Journal of the American Society of Echocardiography最新文献

{"title":"Stress Echocardiography in Patients with Moderate or Severe Myocardial Ischemia: Insights from the ISCHEMIA Trial.","authors":"Michael H Picard, Kyle Saysana, Derek D Cyr, Xin Zeng, Marielle Scherrer-Crosbie, Leslee J Shaw, Roxy Senior, Kian Keong Poh, Sripal Bangalore, Jonathon A Leipsic, Gb John Mancini, Matthew J Budoff, Cameron J Hague, James K Min, Sean M O'Brien, Judith S Hochman, David J Maron, Harmony R Reynolds","doi":"10.1016/j.echo.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.echo.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>This study examined stress echocardiography (SE) in relation to coronary artery anatomy, and outcome in subjects randomized in the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) Trial.</p><p><strong>Methods: </strong>Of 5,179 patients randomized to initial invasive or conservative strategy, SE was performed in 1,079. Coronary computed tomographic angiogram (CCTA) excluded left main disease and quantified coronary lesions. Degree of ischemia was defined by number of segments with stress-induced wall motion abnormalities (WMA) (mild < 3, moderate = 3 and severe > 3). Transient ischemic dilation (TID) was defined as a 10% increase in stress left ventricular (LV) end systolic volume. Primary end point was a composite of cardiovascular death (CVD), nonfatal myocardial infarction (MI), or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest.</p><p><strong>Results: </strong>On CCTA, 607/715 (84%) with CCTA evaluable for ≥70% lesion had one such lesion. Features associated with coronary lesions ≥ 70% were number of ischemic/infarcted segments, 3 or more ischemic segments in the anterior territory and inability to augment LV ejection fraction 10 percentage points . TID, present in 28.5%, was significantly associated with severity of ischemia. For every 0.10 increase in peak wall motion score index (WMSI), there was 12% increased risk of CVD or MI (adjusted HR=1.12 (95% CI: 1.04, 1.21), p=0.003.</p><p><strong>Conclusion: </strong>In patients with chronic coronary disease and moderate or severe myocardial ischemia receiving contemporary therapies, stress echocardiography identified subjects with significant CAD and WMSI provided prognostic value.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671446","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":"Leveraging Natural Language Processing for Echocardiographic Data Extraction in Hypoplastic Left Heart Syndrome.","authors":"Zachary Girvin, Srushti Gangireddy, Andersen Coleman, Henry Ong, Wei-Qi Wei, Prince J Kannankeril, Sudeep D Sunthankar","doi":"10.1016/j.echo.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670162","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":"Calculation of Regurgitant Volume Using Echocardiographic Volumetric Method for Accurate Diagnosis of Severe Mitral Regurgitation.","authors":"Ga Yun Kim, Ha Hye Jo, So-Min Lim, Dayoung Pack, Hye Soo Lee, Jong En Lee, Hyun Jung Koo, Ji Sung Lee, Sahmin Lee, Byung Joo Sun, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song","doi":"10.1016/j.echo.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.012","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of regurgitant volume calculated by volumetric transthoracic echocardiography (RegVol__TTE) for diagnosing severe primary mitral regurgitation (MR).</p><p><strong>Background: </strong>Recent studies have shown suboptimal results of the proximal isovelocity surface area (PISA) method and the American Society of Echocardiography (ASE) algorithm for diagnosing severe primary MR.</p><p><strong>Methods: </strong>A total of 74 patients with primary MR due to prolapse or flail leaflet were prospectively recruited for both TTE and cardiac magnetic resonance imaging (CMR). RegVol was calculated using PISA (RegVol__PISA) or the volumetric method (left ventricular total stroke volume-systolic forward outflow volume; RegVol__TTE). According to the ASE algorithm, patients with four or more parameters were diagnosed with severe MR. RegVol__CMR of ≥60 mL was used as the gold standard for diagnosing severe MR.</p><p><strong>Results: </strong>All subjects had at least moderate to severe MR based on ASE guidelines. CMR confirmed that 30 patients (41%) had severe MR. The concordance correlation coefficient between RegVol__TTE and RegVol__CMR (0.809; 95% confidence interval [CI], 0.715-0.893) was higher than that between RegVol__PISA and RegVol__CMR (0.468; 95% CI, 0.323-0.576). The overall accuracy of RegVol__TTE for the diagnosis of severe MR was 90.5% (95% CI, 81.5-96.1), which was significantly higher than that of RegVol__PISA (64.9%; 95% CI, 52.9-75.6; p<0.001) and the ASE algorithm (77.0%; 95% CI, 65.8-86.0; p=0.004). The area under the curve of RegVol__TTE (0.95; 95% CI, 0.90-1.00) was significantly larger than that of RegVol__PISA (0.88; 95% CI, 0.80-0.96; p=0.028).</p><p><strong>Conclusions: </strong>RegVol__TTE showed better diagnostic performance than the PISA method and the ASE algorithm in diagnosing severe MR. Further investigations are necessary to evaluate the clinical usefulness of routine utilization of RegVol__TTE.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671573","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 Ventricular Rotational Indices in Children with Hypertrophic Cardiomyopathy: Unique Characteristics in Children and Differences from Adults.","authors":"Andrea Montero, Ryusuke Numata, Hunter Kauffman, Renzo Calderon-Anyosa, Putri Yubbu, Tomoyuki Sato, Anirban Banerjee","doi":"10.1016/j.echo.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.echo.2025.03.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631011","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":"From Dyssynchrony to Arrhythmia: Left Ventricle Mechanical Dispersion as an Independent Predictor of Ventricular Arrhythmias in Chronic Chagas Cardiomyopathy.","authors":"Luis Eduardo Echeverría, Lyda Z Rojas, Angie Serrano-García, Laura Daniela Muñoz, María Cantillo-Reines, Lisbeth Becerra-Motta, Lizeth Alarcón, María Alejandra Quintero-Santana, Paola Andrea Mendez-Hernández, Ángela Torres, Karen Andrea García-Rueda, Carlos Luengas, Angel M Chaves, Jaime A Rodríguez, Rafael Campo, Sergio Alejandro Gómez-Ochoa","doi":"10.1016/j.echo.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.echo.2025.03.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626624","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":"CLINICAL RISK PREDICTORS FOR ABNORMAL LEFT VENTRICULAR AND ATRIAL FUNCTION IN LUPUS ERYTHEMATOSUS.","authors":"Matteo Morello, Bethany Gholson, Weiting Huang, William Lain, Maxwell Malter, Antonio Abbate, Brittany N Weber, Jonathan R Lindner","doi":"10.1016/j.echo.2025.03.001","DOIUrl":"10.1016/j.echo.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>In systemic lupus erythematosus (SLE), ventricular dysfunction can occur from primary immune injury or secondarily from SLE-related co-morbidities. The aim of this study was to determine clinical predictors of reduced left ventricular (LV) systolic and diastolic function in an effort to understand potentially mitigating strategies.</p><p><strong>Methods: </strong>We retrospectively studied 76 patients with SLE who had comprehensive transthoracic echocardiography within 3 months of an appointment with a rheumatologist to correlate clinical, laboratory, and echocardiographic features. All key echocardiographic measurements were reviewed and remeasured, when appropriate, by an expert blinded to other study data. Abnormal LV systolic function was defined by global longitudinal strain threshold of -18.0%. Hierarchical cluster analysis was used to define feature interaction.</p><p><strong>Results: </strong>The mean age of the population was 49±15 years and 83% were female. A reduced GLS was found in 24% of the population, of whom 44% had LVEF <50%. Previously documented heart failure symptoms was more prevalent in the reduced GLS cohort (50% vs 12%, p=0.002). Those with reduced GLS had clinical features indicating greater SLE severity over time including reduced renal function and prior pericardial involvement. GLS was strongly associated with RV free wall strain (r = 0.67, p<0.01) and degree of LV diastolic dysfunction. Worsening grades of diastolic dysfunction, like GLS, were associated with renal disease and pericardial involvement. SLE patients with reduced GLS and diastolic function also had abnormal left atrial reservoir strain (LASr). Hierarchical cluster analysis segregated populations with reduced GLS, reduced LASr, pericardial and renal involvement, and an additional feature of C-reactive protein known to be associated with chronic disease activity.</p><p><strong>Conclusion: </strong>Reduced GLS is common in patients with SLE and is associated with heart failure symptoms and markers of increased disease activity over time, particularly pericardial involvement suggesting common immune mechanisms. The associations of GLS with RV function, diastolic dysfunction, and impairment in LASr suggests a common mechanistic basis involving immune injury.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598185","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":"Transaortic Flow Rate and Risk-Stratification in moderate Aortic Stenosis.","authors":"Paolo Springhetti, Michele Tomaselli, Leonardo Portolan, Marco Penso, Jessica Pizzini, Denis Leonardi, Alexandra Clement, Luca Ciceri, Noela Radu, Giorgia Benzoni, Roberto Scarsini, Flavio Ribichini, Denisa Muraru, Giovanni Benfari, Luigi P Badano","doi":"10.1016/j.echo.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.017","url":null,"abstract":"<p><strong>Background: </strong>While left ventricular stroke volume (SV) is commonly used to define flow status in patients with aortic valve stenosis (AS), flow rate (FR) serves as a more precise descriptor of blood flow. However, evidence regarding the prognostic significance and determinates of transaortic FR, specifically in patients with a moderate AS, are limited.</p><p><strong>Objectives: </strong>We aimed to evaluate the association of transaortic FR with outcomes in patients with moderate AS.</p><p><strong>Methods: </strong>We included 292 outpatients (mean age 80±9 years, 45% women) with moderate AS (aortic valve area 1-1.5 cm²) and complete clinical evaluation. Transaortic FR was calculated using the derivation-method (FR_der) and validated in 90 random patients in whom transaortic FR was also directly calculated as stroke volume/ejection time (FR_dir). The primary study endpoint was a composite of all-cause mortality and hospitalization for heart failure(HHF).</p><p><strong>Results: </strong>After median follow-up of 19.3 (Interquartile-Range 12.3-26.0) months, 73 patients reached the primary endpoint (22 HHF and 51 deaths). Patients who met the primary endpoint had a lower transaortic FR_der value compared to those not experiencing events (201±47 mL/s vs 225±48 mL/s). The transaortic FR_der presented excellent correlation with FR_dir (R²=0.93, p<0.0001). The transaortic FR_der threshold for excess risk of adverse outcome was approximately 218 mL/ms. Below this value, the risk increased steeply, showing no plateau effect. Several factors were independently associated with transaortic FR_der<218 mL/s, including female sex, renal insufficiency, previous myocardial infarction, SV index, and at least moderate tricuspid regurgitation (all p<0.02). After comprehensive adjustment, transaortic FR_der<218 ml/s resulted independently associated with events (adjusted Hazard Ratio 2.17 [C.I. 95% 1.14-4.12], p=0.018).</p><p><strong>Conclusions: </strong>Transaortic FR_der<218 ml/s is independently associated with adverse outcomes in moderate AS. Further research is needed to determine if patients with moderate AS and impaired transaortic FR would benefit from more intensive monitoring or earlier aortic valve replacement.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587870","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":"Mitral Annular Disjunction is Associated with Ventricular Arrhythmias in Children with Marfan Syndrome.","authors":"C Sanchez Parra, R M Vaughan, A Iturralde Chavez, C Miyake, S O Valdes, R H Pignatelli, A Parthiban, S A Morris, T T Doan","doi":"10.1016/j.echo.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587867","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":"Lessons from Diastolic Function Assessment After Myocardial Infarction.","authors":"Jae K Oh, Eunjung Lee","doi":"10.1016/j.echo.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587865","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":"Utility of the Ratio Between the Size of the Right Atrium and the Right Ventricle at End-Systole to Diagnose Atrial Secondary Tricuspid Regurgitation","authors":"Alexandra Clement MD ,&nbsp;Denisa Muraru MD, PhD ,&nbsp;Samantha Fisicaro RDCS ,&nbsp;Marco Penso BME ,&nbsp;Michele Tomaselli MD ,&nbsp;Noela Radu MD ,&nbsp;Caterina Delcea MD, PhD ,&nbsp;Alexandra S. Buta MD ,&nbsp;Valeria Rella MD, PhD ,&nbsp;Radu Sascau MD, PhD ,&nbsp;Luigi P. Badano MD, PhD","doi":"10.1016/j.echo.2024.11.012","DOIUrl":"10.1016/j.echo.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>In the multiparametric framework for diagnosing atrial secondary tricuspid regurgitation (A-STR), an end-systolic (ES) right atrial (RA)–to–right ventricular (RV) volume or area ratio ≥1.5 supports the diagnosis of A-STR over the ventricular secondary tricuspid regurgitation phenotype (V-STR). However, this threshold value has never been tested.</div></div><div><h3>Methods</h3><div>A single-center study was conducted, prospectively enrolling consecutive patients with secondary tricuspid regurgitation who underwent two- and three-dimensional echocardiography.</div></div><div><h3>Results</h3><div>A total of 350 patients were enrolled (mean age, 75 ± 13 years; 65% women). Although patients with A-STR and V-STR presented similar degrees of secondary tricuspid regurgitation and comparable RA size, the ES RA/RV volume ratio was significantly larger in A-STR than in V-STR (1.75 [interquartile range, 1.35-2.45] vs 1.18 [interquartile range, 0.81-1.66], respectively; <em>P</em> &lt; .001). On receiver operating characteristic analysis, the ES RA/RV volume ratio showed a significantly higher predictive power for A-STR (area under the curve [AUC], 0.73; 95% CI, 0.68-0.78) compared with RA maximum volume (AUC, 0.6; 95% CI, 0.54-0.66; <em>P</em> = .01), RA minimum volume (AUC, 0.59; 95% CI, 0.53-0.65; <em>P</em> = .007), and ratio of RA minimum volume to RV end-diastolic volume (AUC, 0.57; 95% CI, 0.51-0.63; <em>P</em> &lt; .001). However, the predictive power of the ES RA/RV volume ratio (AUC, 0.73; 95% CI, 0.68-0.78) and the ES RA/RV area ratio (AUC, 0.76; 95% CI, 0.71-0.81) for the diagnosis of A-STR was similar (<em>P</em> = .58). The threshold value for ES RA/RV volume ratio that best distinguished between A-STR and V-STR was 1.40 (AUC, 0.68; 95% CI, 0.63-0.73), whereas for ES RA/RV area ratio, it was 1.6 (AUC, 0.64; 95% CI, 0.59-0.69). A multivariable model that included either ES RA/RV volume ratio or ES RA/RV area ratio, along with LV ejection fraction, RV ejection fraction, RV ES volume, and pulmonary artery systolic pressure, resulted in an AUC of 0.97 for differentiating between A-STR and V-STR.</div></div><div><h3>Conclusions</h3><div>ES RA/RV volume ratio ≥ 1.4 and ES RA/RV area ratio ≥ 1.6 support the diagnosis of A-STR over V-STR.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 212-223"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820026","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}