Journal of the American Society of Echocardiography最新文献

{"title":"Echoes of Alignment: The American Society of Echocardiography Forges Intersociety Partnerships","authors":"David H. Wiener MD, FASE","doi":"10.1016/j.echo.2025.08.010","DOIUrl":"10.1016/j.echo.2025.08.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Page A9"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Ultrasound Density Score Index Performed With Cardiopulmonary Exercise Echocardiography Testing Is Associated With Impaired Exercise Capacity","authors":"Charles E. Luoma MS ,&nbsp;Kathryn F. Larson MD ,&nbsp;Joshua R. Smith PhD, MS ,&nbsp;Jessica A. Narum BS ,&nbsp;Christopher G. Scott MS ,&nbsp;Alexander T. Lee BS ,&nbsp;Meir Tabi MD ,&nbsp;Brandon M. Wiley MD","doi":"10.1016/j.echo.2025.07.005","DOIUrl":"10.1016/j.echo.2025.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Exercise stress echocardiography and cardiopulmonary exercise testing (CPET) are frequently used for the evaluation of patients with dyspnea and exercise intolerance. Lung ultrasound (LUS) has been shown to increase the prognostic utility of stress echocardiography. Integration of LUS into stress echocardiography for undifferentiated ambulatory patients undergoing clinically indicated simultaneous CPET has not been previously evaluated.</div></div><div><h3>Objectives</h3><div>To determine whether LUS, when performed immediately before and after exercise testing, is associated with reduced exercise capacity, as defined by peak oxygen consumption (<span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2peak), in patients undergoing clinically indicated stress echocardiography with CPET.</div></div><div><h3>Methods</h3><div>Lung ultrasound performed pre- and postexercise in a retrospective cohort of 261 consecutive patients with normal left ventricular ejection fraction undergoing simultaneous stress echocardiography and CPET. Lung ultrasound was performed in 4 lung zones, and a semiquantitative assessment of B-line burden was accomplished using the novel LUS density score index (LUDSI).</div></div><div><h3>Results</h3><div>Lung ultrasound was feasible in 100% of patients pre- and postexercise. An LUDSI ≥0.5 was associated with impaired exercise capacity (<span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2peak of &lt;90% predicted) at rest (area under the curve [AUC] = 0.75) and poststress (AUC = 0.76) after adjusting for age and sex. The association of LUDSI ≥0.5 and impaired exercise capacity was only incrementally improved with the integration of diastolic function (E/e’) performed at rest (AUC = 0.77) and poststress (AUC = 0.78).</div></div><div><h3>Conclusions</h3><div>The LUDSI is a simple and highly feasible measure of B-line burden that can be performed pre- and postexercise. A LUDSI ≥0.5 was associated with impaired exercise capacity in patients with normal left ventricular ejection fraction undergoing simultaneous stress echocardiography and CPET.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 890-901"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Pressure-Volume Analysis by Three-Dimensional Echocardiography: A Novel Powerful Method for Evaluating Left Ventricular Function","authors":"Lars-Egil R. Hammersboen MD ,&nbsp;Espen Boe MD, PhD ,&nbsp;Jürgen Duchenne MSc, PhD ,&nbsp;John M. Aalen MD, PhD ,&nbsp;Hans Henrik Odland MD, PhD ,&nbsp;Manuel Villegas-Martinez MSc, PhD ,&nbsp;Vetle C. Frostelid MSc ,&nbsp;Faraz H. Khan MD ,&nbsp;Ole Jakob Sletten MD ,&nbsp;Marit Witsoe MD ,&nbsp;Helge Skulstad MD, PhD ,&nbsp;Filip Rega MD, PhD ,&nbsp;Olivier Gheysens MD, PhD ,&nbsp;Jens-Uwe Voigt MD, PhD ,&nbsp;Otto A. Smiseth MD, PhD ,&nbsp;Marie Stugaard MD, PhD ,&nbsp;Espen W. Remme MSc, PhD","doi":"10.1016/j.echo.2025.05.008","DOIUrl":"10.1016/j.echo.2025.05.008","url":null,"abstract":"<div><h3>Background</h3><div>Pressure-volume (PV) analysis is the gold standard for evaluating left ventricular (LV) function but is rarely used clinically due to its invasiveness. We validated a noninvasive method for PV analysis by three-dimensional (3D) echocardiography against invasive reference measurements and a novel index of LV efficiency against LV efficiency derived from metabolism by positron emission tomography-computed tomography (PET-CT).</div></div><div><h3>Methods</h3><div>In 22 canines, LV volume was measured invasively using piezoelectric crystals and LV pressure by micromanometer. Echocardiography and peak pressure were used to obtain 3D LV volume traces and LV pressure trace estimates. Stroke work, single-beat contractility indices, arterial elastance, and an index of LV efficiency were derived from echocardiography and compared with their invasively measured counterparts at baseline and different interventions. In 12 sheep, the LV efficiency index was compared with efficiency calculated as stroke work divided by total LV glucose metabolism from PET-CT. The sheep underwent 8 weeks of rapid dyssynchronous pacing to induce heart failure (HF). Recordings were performed during synchronous and dyssynchronous electrical activation, at baseline, and after 8 weeks of pacing-induced HF.</div></div><div><h3>Results</h3><div>In canines, there was a very good correlation and agreement between noninvasive and invasive measurements of LV stroke work (<em>r</em> = 0.98, <em>P</em> &lt; .0001; difference 237 ± 212 mm Hg × mL, mean ± SD). The noninvasive and invasive efficiency indices also showed very good agreement (<em>r</em> = 0.95, <em>P</em> &lt; .0001; difference 0.4% ± 3.4%). The changes in LV function by the different interventions resulted in similar changes in the noninvasive and invasive PV indices (all <em>P</em> &lt; .001). In sheep, the efficiency index showed similar decline compared to efficiency by PET-CT after induction of HF and after switching from synchronous to dyssynchronous electrical activation (<em>r</em> = 0.67, <em>P</em> &lt; .001 for all interventions).</div></div><div><h3>Conclusions</h3><div>Noninvasive PV analysis by three-dimensional echocardiography is feasible and accurate, making PV loop parameters for evaluating LV function accessible for clinical use. Further studies should explore the clinical utility of this method.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 946-958"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality Imaging in Presurgical Evaluation of Total Anomalous Pulmonary Venous Connection: Single-Center Practice Variability and a Systematic Review of Diagnostic Error","authors":"Helen M. Stanley MD,&nbsp;Danish Vaiyani MD,&nbsp;Meryl S. Cohen MD, MSEd,&nbsp;Shobha S. Natarajan MD,&nbsp;Brian R. White MD, PhD","doi":"10.1016/j.echo.2025.05.020","DOIUrl":"10.1016/j.echo.2025.05.020","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary vein anatomy varies widely in total anomalous pulmonary venous connection (TAPVC), with diagnostic accuracy affecting surgical planning and prognosis. Echocardiography is the preferred screening modality. Cross-sectional imaging (cardiac computed tomography [CT] or magnetic resonance [MR]) may offer added value.</div></div><div><h3>Methods</h3><div>As the first step in a quality improvement initiative, we sought to describe practice patterns in presurgical imaging in TAPVC with attention to diagnostic error. We also evaluated the available literature on diagnostic accuracy of imaging in TAPVC. Patients with TAPVC who underwent repair at our center (January 1, 2006, to September 15, 2022) were included.</div></div><div><h3>Results</h3><div>Thirty-three of 167 patients (20%) underwent presurgical CT or MR. Initial echocardiogram incorrectly diagnosed the subtype of TAPVC in 9% (15/167). Patients with birth weight under 3 kg, born preterm, or with an initial diagnosis of mixed-type TAPVC were more likely to have misdiagnosis by initial echocardiogram. Computed tomography or MR miscategorized 3/33 patients. A systematic literature review revealed 10 studies that evaluated CT imaging diagnostic accuracy in TAPVC, one of which also included MR studies. Among 171 total patients, there were no patients with inaccurate anatomic diagnosis by CT or MR.</div></div><div><h3>Conclusions</h3><div>Cross-sectional angiography is used increasingly in this population and with diagnostic excellence, although it is not infallible. Efforts to improve echocardiographic quality as well as multimodality imaging in high-risk patients may improve diagnostic accuracy and surgical planning.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 924-931"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0894-7317(25)00497-3","DOIUrl":"10.1016/S0894-7317(25)00497-3","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages A7-A8"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Echocardiography for Risk Stratification in Unexplained Dyspnea: The Incremental Value of the Mean Pulmonary Artery Pressure/Slope","authors":"Maarten Falter MD ,&nbsp;Youri Bekhuis MD ,&nbsp;Wouter L’Hoyes MD ,&nbsp;Mauricio Milani MD, PhD ,&nbsp;Sarah Hoedemakers MD ,&nbsp;Lucie Soens MD ,&nbsp;Sara Moura-Ferreira MD ,&nbsp;Sebastiaan Dhont MD ,&nbsp;Rik Pauwels MD ,&nbsp;Annemie Jacobs MD ,&nbsp;Stephanie De Schutter MD ,&nbsp;Boris Delpire MD ,&nbsp;Johan Verbeeck PhD ,&nbsp;Jan Stassen MD, PhD ,&nbsp;Andreas B. Gevaert MD, PhD ,&nbsp;Philippe Debonnaire MD, PhD ,&nbsp;Alexander Van de Bruaene MD, PhD ,&nbsp;Philippe B. Bertrand MD, PhD ,&nbsp;Lieven Herbots MD, PhD ,&nbsp;Ruta Jasaityte MD, PhD ,&nbsp;Jan Verwerft MD","doi":"10.1016/j.echo.2025.06.007","DOIUrl":"10.1016/j.echo.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Patients with unexplained dyspnea and an elevated mean pulmonary artery pressure (mPAP)/cardiac output (CO) slope on invasive hemodynamic assessment during exercise have worse clinical outcomes. The aim of this study was to evaluate the incremental prognostic value of the noninvasive mPAP/CO slope in addition to heart failure with preserved ejection fraction (HFpEF) probability scores and diastolic stress testing in patients with unexplained dyspnea.</div></div><div><h3>Methods</h3><div>In a multicenter cohort study involving six Belgian dyspnea clinics, patients with unexplained dyspnea underwent exercise echocardiography for mPAP/CO slope assessment. Positive HFpEF scores were defined as HFA-PEFF (Heart Failure Association pretest probability echocardiography, functional testing, final diagnosis) score ≥ 5 and H₂FPEF (heavy, hypertensive, atrial fibrillation, pulmonary hypertension, elder, filling pressure) score ≥ 6. The outcome evaluated was a composite of all-cause mortality or heart failure hospitalization.</div></div><div><h3>Results</h3><div>Among 2,452 patients (mean age, 63 ± 15 years; 53% women), mPAP/CO slope &gt; 3.5 mm Hg · L⁻¹ · min⁻¹ best predicted adverse outcomes. The prognostic value of the mPAP/CO slope was greater in patients with negative HFpEF scores than in those with positive scores (interaction <em>P</em> = .02). The mPAP/CO slope remained independently prognostic after adjustment for N-terminal pro–B-type natriuretic peptide (hazard ratio [HR], 2.26; 95% CI, 1.33-3.82) and for HFpEF scores and diastolic stress testing (HR, 1.99; 95% CI, 1.37-2.88), whereas exercise tricuspid regurgitant velocity did not. Both HFpEF score–negative patients with slope &gt; 3.5 mm Hg · L⁻¹ · min⁻¹ (HR, 2.99; 95% CI, 1.81-4.95) and HFpEF score–positive patients (HR, 6.29; 95% CI, 4.25-9.31) showed significantly higher risk compared with HFpEF score–negative patients with slope ≤ 3.5 mm Hg · L⁻¹ · min⁻¹.</div></div><div><h3>Conclusions</h3><div>The mPAP/CO slope, unlike exercise tricuspid regurgitant velocity, adds prognostic value beyond natriuretic peptides, HFpEF scores, and diastolic stress testing, identifying high-risk patients with exercise-induced hemodynamic abnormalities who may benefit from invasive confirmation and closer follow-up.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 875-889"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Mitral Annular Calcification With Echocardiography: Comparison to Calcium Score With Computed Tomography","authors":"Jon R. Peacock MD,&nbsp;Connor P. Craig MD,&nbsp;William K. Harvey Jr., MD,&nbsp;Sheldon E. Litwin MD","doi":"10.1016/j.echo.2025.06.010","DOIUrl":"10.1016/j.echo.2025.06.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 975-977"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leaflet Modification During Transcatheter Aortic Valve-in-Valve Replacement—Imaging Guidance for the ShortCut Procedure","authors":"Julien Ternacle MD, PhD ,&nbsp;Marian Kukucka MD ,&nbsp;Benjamin Seguy MD ,&nbsp;Sabah Skaf MD ,&nbsp;Moody Makar MD ,&nbsp;Shemy Carasso MD ,&nbsp;Daniel Kalbacher MD ,&nbsp;Thomas Modine MD ,&nbsp;Susheel Kodali MD ,&nbsp;Didier Tchetche MD, PhD ,&nbsp;Danny Dvir MD ,&nbsp;Philippe Pibarot DVM, PhD","doi":"10.1016/j.echo.2025.05.019","DOIUrl":"10.1016/j.echo.2025.05.019","url":null,"abstract":"<div><div>Transcatheter aortic valve-in-valve implantation is a validated alternative to redo surgery in patients with severe bioprosthetic valve dysfunction related to structural valve deterioration. The major life-threatening procedural complication is coronary occlusion related to the displacement of degenerated bioprosthetic leaflets, which can be avoided by using leaflet modification. The aim of this article is to present a step-by-step guide for imaging this procedure using the ShortCut device.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 959-970"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Controlled Trial of a Clinical Support Tool to Increase Value in Transthoracic Echocardiography","authors":"Nisha Raiker MD,&nbsp;Aditya Nagori PhD,&nbsp;Karunakar Dirisala MS,&nbsp;Patrick Hong MSCE,&nbsp;Katy Lonergan MD,&nbsp;Susan Matulevicius MD, MSCS,&nbsp;Gail Peterson MD,&nbsp;Ambarish Pandey MD, MSCS,&nbsp;Rebecca Vigen MD, MPA, MSCS","doi":"10.1016/j.echo.2025.06.011","DOIUrl":"10.1016/j.echo.2025.06.011","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 978-980"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Detection of Subclinical Atherosclerosis on Carotid Ultrasound on Cardiovascular Events in a Primary Prevention Clinical Setting","authors":"Tasneem Z. Naqvi MD ,&nbsp;Chieh-Ju Chao MD ,&nbsp;Richard J. Butterfield MA ,&nbsp;Songnan Wen MD ,&nbsp;Nan Zhang MS","doi":"10.1016/j.echo.2025.06.009","DOIUrl":"10.1016/j.echo.2025.06.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The relative contribution of common carotid artery (CCA) intimal medial thickness (IMT), carotid bifurcation plaque presence, and its burden in predicting cardiovascular disease (CVD) events in a primary prevention clinical cohort remain unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;To assess the usefulness of distal far wall of right and left CCA IMT assessment (in the absence of carotid bifurcation plaque) and plaque presence and plaque number on incident CVD in a primary prevention clinical setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Observational study of consecutive 1,903 patients free of known CVD clinically referred for right and left carotid bifurcation two-dimensional ultrasound for subclinical atherosclerosis assessment between 2007 and 2014 at a single center. Incident composite CVD (cardiac death, myocardial infarction, unstable angina, and ischemic stroke) was compared between patients with and without plaque (defined as focal or diffuse medial-adventitial border to luminal border thickening of ≥1.5 mm), with increasing plaque number and with increasing CCA IMT percentiles (&lt;25th, 25th-49th, 50th-74th, and &gt;75th centiles) adjusted for atherosclerotic CVD scores using Pooled Cohort Equation and Framingham Risk Score in the absence of bifurcation plaque.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The final study cohort contained 1,569 patients (mean age, 55.1 ± 8.6 years; female, 36%) after study exclusions with a mean follow-up of 9.8 ± 5.5 years. Eight hundred fifty-nine (54.7%) had carotid plaque, and 710 (45.3%) had no plaque. Incident composite CVD occurred in 90 (5.7%) patients, with no difference in patients with and without plaque (hazard ratio [HR] = 1.19; 95% CI, 0.78-1.82; &lt;em&gt;P&lt;/em&gt; = .425) or with ≥75th versus &lt;75th IMT percentile in the absence of plaque (HR = 1.35; 95% CI, 0.64-2.85; &lt;em&gt;P&lt;/em&gt; = .431). Increased incident CVD events occurred in patients with 3 or more plaques versus no plaque (HR = 2.9; 95% CI, 1.48-5.65; &lt;em&gt;P&lt;/em&gt; = .002), which remained significant after adjusting for the Pooled Cohort Equation (HR = 2.45; 95% CI, 1.13-5.3; &lt;em&gt;P&lt;/em&gt; = .023) and Framingham Risk Score. Patients with IMT centile ≥75% and presence of carotid plaque received increasing new statin prescriptions after carotid ultrasound result. Significant low-density lipoprotein cholesterol reduction (19.3 ± 25.7 mg/dL; &lt;em&gt;P&lt;/em&gt; &lt; .001) on follow-up occurred only in patients in whom plaque was identified.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The number of carotid bifurcation plaques on carotid ultrasound is associated with incident CVD in a primary prevention cohort. Given the referral nature of the study cohort, evaluation of only carotid vascular bed, and increased statin prescriptions after carotid ultrasound result, our findings regarding the lack of prognostic value of CCA IMT or of any plaque should be interpreted with caution. Presence of plaque on carotid ultrasound led to increased statin p","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 902-915"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}