Journal of the American Society of Echocardiography最新文献

{"title":"Systolic Function in the Fontan Circulation Is Exercise, but Not Preload, Recruitable","authors":"Simone Goa Diab MD ,&nbsp;Assami Rösner MD, PhD ,&nbsp;Gaute Døhlen MD, PhD ,&nbsp;Henrik Brun MD, PhD ,&nbsp;Guro Grindheim MD, PhD ,&nbsp;Kanyalak Vithessonthi MD ,&nbsp;Mark K. Friedberg MD, PhD ,&nbsp;Henrik Holmstrøm MD, PhD ,&nbsp;Thomas Möller MD, PhD","doi":"10.1016/j.echo.2024.11.005","DOIUrl":"10.1016/j.echo.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Fontan circulatory failure with impaired systolic function is well documented; however, its mechanisms are not fully understood. The aim of this study was to explore myocardial functional reserve in adolescent patients with Fontan circulation in response to exercise or acute preload increase.</div></div><div><h3>Methods</h3><div>The study included 32 patients (median age, 16.7 years; range, 15.4–17.9 years; 12 female patients) with Fontan circulation. Echocardiographic imaging was performed during exercise using a recumbent cycle ergometer and during heart catheterization with a rapid infusion of 0.9% saline infusion at 5 mL/kg body weight. Myocardial peak longitudinal strain (LS) was measured in a four-chamber view during specific time intervals before, during, and after exercise (LS_stress) and volume load (LS_cath). During catheterization, central venous pressure and ventricular end-diastolic pressure were simultaneously recorded. A control group of 16 healthy individuals participated in the exercise test.</div></div><div><h3>Results</h3><div>Mean LS_stress was less negative for patients than for control subjects (<em>P</em> ≤ .001 at all stages); however, it significantly improved from −18.4 ± 5.5% at baseline to −22.0 ± 6.5% (<em>P</em> = .004) at maximal loading. LS_stress at maximal loading did not correlate with changes in heart rate. During catheterization, mean LS_cath was −19.6 ± 6.0% at baseline and did not improve significantly at 1.00 to 2.00 minutes and at 4.00 to 6.00 minutes after saline infusion. In more than half of the patients, LS_cath worsened or improved by less than −2% after saline infusion. Worsening of LS_cath correlated with central venous pressure and ventricular end-diastolic pressure in all conditions (<em>P</em> ≤ .017). There was no difference in LS_stress or LS_cath between the morphologic right ventricle and the morphologic left ventricle.</div></div><div><h3>Conclusions</h3><div>Patients with Fontan circulation demonstrate systolic myocardial functional reserve that can be recruited with exercise stress but not with an acute increase in preload.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 342-352"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645106","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":"Role of Quantitative Assessment of Atrial Functional Mitral Regurgitation","authors":"Jwan A. Naser MBBS,&nbsp;Serena J. Rahme MD,&nbsp;Hossam Ibrahim MBBCh,&nbsp;Christopher G. Scott MS,&nbsp;Hector I. Michelena MD,&nbsp;Barry A. Borlaug MD,&nbsp;Austin M. Kennedy BS,&nbsp;Mackram F. Eleid MD,&nbsp;Vuyisile T. Nkomo MD, MPH,&nbsp;Patricia A. Pellikka MD,&nbsp;Maurice Enriquez-Sarano MD,&nbsp;Sorin V. Pislaru MD, PhD","doi":"10.1016/j.echo.2024.12.005","DOIUrl":"10.1016/j.echo.2024.12.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 353-355"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839644","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":"Reevaluating Normal-Flow Low-Gradient Severe Aortic Stenosis: Clinical Phenotypes and Outcomes in Severe Aortic Stenosis Among Transcatheter Aortic Valve Replacement Patients","authors":"Amro Badr MD ,&nbsp;Mustafa Suppah MD ,&nbsp;Kamal Awad MD ,&nbsp;Juan Farina MD ,&nbsp;Bobbi Jo Heon RCDS ,&nbsp;Rachel Wraith RCDS ,&nbsp;Bishoy Abraham MD ,&nbsp;Sara Kaldas MD ,&nbsp;Vuyisile Nkomo MD, MPH ,&nbsp;Reza Arsanjani MD ,&nbsp;Chieh-Ju Chao MD ,&nbsp;David Holmes MD ,&nbsp;Said Alsidawi MD","doi":"10.1016/j.echo.2024.12.010","DOIUrl":"10.1016/j.echo.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is a complex condition with various hemodynamic subtypes, each with distinct clinical profiles and outcomes. The aim of this study was to assess the characteristics and outcomes of different AS phenotypes on the basis of flow and gradient patterns.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 930 patients who underwent transcatheter aortic valve replacement for severe symptomatic AS at Mayo Clinic sites from 2012-2017 were included. Patients were classified into three groups: high gradient (HG), low-flow low-gradient (LFLG), and normal-flow low-gradient (NFLG). Baseline clinical, echocardiographic, and computed tomographic characteristics, including aortic valve area, aortic valve calcium score, left ventricular ejection fraction, and the prevalence of tricuspid regurgitation, and atrial fibrillation were analyzed. One- and 5-year all-cause mortality outcomes were compared using Kaplan-Meier analysis and Cox proportional-hazards models.</div></div><div><h3>Results</h3><div>The final cohort included 273 patients in the NFLG group (29.4%), 563 in the HG group (60.5%), and 94 in the LFLG group (10.1%). After reevaluation and careful review of the echocardiograms, 41 patients with NFLG AS were reclassified into the LFLG group. Patients with LFLG AS had the highest prevalence of atrial fibrillation or flutter (60%) and tricuspid regurgitation (17%). Aortic valve calcium score was significantly lower in the NFLG group compared with the HG and LFLG groups. One-year mortality was highest in the LFLG group (17.4%), followed by the HG (13.9%) and NFLG (10.9%) groups, but the difference was not statistically significant (<em>P</em> = .20). The 5-year mortality rate was higher in the LFLG group (55.6%) compared with the NFLG (47.2%) and HG (47.9%) groups but did not reach statistical significance (<em>P</em> = .20).</div></div><div><h3>Conclusions</h3><div>LFLG AS was associated with more comorbidities and higher mortality compared with HG and NFLG AS, though differences in mortality were not statistically significant. The NFLG group, after close review and reclassification, showed the least significant AS. Randomized trials are needed to clarify the prognosis and management of NFLG AS.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 310-319"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957969","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":"The Elusive Nature of “Simple” D-Transposition During Perinatal Transition","authors":"Rajesh Punn MD ,&nbsp;Anita J. Moon-Grady MD","doi":"10.1016/j.echo.2025.02.002","DOIUrl":"10.1016/j.echo.2025.02.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 340-341"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415850","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":"Normal Fetal Ventricular Strain Pilot Study","authors":"Carol McFarland MD,&nbsp;Cathleen Pruitt MD,&nbsp;Mary T. Donofrio MD,&nbsp;Lindsay R. Freud MD,&nbsp;Leo Lopez MD,&nbsp;L. LuAnn Minich MD,&nbsp;Anita J. Moon-Grady MD,&nbsp;Zhining Ou MS,&nbsp;Rajesh Punn MD,&nbsp;Theresa A. Tacy MD,&nbsp;Oluwatosin Fatusin MD,&nbsp;Nelangi Pinto MD,&nbsp;the Fetal Heart Society Research Collaborative","doi":"10.1016/j.echo.2024.10.020","DOIUrl":"10.1016/j.echo.2024.10.020","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 361-363"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631312","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":"Acute Maternal Hyperoxygenation to Predict Hypoxia and Need for Emergency Intervention in Fetuses With Transposition of the Great Arteries: A Pilot Study","authors":"Trisha V. Vigneswaran MBBS, BSc(Hons), MD(res) ,&nbsp;Chris Oakley MBBS ,&nbsp;Hannah R. Bellsham-Revell MBBS, MD(res) ,&nbsp;Matthew Jones MBBS ,&nbsp;Vita Zidere DM, MD ,&nbsp;Reza Razavi MBBS, MD ,&nbsp;John M. Simpson MD","doi":"10.1016/j.echo.2024.12.011","DOIUrl":"10.1016/j.echo.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Newborns with transposition of the great arteries (TGA) are at risk of severe hypoxia from inadequate atrial mixing, closure of the arterial duct, and/or persistent pulmonary hypertension of the newborn (PPHN). Acute maternal hyperoxygenation (AMH) might assist in identifying at-risk fetuses. We report pulmonary vasoreactivity to AMH in TGA fetuses and its relationship to early postnatal hypoxia and requirement for emergency balloon atrial septostomy (e-BAS).</div></div><div><h3>Methods</h3><div>Standard fetal echocardiographic (FE) assessment of the foramen ovale (FO): to total septal length and morphology of flap valve of the FO were used to predict the need for e-BAS. Following prospective recruitment, additional assessments were performed in fetuses with TGA at baseline and repeated after 10 minutes of 10 L/min of 100% oxygen delivered via non-rebreather mask to the pregnant mother. Analysis included measurement of atrial septal excursion, branch pulmonary artery pulsatility index (PA PI), middle cerebral artery (MCA) PI, and cardiac output. Delivery and newborn status were reviewed. Hypoxia was defined as preductal oxygen saturations &lt;75% and e-BAS when undertaken within 2 hours of birth. Area under receiver operating characteristics curves were calculated.</div></div><div><h3>Results</h3><div>Thirty cases underwent FE at 34.6 weeks’ gestation (interquartile range, 34.6-35.6). All 7 predicted to require e-BAS based on standard FE were correctly identified prenatally. Three of 30 were hypoxic without FO restriction and treated with nitric oxide (PPHN). Change in PA PI ≤ 15% was associated with PPHN (<em>P</em> = .001) but not with e-BAS. The MCA PI response to AMH varied according to newborn condition, a mean reduction occurred in the non-hypoxic newborns (−7.8 ± 18.3, <em>P</em> = .05). Increase in MCA PI <em>Z</em> score (area under receiver operating characteristics curves; 0.837; 95% CI, 0.663-1.00, <em>P</em> = .01), reduction in right ventricular cardiac output (0.811; 95% CI, 0.623-0.998, <em>P</em> = .04), and reduction in combined cardiac output (0.851; 95% CI, 0.699-1.0, <em>P</em> = .01) were moderately associated with e-BAS. Changes in atrial septal excursion and FO flow direction with AMH did not correlate with newborn condition.</div></div><div><h3>Conclusions</h3><div>A PA PI change ≤15% to AMH was associated with postnatal hypoxia due to PPHN. Increase in right and combined cardiac output and reduced MCA resistance with AMH are seen in those who do not require e-BAS.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 331-339"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957967","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":"Designing a Tailored Career Path: A Guide to Creating Flexible Career Ladders","authors":"","doi":"10.1016/j.echo.2025.02.007","DOIUrl":"10.1016/j.echo.2025.02.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages A18-A22"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746707","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":"Extending the Mitral Annular Disjunction Phenotype: Anomalous Attachment of the Posterior Mitral Annulus to the Crest of the Left Ventricle","authors":"Jeffrey J. Silbiger MD,&nbsp;Raveen Bazaz MD","doi":"10.1016/j.echo.2025.01.014","DOIUrl":"10.1016/j.echo.2025.01.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 364-365"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257256","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":"Muscling Out of Musculoskeletal Injury in Cardiovascular Ultrasound","authors":"Allyson Boyle MHA, ACS, RDCS, FASE ,&nbsp;Ashlee Davis ACS, RDCS, RCCS, FASE","doi":"10.1016/j.echo.2025.02.015","DOIUrl":"10.1016/j.echo.2025.02.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages A15-A17"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746706","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)00129-4","DOIUrl":"10.1016/S0894-7317(25)00129-4","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages A11-A12"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748685","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}