Journal of the American Society of Echocardiography最新文献

{"title":"ADHERENCE TO SURVEILLANCE IMAGING GUIDELINES FOR AORTIC DILATION IDENTIFIED BY ECHOCARDIOGRAPHY.","authors":"Kirsten E Shaw, Steven M Bradley, Ellen Cravero, Julia M Harris, Kevin M Harris","doi":"10.1016/j.echo.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.echo.2026.04.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845373","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":"Applying Machine Learning to Fetal Echocardiograms: A Novel Method for Predicting Critical Coarctation of the Aorta.","authors":"Robert McRae, Matthew J Magoon, Kathryn Virk, Aaron Phillips, Malika Waschman, Kaitlyn Freeman, Shiraz Maskatia, Nelangi Pinto, Patrick M Boyle, Bhawna Arya","doi":"10.1016/j.echo.2026.04.016","DOIUrl":"https://doi.org/10.1016/j.echo.2026.04.016","url":null,"abstract":"<p><strong>Background: </strong>Current fetal echocardiographic metrics are inadequate for confident prediction of neonatal critical coarctation of the aorta due to low specificity. Random forest algorithms, a subset of machine learning, have not been applied to fetal echocardiography. We aimed to determine if a random forest classifier improved the accuracy of critical coarctation prediction compared to previously published risk metrics.</p><p><strong>Methods: </strong>Patients with prenatal concern for coarctation at a single center were included. Eight fetal echocardiogram measurements were used to train a random forest classifier with 80:20 splits and 5-fold cross-validation to predict coarctation intervention within 30 days of life. Gestational age at the time of fetal echocardiogram was also included. A Shapley additive explanations (SHAP) analysis assessed the marginal contribution of each feature. A consolidated model was then validated with an external patient cohort from a different academic center.</p><p><strong>Results: </strong>Inclusion criteria were met by 132 patients in the initial cohort and 64 patients in the external validation cohort, of whom 44% (n=58) and 25% (n=16) respectively had coarctation requiring intervention. SHAP analysis for both cohorts demonstrated aortic arch angles as the most influential features. Using internal cross-validation on the initial cohort, the area under the receiver operating characteristic curve was 0.95 ± 0.01 (sensitivity 1.0, specificity 0.96) with an F1 score of 0.97 ± 0.03. Validation of a consolidated model with the external cohort produced a sensitivity of 0.81, specificity of 0.98, and F1 of 0.87.</p><p><strong>Conclusions: </strong>A random forest classifier using fetal echocardiogram features predicted neonatal critical coarctation with higher accuracy than previously published metrics. The model maintained excellent specificity when validated with an external patient cohort. Aortic arch angles most significantly impacted the model's accuracy. Future directions include prospective validation and converting the model to a distributable clinical calculator.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845400","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":"Reduced Left Atrial Reservoir Strain is Associated with Histopathologically Confirmed ANP-Amyloid Deposition.","authors":"Shun Nishino, Yujiro Asada, Chiharu Nishino, Michikazu Nakai, Atsuko Yokota, Masanori Nishimura, Mitsuhiro Yano, Kinta Hatakeyama, Yoshisato Shibata","doi":"10.1016/j.echo.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.echo.2026.04.014","url":null,"abstract":"<p><strong>Background: </strong>Isolated atrial amyloidosis is characterized by atrial natriuretic peptide (ANP)-amyloid deposition confined to the atria and has been primarily linked to atrial fibrillation. However, its relationship with atrial mechanical function remains unclear. We investigated the association between left atrial reservoir strain (LASr) and histopathologically confirmed ANP-amyloid deposition. We also explored the potential clinical implications.</p><p><strong>Methods: </strong>We retrospectively analyzed the available left atrial appendage tissue of 166 consecutive patients who underwent cardiac surgery. ANP-amyloid deposition was semi-quantitatively graded (0-3+) and categorized as negative (0-1+) or positive (2+-3+). Echocardiographic parameters were analyzed across grades. Multivariable logistic regression and sensitivity analyses were performed. The primary endpoint was a composite outcome comprising all-cause death, stroke or systemic embolism, and heart failure hospitalization. Perioperative and longitudinal clinical outcomes were assessed.</p><p><strong>Results: </strong>ANP-amyloid deposition was present in 51.2% of patients. LASr declined progressively across increasing amyloid grades, which indicated a graded inverse relationship (p for trend < 0.001). Multivariable analysis showed that lower LASr remained significantly associated with ANP-amyloid positivity (adjusted odds ratio 0.75 per 1% increase, 95% confidence interval 0.65-0.87; p < 0.001). Sensitivity analyses showed consistent results. Perioperative outcomes did not differ significantly between groups. During follow-up, ANP-amyloid positivity was associated with a higher incidence of the composite endpoint. This association was primarily driven by an increased risk of heart failure hospitalization, whereas all-cause mortality and thromboembolic events did not differ significantly between groups.</p><p><strong>Conclusions: </strong>In this surgical cohort, reduced LASr was associated with higher ANP-amyloid deposition as confirmed through histopathology. These findings support an association between atrial mechanical dysfunction and histopathologically confirmed localized atrial amyloid involvement. ANP-amyloid deposition was associated with a higher incidence of composite clinical events, predominantly driven by heart failure hospitalization, warranting further investigation.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845529","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":"Myocardial Work Indices in Olympic athletes: sex-specific reference values and the impact of sports disciplines.","authors":"Giuseppe Di Gioia, Armando Ferrera, Davide Ortolina, Francesco Raffaele Spera, Viviana Maestrini, Federica Mango, Daniele Ginelli, Giulia Paoletti, Sara Monosilio, Maria Rosaria Squeo, Antonio Pelliccia","doi":"10.1016/j.echo.2026.04.013","DOIUrl":"https://doi.org/10.1016/j.echo.2026.04.013","url":null,"abstract":"<p><strong>Introduction: </strong>Differentiating exercise-induced cardiac remodelling from early dilated cardiomyopathy remains challenging in athletes, as conventional echocardiographic parameters may overlap in cardiomyopathies and physiologic remodelling. Myocardial work indices (MWI) have been proposed as a promising tool to improve characterization of physiologic remodelling and eventually help in this distinction. However, reference values in athletic populations are currently lacking.</p><p><strong>Objectives: </strong>The aim of this study was to define sex-specific and sport-independent reference values for MWI in a large cohort of Olympic athletes.</p><p><strong>Methods: </strong>662 Olympic athletes (51.7% males, mean age 25.5±5.3 years) undergoing standardized pre-participation cardiovascular screening, including comprehensive transthoracic echocardiography with two-dimensional speckle-tracking. Global myocardial work index (GWI), constructive work (GCW), wasted work (GWW), and global work efficiency (GWE) were calculated using non-invasive LV pressure-strain loops. Athletes were categorized into power, skill, endurance, and mixed disciplines. Sex- and discipline-specific comparisons were performed, reference values were derived using the 2.5th-97.5th percentiles, and associations with age were explored.</p><p><strong>Results: </strong>In the overall cohort, mean GWI was 1806.1±250 mmHg%, GCW 2188.9±282 mmHg%, GWW 85.8±42.4 mmHg%, and GWE 95.7±2.0%. GWI and GCW did not differ between males and females, whereas males showed higher GWW (91.5±45.7 vs. 79.7±37.7 mmHg%, p=0.0008) and slightly lower GWE (95.4±2.3 vs. 95.9±1.7%, p=0.0004). No significant differences in MWI were observed across sport disciplines. Segmental analysis revealed sex-related differences mainly in basal and mid-LV segments. Age showed only weak, clinically negligible associations with MWI. Proposed limit thresholds were 1346.7 mmHg% for GWI, 1656.1 mmHg% for GCW, GWW >206.8 mmHg% in males and >174 mmHg% in females, and GWE <91% in males and <92% in females.</p><p><strong>Conclusions: </strong>In Olympic athletes, myocardial work is largely independent of sport discipline and age, while sex-specific differences are driven by myocardial efficiency and wasted work. This study establishes sport-independent, sex-specific reference values and preliminary thresholds for MWI, observed in a large cohort of elite athletes, that may help in guiding diagnosis when evaluating doubtful cases of cardiac remodelling.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845500","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":"ASE Echoes around the Globe: The Worldwide Impact of the American Society of Echocardiography","authors":"David H. Wiener MD, FASE","doi":"10.1016/j.echo.2026.03.005","DOIUrl":"10.1016/j.echo.2026.03.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Pages A11-A12"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807450","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(26)00148-3","DOIUrl":"10.1016/S0894-7317(26)00148-3","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Pages A9-A10"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807465","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":"Reclassification of Diastolic Function by the 2025 American Society of Echocardiography Diastolic Function Guidelines and Risk of Mortality","authors":"Nicholas Spetko MD ,&nbsp;Craig H. Scott MD ,&nbsp;Constance Angell-James MPH ,&nbsp;Madeline Cassidy BS ,&nbsp;Tooba Alwani MD ,&nbsp;Monica Mukherjee MD, MPH ,&nbsp;Sherif F. Nagueh MD ,&nbsp;Jordan B. Strom MD, MSc","doi":"10.1016/j.echo.2026.01.006","DOIUrl":"10.1016/j.echo.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Whether the 2025 American Society of Echocardiography (ASE) diastolic dysfunction (DD) algorithm (DD25) improves mortality prognostication compared to the 2016 algorithm (DD16) in real-world practice is uncertain.</div></div><div><h3>Methods</h3><div>We applied the DD25 algorithm to adult transthoracic echocardiography reports across a large academic multisite echocardiography laboratory from 2018 2024, linked to state mortality data, and determined reclassification of DD and mortality risk.</div></div><div><h3>Results</h3><div>Of 12,948 included (age 62.8 ± 18.1, 51.4% women, 55.8% outpatient), 10,205 (78.8%) had diastology quantified by the 2016 and 2025 guidelines. Of these, 2,601 (25.5%) were reclassified by DD25 with increases in DD grade in 1,428 (54.9%) and decreases in 1,173 (45.1%). Among those reclassified, 2,391 (91.9%) had a single grade change in DD severity. A larger proportion of female patients (52% vs 48.7%) were classified as having DD by DD25 versus DD16. The rate of indeterminate DD was lower by DD25 (1,358 [10.4%]) vs DD16 (1,983 [15.3%]). The DD25 algorithm improved discrimination of mortality risk compared to DD16 (difference in areas under the curve = 0.02; 95% CI, 0.001-0.04; <em>P</em> = .03), although the magnitude of the associated risk across the follow-up period was similar after multivariable adjustment (<em>P</em> value for comparison of adjusted hazard ratios = .67).</div></div><div><h3>Conclusions</h3><div>In a large academic health system, one-quarter of patients had reclassification of diastolic function by the 2025 ASE diastology guidelines. As compared to the 2016 algorithm, the 2025 algorithm resulted in a larger proportion with DD, less indeterminate diastolic function, and improved discrimination of mortality.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Pages 501-510"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576353","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":"Domain-Specific Speckle-Tracking Longitudinal Strain in LMNA-Related Cardiomyopathy","authors":"Matteo Castrichini MD ,&nbsp;Ramin Garmany PhD ,&nbsp;Michael J. Ackerman M.D, PhD ,&nbsp;Patricia A. Pellikka MD ,&nbsp;John R. Giudicessi MD, PhD","doi":"10.1016/j.echo.2026.01.008","DOIUrl":"10.1016/j.echo.2026.01.008","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Pages 523-526"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137898","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":"Mid–Coronary Artery Wall Echogenicity Can Contribute to the Initial Diagnosis of Kawasaki Disease: Quantitative Measurements by Transthoracic Echocardiography","authors":"Naoto Yamashita MD ,&nbsp;Yoshihiko Kodama MD, PhD ,&nbsp;Hirofumi Irisa MD ,&nbsp;Toshinobu Ifuku MD ,&nbsp;Keigo Nakatani MD, PhD ,&nbsp;Yoshikazu Uchiyama PhD ,&nbsp;Hiroshi Moritake MD, PhD ,&nbsp;Nozomi Watanabe MD, PhD","doi":"10.1016/j.echo.2025.12.013","DOIUrl":"10.1016/j.echo.2025.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Periarterial echogenicity in the proximal coronary arteries (CAs) increases in the acute phase of Kawasaki disease (KD). However, some studies have questioned the diagnostic value of periarterial echogenicity in differentiating KD from other febrile diseases (non-KD) because of its relatively low specificity. In this study, the authors quantitatively assessed the degree of echogenicity in the proximal and mid segments of both CAs to determine its additional diagnostic value in patients with clinically suspected KD.</div></div><div><h3>Methods</h3><div>A total of 109 consecutive children (median age, 21 months; interquartile range, 11.0-47.8 months) who underwent transthoracic echocardiography for suspected KD (April 2021 to March 2023) were retrospectively examined. Two-dimensional echocardiographic images in the proximal and mid segments of both CAs were digitally stored and transferred to an offline image analysis system. The mean pixel value of the arterial wall was calculated in grayscale ranging from 0 to 255 (corrected for the intracardiac blood pool adjacent to the target site).</div></div><div><h3>Results</h3><div>A total of 109 patients were included, 87 (80%) ultimately diagnosed with KD (including 18 with incomplete KD) and 22 (20%) ultimately diagnosed with non-Kawasaki febrile diseases. Although the KD group generally showed higher CA wall echogenicity than the non-KD febrile group, there was no significant difference in the mean pixel values at the proximal segment (<em>P</em> = .34 for each). The KD group showed significantly higher echogenicity in the mid segments of both CAs than the non-KD febrile group (mid right coronary artery, <em>P</em> = .0049; mid left anterior descending coronary artery, <em>P</em> = .011). Similar results were observed in a small prospective cohort of 31 children examined under rigorously standardized ultrasound settings.</div></div><div><h3>Conclusions</h3><div>CA echogenicity in the mid segments may have potential diagnostic value in the early evaluation of suspected KD, possibly reflecting the characteristic diffuse involvement of the CAs in the acute phase.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Pages 511-519"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858932","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.2026.03.002","DOIUrl":"10.1016/j.echo.2026.03.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 5","pages":"Page A13"},"PeriodicalIF":6.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807463","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}