, Caroline J Coats, Robert M Cooper, Rebecca Schofield, Shaun Robinson, Allan Harkness, David L Oxborough, Julian D Gillmore, Carol Whelan, Daniel X Augustine, Marianna Fontana, Richard P Steeds","doi":"10.1186/s44156-023-00028-7","DOIUrl":"10.1186/s44156-023-00028-7","url":null,"abstract":"<p><p>These guidelines form an update of the BSE guideline protocol for the assessment of restrictive cardiomyopathy (Knight et al. in Echo Res Prac, 2013). Since the original recommendations were conceived in 2013, there has been an exponential rise in the diagnosis of cardiac amyloidosis fuelled by increased clinician awareness, improvements in cardiovascular imaging as well as the availability of new and effective disease modifying therapies. The initial diagnosis of cardiac amyloidosis can be challenging and is often not clear-cut on the basis of echocardiography, which for most patients presenting with heart failure symptoms remains the first-line imaging test. The role of a specialist echocardiographer will be to raise the suspicion of cardiac amyloidosis when appropriate, but the formal diagnosis of amyloid sub-type invariably requires further downstream testing. This document seeks to provide a focused review of the literature on echocardiography in cardiac amyloidosis highlighting its important role in the diagnosis, prognosis and screening of at risk individuals, before concluding with a suggested minimum data set, for use as an aide memoire when reporting.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"13"},"PeriodicalIF":6.3,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150270","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":"Three-dimensional printing in modelling mitral valve interventions.","authors":"Apurva H Bharucha,&nbsp;John Moore,&nbsp;Patrick Carnahan,&nbsp;Philip MacCarthy,&nbsp;Mark J Monaghan,&nbsp;Max Baghai,&nbsp;Ranjit Deshpande,&nbsp;Jonathan Byrne,&nbsp;Rafal Dworakowski,&nbsp;Mehdi Eskandari","doi":"10.1186/s44156-023-00024-x","DOIUrl":"https://doi.org/10.1186/s44156-023-00024-x","url":null,"abstract":"<p><p>Mitral interventions remain technically challenging owing to the anatomical complexity and heterogeneity of mitral pathologies. As such, multi-disciplinary pre-procedural planning assisted by advanced cardiac imaging is pivotal to successful outcomes. Modern imaging techniques offer accurate 3D renderings of cardiac anatomy; however, users are required to derive a spatial understanding of complex mitral pathologies from a 2D projection thus generating an 'imaging gap' which limits procedural planning. Physical mitral modelling using 3D printing has the potential to bridge this gap and is increasingly being employed in conjunction with other transformative technologies to assess feasibility of intervention, direct prosthesis choice and avoid complications. Such platforms have also shown value in training and patient education. Despite important limitations, the pace of innovation and synergistic integration with other technologies is likely to ensure that 3D printing assumes a central role in the journey towards delivering personalised care for patients undergoing mitral valve interventions.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"12"},"PeriodicalIF":6.3,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307438","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":"Feasibility of 2-dimensional speckle tracking echocardiography strain analysis of the right ventricle with trans-thoracic echocardiography in intensive care: a literature review and meta-analysis.","authors":"James McErlane,&nbsp;Ben Shelley,&nbsp;Philip McCall","doi":"10.1186/s44156-023-00021-0","DOIUrl":"https://doi.org/10.1186/s44156-023-00021-0","url":null,"abstract":"<p><strong>Objectives: </strong>To identify variables that affect the feasibility of 2-dimensional right ventricular speckle tracking echocardiography (RV-STE) in the intensive care unit.</p><p><strong>Background: </strong>Trans-thoracic echocardiography (TTE) of the right ventricle is challenging. RV-STE is a novel echocardiography method thought to measure global RV function more fully than conventional TTE parameters. The feasibility of RV-STE in ICU populations has not been well described, and variables influencing RV-STE in ICU have not been investigated. This study aimed to address this.</p><p><strong>Methods: </strong>A literature review using Ovid MEDLINE(R) was undertaken. We performed meta-analysis with subgroup analysis of; RV-STE type (RV free-wall [RVFWLS] versus RV global longitudinal strain [RVGLS]), study design (prospective versus retrospective), coronavirus disease-19 (COVID-19) study or not, and strain software used. This was followed by meta-regression of proportion of invasive mechanical ventilation (IMV), with and without COVID-19 studies as a co-variate.</p><p><strong>Results: </strong>Eleven relevant studies from the literature search were identified, reporting an overall feasibility of RV-STE of 83.3% (95%CI 74.6-89.4%). Prospective study design was associated with higher feasibility compared with retrospective studies (p = 0.02). There were no statistical differences on univariate analysis between RVFWLS versus RVGLS, COVID-19 study or not, or strain software used. Meta-regression with COVID-19 study as a covariate demonstrated that higher proportions of IMV were significantly associated with worse feasibility (p = 0.04), as were COVID-19 studies (p < 0.01).</p><p><strong>Conclusions: </strong>We have identified three variables associated with poor feasibility; retrospective study design, COVID-19 studies, and proportion of IMV. A prospective study design should be viewed as gold standard to maximise RV-STE feasibility.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"11"},"PeriodicalIF":6.3,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840233","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":"Semi-automated quantification of tricuspid valve dynamics and structure in tetralogy of Fallot and hypoplastic left heart syndrome using three-dimensional echocardiography.","authors":"Vivek Jani,&nbsp;Ling Li,&nbsp;Mary Craft,&nbsp;Federico Veronesi,&nbsp;Nee Khoo,&nbsp;David Danford,&nbsp;Denisa Muraru,&nbsp;Shelby Kutty","doi":"10.1186/s44156-023-00023-y","DOIUrl":"https://doi.org/10.1186/s44156-023-00023-y","url":null,"abstract":"<p><p>Anomalies of the tricuspid valve (TV) are associated with worsened prognosis in congenital heart disease (CHD). Here, we present a descriptive study examining changes in TV morphology in two CHD conditions-repaired tetralogy of Fallot (rTOF) and hypoplastic left heart syndrome (HLSH), using three-dimensional echocardiography. Full volume acquisitions of the TV and right ventricle (RV) were performed from an RV-focused apical view using ECG gating over 2-5 consecutive cardiac cycles using 3D echocardiography, from which TV annulus and leaflet parameters were quantified. A total of 40 rTOF patients (age 14 ± 9.8 years), 40 HLHS patients (age1.0 ± 1.5 years) and 80 age and gender matched controls were included. Among leaflet parameters, antero-posterior and posterior-septal TV coaptation heights were smaller in rTOF (p < 0.001) vs. control. Conversely, only the short-axis TV height was different in HLHS vs. controls (HLHS 1.6 ± 0.4 cm vs. control 1.4 ± 0.3 cm). TV leaflet parameters tended to be larger in HLHS, while leaflet coaptation distances were similar between groups. We demonstrate that 3D echocardiography for assessment of the TV is feasible in rTOF and HLHS patients and identifies unique differences in TV morphology. Future studies should clarify the clinical significance of TV morphology in these patient populations.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"10"},"PeriodicalIF":6.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10324229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9806765","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":"Usefulness of the velocity-time integral of the left ventricular outflow tract variability index to predict fluid responsiveness in patients undergoing cardiac surgery.","authors":"Aldo Pérez-Manjarrez,&nbsp;Edgar García-Cruz,&nbsp;Rodrigo Gopar-Nieto,&nbsp;Gian Manuel Jiménez-Rodríguez,&nbsp;Emmanuel Lazcano-Díaz,&nbsp;Gustavo Rojas-Velasco,&nbsp;Daniel Manzur-Sandoval","doi":"10.1186/s44156-023-00022-z","DOIUrl":"https://doi.org/10.1186/s44156-023-00022-z","url":null,"abstract":"<p><strong>Background: </strong>Haemodynamic monitoring of patients after cardiac surgery using echocardiographic evaluation of fluid responsiveness is both challenging and increasingly popular. We evaluated fluid responsiveness in the first hours after surgery by determining the variability of the velocity-time integral of the left ventricular outflow tract (VTI-LVOT).</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 50 consecutive adult patients who underwent cardiac surgery and in whom it was possible to obtain VTI-LVOT measurements. We then determined the variability and correlations with our pulse pressure variation (PPV) measurements to predict fluid responsiveness.</p><p><strong>Results: </strong>A strong positive correlation was seen between the VTI-LVOT variability index absolute values and PPV for predicting fluid responsiveness in the first hours after cardiac surgery. We also found that the VTI-LVOT variability index has high specificity and a high positive likelihood ratio compared with the gold standard using a cut-off point of ≥ 12%.</p><p><strong>Conclusions: </strong>The VTI-LVOT variability index is a valuable tool for determining fluid responsiveness during the first 6 postoperative hours in patients undergoing cardiac surgery.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"9"},"PeriodicalIF":6.3,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10105605","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":"Real world hospital costs following stress echocardiography in the UK: a costing study from the EVAREST/BSE-NSTEP multi-entre study.","authors":"Casey L Johnson,&nbsp;William Woodward,&nbsp;Annabelle McCourt,&nbsp;Cameron Dockerill,&nbsp;Samuel Krasner,&nbsp;Mark Monaghan,&nbsp;Roxy Senior,&nbsp;Daniel X Augustine,&nbsp;Maria Paton,&nbsp;Jamie O'Driscoll,&nbsp;David Oxborough,&nbsp;Keith Pearce,&nbsp;Shaun Robinson,&nbsp;James Willis,&nbsp;Rajan Sharma,&nbsp;Apostolos Tsiachristas,&nbsp;Paul Leeson","doi":"10.1186/s44156-023-00020-1","DOIUrl":"https://doi.org/10.1186/s44156-023-00020-1","url":null,"abstract":"<p><strong>Background: </strong>Stress echocardiography is widely used to detect coronary artery disease, but little evidence on downstream hospital costs in real-world practice is available. We examined how stress echocardiography accuracy and downstream hospital costs vary across NHS hospitals and identified key factors that affect costs to help inform future clinical planning and guidelines.</p><p><strong>Methods: </strong>Data on 7636 patients recruited from 31 NHS hospitals within the UK between 2014 and 2020 as part of EVAREST/BSE-NSTEP clinical study, were used. Data included all diagnostic tests, procedures, and hospital admissions for 12 months after a stress echocardiogram and were costed using the NHS national unit costs. A decision tree was built to illustrate the clinical pathway and estimate average downstream hospital costs. Multi-level regression analysis was performed to identify variation in accuracy and costs at both patient, procedural, and hospital level. Linear regression and extrapolation were used to estimate annual hospital cost-savings associated with increasing predictive accuracy at hospital and national level.</p><p><strong>Results: </strong>Stress echocardiography accuracy varied with patient, hospital and operator characteristics. Hypertension, presence of wall motion abnormalities and higher number of hospital cardiology outpatient attendances annually reduced accuracy, adjusted odds ratio of 0.78 (95% CI 0.65 to 0.93), 0.27 (95% CI 0.15 to 0.48), 0.99 (95% CI 0.98 to 0.99) respectively, whereas a prior myocardial infarction, angiotensin receptor blocker medication, and greater operator experience increased accuracy, adjusted odds ratio of 1.77 (95% CI 1.34 to 2.33), 1.64 (95% CI 1.22 to 2.22), and 1.06 (95% CI 1.02 to 1.09) respectively. Average downstream costs were £646 per patient (SD 1796) with significant variation across hospitals. The average downstream costs between the 31 hospitals varied from £384-1730 per patient. False positive and false negative tests were associated with average downstream costs of £1446 (SD £601) and £4192 (SD 3332) respectively, driven by increased non-elective hospital admissions, adjusted odds ratio 2.48 (95% CI 1.08 to 5.66), 21.06 (95% CI 10.41 to 42.59) respectively. We estimated that an increase in accuracy by 1 percentage point could save the NHS in the UK £3.2 million annually.</p><p><strong>Conclusion: </strong>This study provides real-world evidence of downstream costs associated with stress echocardiography practice in the UK and estimates how improvements in accuracy could impact healthcare expenditure in the NHS. A real-world downstream costing approach could be adopted more widely in evaluation of imaging tests and interventions to reflect actual value for money and support realistic planning.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"8"},"PeriodicalIF":6.3,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10230715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9617966","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":"Transthoracic Echocardiographic Assessment of the Heart in Pregnancy-a position statement on behalf of the British Society of Echocardiography and the United Kingdom Maternal Cardiology Society.","authors":"Stephanie L Curtis,&nbsp;Mark Belham,&nbsp;Sadie Bennett,&nbsp;Rachael James,&nbsp;Allan Harkness,&nbsp;Wendy Gamlin,&nbsp;Baskaran Thilaganathan,&nbsp;Veronica Giorgione,&nbsp;Hannah Douglas,&nbsp;Aisling Carroll,&nbsp;Jamie Kitt,&nbsp;Claire Colebourn,&nbsp;Isabel Ribeiro,&nbsp;Sarah Fairbairn,&nbsp;Daniel X Augustine,&nbsp;Shaun Robinson,&nbsp;Sara A Thorne","doi":"10.1186/s44156-023-00019-8","DOIUrl":"https://doi.org/10.1186/s44156-023-00019-8","url":null,"abstract":"<p><p>Pregnancy is a dynamic process associated with profound hormonally mediated haemodynamic changes which result in structural and functional adaptations in the cardiovascular system. An understanding of the myocardial adaptations is important for echocardiographers and clinicians undertaking or interpreting echocardiograms on pregnant and post-partum women. This guideline, on behalf of the British Society of Echocardiography and United Kingdom Maternal Cardiology Society, reviews the expected echocardiographic findings in normal pregnancy and in different cardiac disease states, as well as echocardiographic signs of decompensation. It aims to lay out a structure for echocardiographic scanning and surveillance during and after pregnancy as well as suggesting practical advice on scanning pregnant women.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"7"},"PeriodicalIF":6.3,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9420461","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":"Serial image interpretation tasks improve accuracy and increase confidence in Level 1 echocardiography reporting: a pilot study.","authors":"Richard Fisher,&nbsp;Amal Zayan,&nbsp;Jennifer Gosling,&nbsp;Joao Ramos,&nbsp;Mahmoud Nasr,&nbsp;David Garry,&nbsp;Alexandros Papachristidis,&nbsp;Francisca Caetano,&nbsp;Philip Hopkins","doi":"10.1186/s44156-023-00018-9","DOIUrl":"https://doi.org/10.1186/s44156-023-00018-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Focused echocardiography is increasingly used in acute and emergency care, with point-of-care ultrasound integrated into several specialist training curricula (e.g. Emergency Medicine, Cardiology, Critical Care). Multiple accreditation pathways support development of this skill but there is scant empirical evidence to inform selection of teaching methods, accreditation requirements or quality assurance of education in focussed echocardiography. It has also been noted that access to in-person teaching can be a barrier to completing accreditation programmes, and that this may affect learners disproportionately depending on the location or nature of their institution. The purpose of the study was to determine whether serial image interpretation tasks as a distinct learning tool improved novice echocardiographers' ability to accurately identify potentially life-threatening pathology from focused scans. We also aimed to describe the relationship between accuracy of reporting and participants' confidence in those reports, and to assess users' satisfaction with a learning pathway that could potentially be delivered remotely.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;27 participants from a variety of healthcare roles completed a program of remote lectures and 2 in-person study days. During the program they undertook 4 'packets' of 10 focused echocardiography reporting tasks (total = 40) based on images from a standardised dataset. Participants were randomized to view the scans in varying orders. Reporting accuracy was compared with consensus reports from a panel of expert echocardiographers, and participants self-reported confidence in their image interpretation and their satisfaction with the learning experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was a stepwise improvement in reporting accuracy with each set of images reported, from an average reporting score of 66% for the 1st packet to 78% for the 4th packet. Participants felt more confident in identifying common life-threatening pathologies as they reported more echocardiograms. The correlation between report accuracy and confidence in the report was weak and did not increase during the study (r&lt;sub&gt;s&lt;/sub&gt; = 0.394 for the 1st packet, r&lt;sub&gt;s&lt;/sub&gt; = 0.321 for the 4th packet). Attrition during the study related primarily to logistical issues. There were high levels of satisfaction amongst participants, with most reporting that they would use and / or recommend a similar teaching package to colleagues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Healthcare professionals undertaking remote training with recorded lectures, followed by multiple reporting tasks were capable of interpreting focused echocardiograms. Reporting accuracy and confidence in identifying life-threatening pathology increased with the number of scans interpreted. The correlation between accuracy and confidence for any given report was weak (and this relationship should be explored further given the potential safety","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"6"},"PeriodicalIF":6.3,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9639582","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: Clinical indications and triaging for adult transthoracic echocardiography: a statement by the British Society of Echocardiography.","authors":"Sadie Bennett,&nbsp;Martin Stout,&nbsp;Thomas E Ingram,&nbsp;Keith Pearce,&nbsp;Timothy Griffiths,&nbsp;Simon Duckett,&nbsp;Grant Heatlie,&nbsp;Patrick Thompson,&nbsp;Judith Tweedie,&nbsp;Jo Sopala,&nbsp;Sarah Ritzmann,&nbsp;Kelly Victor,&nbsp;Judith Skipper,&nbsp;Shaun Robinson,&nbsp;Andrew Potter,&nbsp;Daniel X Augustine,&nbsp;Claire L Colebourn","doi":"10.1186/s44156-022-00014-5","DOIUrl":"https://doi.org/10.1186/s44156-022-00014-5","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"5"},"PeriodicalIF":6.3,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9999572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9455376","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":"Atrial secondary mitral regurgitation: prevalence, characteristics, management, and long-term outcomes.","authors":"Sam Straw,&nbsp;Ankit Gupta,&nbsp;Kerryanne Johnson,&nbsp;Charlotte A Cole,&nbsp;Kinan Kneizeh,&nbsp;John Gierula,&nbsp;Mark T Kearney,&nbsp;Christopher J Malkin,&nbsp;Maria F Paton,&nbsp;Klaus K Witte,&nbsp;Dominik Schlosshan","doi":"10.1186/s44156-023-00015-y","DOIUrl":"https://doi.org/10.1186/s44156-023-00015-y","url":null,"abstract":"<p><strong>Background: </strong>The prevalence, clinical characteristics, management and long-term outcomes of patients with atrial secondary mitral regurgitation (ASMR) are not well described.</p><p><strong>Methods: </strong>We performed a retrospective, observational study of consecutive patients with grade III/IV MR determined by transthoracic echocardiography. The aetiology of MR was grouped as being either primary (due to degenerative mitral valve disease), ventricular SMR (VSMR: due to left ventricular dilatation/dysfunction), ASMR (due to LA dilatation), or other.</p><p><strong>Results: </strong>A total of 388 individuals were identified who had grade III/IV MR; of whom 37 (9.5%) had ASMR, 113 (29.1%) had VSMR, 193 had primary MR (49.7%), and 45 (11.6%) were classified as having other causes. Compared to MR of other subtypes, patients with ASMR were on average older (median age 82 [74-87] years, p < 0.001), were more likely to be female (67.6%, p = 0.004) and usually had atrial fibrillation (83.8%, p = 0.001). All-cause mortality was highest in patients with ASMR (p < 0.001), but similar to that in patients with VSMR once adjusted for age and sex (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.52-1.25). Hospitalisation for worsening heart failure was more commonly observed in those with ASMR or VSMR (p < 0.001) although was similar between these groups when age and sex were accounted for (HR 0.74, 95% CI 0.34-1.58). For patients with ASMR, the only variables associated with outcomes were age and co-morbidities.</p><p><strong>Conclusions: </strong>ASMR is a prevalent and distinct disease process associated with a poor prognosis, with much of this related to older age and co-morbidities.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"10 1","pages":"4"},"PeriodicalIF":6.3,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9993529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9167488","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}