Nils Sofus Borg Mogensen, Mulham Ali, Rasmus Carter-Storch, Mohamed-Salah Annabi, Jasmine Grenier-Delaney, Jacob Eifer Møller, Kristian Altern Øvrehus, Patricia A Pellikka, Philippe Pibarot, Marie-Annick Clavel, Jordi Sanchez Dahl
{"title":"Dobutamine in low-flow, low-gradient severe aortic stenosis with preserved ejection fraction: Is exercise testing the key? - Authors' reply.","authors":"Nils Sofus Borg Mogensen, Mulham Ali, Rasmus Carter-Storch, Mohamed-Salah Annabi, Jasmine Grenier-Delaney, Jacob Eifer Møller, Kristian Altern Øvrehus, Patricia A Pellikka, Philippe Pibarot, Marie-Annick Clavel, Jordi Sanchez Dahl","doi":"10.1016/j.echo.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.013","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591304","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":"Applicability of Appropriate Use Criteria for Echocardiography in an Underserved Population","authors":"","doi":"10.1016/j.echo.2024.07.003","DOIUrl":"10.1016/j.echo.2024.07.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581359","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}
Elena Surkova MD, MSc, PhD, Andrew Constantine MA, MBBS, PhD, Marichelle Alviento BSc, Armi Austria-Manlapig BSc, Zhuoyuan Xu MD, Cathy West MSc, AMS, Konstantinos Dimopoulos MD, MSc, PhD, Wei Li MD, PhD
{"title":"Comparative Prognostic Value of Echocardiographic Parameters of the Subpulmonary Left Ventricle in Adults With a Systemic Right Ventricle","authors":"Elena Surkova MD, MSc, PhD, Andrew Constantine MA, MBBS, PhD, Marichelle Alviento BSc, Armi Austria-Manlapig BSc, Zhuoyuan Xu MD, Cathy West MSc, AMS, Konstantinos Dimopoulos MD, MSc, PhD, Wei Li MD, PhD","doi":"10.1016/j.echo.2024.07.009","DOIUrl":"10.1016/j.echo.2024.07.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735526","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}
Benjamin S. Wessler MD, Melissa Tsoi MD, Monica M. Dehn RDCS, Ayan R. Patel MD
{"title":"Complete Hemodynamic Assessment of the Aortic Valve","authors":"Benjamin S. Wessler MD, Melissa Tsoi MD, Monica M. Dehn RDCS, Ayan R. Patel MD","doi":"10.1016/j.echo.2024.08.001","DOIUrl":"10.1016/j.echo.2024.08.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914393","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(24)00477-2","DOIUrl":"10.1016/S0894-7317(24)00477-2","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573104","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":"Left Atrioventricular Coupling Index: A Novel Diastolic Parameter to Refine Prognosis in Heart Failure","authors":"","doi":"10.1016/j.echo.2024.06.013","DOIUrl":"10.1016/j.echo.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>Left atrioventricular coupling index (LACI), an index coupling left atrial to left ventricular (LV) volume at end-diastole, has been shown to be associated with prognosis in different clinical settings. However, the relation between LACI and LV diastolic dysfunction (DD) remains to be established. The aims of the present study were to investigate the association between LACI and LV DD and to assess its prognostic value in patients with heart failure (HF).</div></div><div><h3>Methods</h3><div>A total of 1,158 patients with HF in stable condition, on optimal medical therapy, were retrospectively analyzed (derivation cohort). Clinical and echocardiographic features were characterized across LACI tertiles. The independent prognostic value of LACI (end point: all-cause death or HF hospitalization) was assessed using Cox regression. Results were validated in an external cohort of 242 patients with HF.</div></div><div><h3>Results</h3><div>In the derivation cohort, the median LACI value was 0.29 (interquartile range, 0.19-0.42). Patients in the third tertile (LACI > 0.36) were older and presented with more advanced HF symptoms. Although the prevalence of grade 1 DD (American Society of Echocardiography/European Association of Cardiovascular Imaging classification) progressively decreased across LACI tertiles, the prevalence of grade 3 DD significantly increased (8%, 23%, and 46%, respectively; <em>P</em> < .0001). A cutoff value of ≥0.26 identified moderate to severe DD with an area under the curve of 0.75. During follow-up (median, 28 months; interquartile range, 11-53 months), 407 patients (35%) reached the end point. On multivariable analysis, LACI was independently associated with outcomes (hazard ratio for a 1-SD increase, 1.16; 95% CI, 1.06-1.28; <em>P</em> = .002), showing incremental predictive value over the DD grading system (net reclassification improvement = 0.150, <em>P</em> < .0001). The prognostic value of LACI was consistent in the external validation cohort.</div></div><div><h3>Conclusions</h3><div>LACI is associated with DD severity and is an independent predictor of outcomes in patients with HF.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477832","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}
Luigi P. Badano MD, PhD , Michele Tomaselli MD , Denisa Muraru MD, PhD , Xavier Galloo MD , Chi Hion Pedro Li MD , Nina Ajmone Marsan MD, PhD
{"title":"Advances in the Assessment of Patients With Tricuspid Regurgitation: A State-of-the-Art Review on the Echocardiographic Evaluation Before and After Tricuspid Valve Interventions","authors":"Luigi P. Badano MD, PhD , Michele Tomaselli MD , Denisa Muraru MD, PhD , Xavier Galloo MD , Chi Hion Pedro Li MD , Nina Ajmone Marsan MD, PhD","doi":"10.1016/j.echo.2024.07.008","DOIUrl":"10.1016/j.echo.2024.07.008","url":null,"abstract":"<div><div>Tricuspid regurgitation (TR) can have a significant impact on the health and mortality of a patient. Unfortunately, many patients with advanced right-sided heart failure are not referred for isolated tricuspid valve (TV) surgery in a timely manner. This delayed referral has resulted in a high in-hospital mortality rate and significant undertreatment. Fortunately, transcatheter TV intervention (TTVI) has emerged as a safe and effective alternative to surgery, successfully reducing TR severity and improving patients’ quality of life. Current guidelines emphasize the importance of assessing TR severity and its impact on the right heart chambers for selecting the appropriate intervention. However, the echocardiographic assessment of both right chambers and TV anatomy, along with TR severity, poses specific challenges, leading to the underestimation of TR severity. Recently, three-dimensional echocardiography has become crucial to enhance the characterization of TR severity. Moreover, it is essential to evaluate residual TR after TTVI to gauge the intervention’s success and predict the patient’s prognosis. This review provides a thorough evaluation of the echocardiographic parameters used to assess TR severity before and after TTVI. It presents a critical analysis of the accuracy and reliability of these parameters, highlighting their strengths and limitations to establish standardized diagnostic criteria and treatment protocols for TR, which will inform clinical decision-making and improve patient outcomes.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Refining the Role of Dobutamine Stress Echocardiography for Low-Gradient Aortic Stenosis in the Current Management Era","authors":"Ching-Hui Sia MBBS , Kian-Keong Poh MBBChir, MMed","doi":"10.1016/j.echo.2024.08.006","DOIUrl":"10.1016/j.echo.2024.08.006","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019377","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":"Continuing Education and Meeting Calendar","authors":"","doi":"10.1016/j.echo.2024.08.010","DOIUrl":"10.1016/j.echo.2024.08.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573102","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":"Dobutamine Stress Echocardiography in Low-Gradient Aortic Stenosis","authors":"","doi":"10.1016/j.echo.2024.06.017","DOIUrl":"10.1016/j.echo.2024.06.017","url":null,"abstract":"<div><h3>Importance</h3><div>Guidelines recommend the use of dobutamine stress echocardiography (DSE) in patients with low-gradient aortic stenosis (AS) and left ventricular ejection fraction (LVEF) <50%. However, a paucity of DSE data exists when LVEF >35%.</div></div><div><h3>Objective</h3><div>To examine the diagnostic accuracy of DSE in patients with low-gradient AS with a wide range of LVEF and to examine the interaction between the diagnostic accuracy of DSE and LVEF.</div></div><div><h3>Design, Setting, and Participants</h3><div>Patients with mean gradient <40 mm Hg, aortic valve area <1.0 cm<sup>2</sup>, and stroke volume index ≤35 mL/m<sup>2</sup> undergoing DSE and cardiac computer tomography (C-CT) were identified from 3 prospectively collected patient cohorts and stratified according to LVEF: LVEF<35%, LVEF 35% to 50%, and LVEF>50%.</div></div><div><h3>Exposure</h3><div>Dobutamine stress echocardiography and C-CT were performed on patients with low-gradient AS.</div></div><div><h3>Main Outcomes and Measures</h3><div>Severe AS was defined as aortic valve calcification score ≥2,000 arbitrary units (AU) among men and ≥1,200 AU for women on C-CT.</div></div><div><h3>Results</h3><div>Of 221 patients included in the study, 78 (35%) presented with LVEF <35%, 67 (30%) with LVEF 35% to 50%, and 76 (34%) with LVEF >50%. Mean-gradient and aortic valve peak velocity during DSE showed significant diagnostic heterogeneity between LVEF groups, being most precise when LVEF <35% (both areas under the curve [AUC] = 0.90), albeit with optimal thresholds of 30 mm Hg and 377 cm/sec and a limited diagnostic yield in patients with LVEF ≥35% (AUC = 0.67 and 0.66 in LVEF 35% to 50% and AUC = 0.65 and 0.60 in LVEF ≥50%). Using guideline thresholds led to a sensitivity/specificity of 49%/84% for all patients with LVEF <50%.</div></div><div><h3>Conclusion and Relevance</h3><div>While DSE is safe and leads to an increase in stroke volume in patients with low-gradient AS regardless of LVEF, the association between DSE gradients and AS severity assessed by C-CT demonstrates important heterogeneity depending on LVEF, with the highest accuracy in patients with LVEF <35%.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555752","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}