Journal of the American Society of Echocardiography最新文献

{"title":"Fetal Echocardiography From 10 to 15 Weeks of Gestation-Reliability, Genetic Associations, and Outcomes.","authors":"Leila Rittey, Hannah Davidson, Lisa K Hornberger, Luke Eckersley, Cleighton Boehme, Angela McBrien","doi":"10.1016/j.echo.2024.08.012","DOIUrl":"10.1016/j.echo.2024.08.012","url":null,"abstract":"<p><strong>Introduction: </strong>There is increasing demand for accurate early fetal cardiac disease (FCD). We assessed the accuracy of early fetal echo (EFE) conducted in our high-volume fetal cardiac program and reviewed the spectrum of FCD, associated genetic anomalies, and outcomes encountered.</p><p><strong>Methods: </strong>We identified all EFEs performed from 10⁺⁰ to 15⁺⁶ weeks of gestation from 2009 to 2021. We compared findings at EFE to fetal echo at ≥18⁺⁰ weeks or autopsy and documented genetic testing results for all FCD cases. For those with discrepancy between EFE and later exam, the discrepancy impact was reviewed. A score was used to quantify the anatomy assessed.</p><p><strong>Results: </strong>A total of 1,662 EFEs were performed in 1,387 pregnancies; all but 41 were considered diagnostic. Fetal cardiac disease was diagnosed at EFE in 130, including 101 major, 12 minor, 13 other FCD, and 4 arrhythmias. In 14/130 with FCD, endovaginal imaging was undertaken, which increased the score (1.6/9 vs 3.5/9; P = .049). Thirty-five of 130 had repeat EFE, which increased the score (5.2/9 vs 7.4/9, P < .0001). Fetal loss occurred before confirmation of FCD in 16 and termination in 64, and 11 were lost to follow-up. Thirty-nine had autopsy and/or fetal echo ≥18⁺⁰: 35 had FCD confirmed, and 4 had resolution. Of the 35 confirmed FCD, 27 had no, 7 minor, and 1 major change. Of 1,489 with normal EFE, later echo demonstrated FCD in 14: 3 major and 11 minor. In 16, FCD evolved, including 4 arrhythmias and 12 with progressive FCD. Sensitivity, specificity, and positive and negative predictive values of EFE in identifying major FCD were 92.9%, 100%, 100%, and 99.7%, respectively. In cases with FCD, 85.4% had genetic testing, of whom 71% (60.8% of the total) had abnormal results.</p><p><strong>Conclusions: </strong>In our experience, EFE permits accurate diagnosis and exclusion of most FCD. Endovaginal imaging and repeat EFE studies improved the ability to visualize structures adequately.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114234","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 Imaging for Native Aortic Valve Regurgitation.","authors":"Vidhu Anand, Hector I Michelena, Patricia A Pellikka","doi":"10.1016/j.echo.2024.08.009","DOIUrl":"10.1016/j.echo.2024.08.009","url":null,"abstract":"<p><p>Aortic regurgitation (AR) is associated with left ventricular (LV) volume and pressure overload, resulting in eccentric LV remodeling and enlargement. This condition may be well tolerated for years before the onset of myocardial dysfunction and symptoms. Echocardiography plays a crucial role in the diagnosis of AR, assessing its mechanism and severity, and detecting LV remodeling. The assessment of AR severity is challenging and frequently requires the integration of information from multiple different measurements to assess the severity. Recent data suggest that echocardiographically derived LV volumes (end-systolic volume index > 45 mL/m²), an ejection fraction threshold of <60%, and abnormal global longitudinal strain may help identify early dysfunction and may be used to improve clinical outcomes. Consequently, these parameters can identify candidates for surgery. Cardiac magnetic resonance imaging is emerging as a valuable tool for assessing severity when it remains unclear after an echocardiographic evaluation. This review emphasizes the importance of imaging, particularly echocardiography, in the evaluation of AR. It focuses on various echocardiographic parameters, including technical details, and how to integrate them for assessing the mechanism and severity of AR as well as LV remodeling.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114237","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":"Echocardiographic Predictors of Readiness for Double Switch Operation and Postoperative Ejection Fraction in Patients With Congenitally Corrected Transposition of the Great Arteries Undergoing Left Ventricular Retraining.","authors":"Son Q Duong, Deborah Ho, Rajesh Punn, Danielle Sganga, Richard Mainwaring, Michael Ma, Frank L Hanley, Kyong-Jin Lee, Shiraz A Maskatia","doi":"10.1016/j.echo.2024.08.011","DOIUrl":"10.1016/j.echo.2024.08.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In patients with congenitally corrected transposition of the great arteries (ccTGA), assessment of readiness for the double switch operation (DSO) after pulmonary arterial band (PAB) placement involves cardiac magnetic resonance imaging (cMRI) to measure left ventricular ejection fraction (LVEF) and mass and cardiac catheterization (catheterization) to assess the ratio of left ventricular to right ventricular pressure (LV:RVp). The aims of this study were to describe the relationships between echocardiographic and catheterization and cMRI measures of readiness for DSO and to develop risk factors for left ventricular (LV) dysfunction after DSO on the basis of echocardiographic measures of ventricular-arterial coupling (VAC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with ccTGA undergoing LV retraining at a DSO referral center were reviewed. LVEF measured by echocardiography was compared with that measured by cMRI, and LV:RVp measured by echocardiography was compared with that measured by catheterization using Bland-Altman analysis. The relationship between preoperative VAC markers and postoperative echocardiography was analyzed using ventricular end-systolic elastance (EES) and a novel marker consisting of the product of LVEF and LV:RVp (EFPR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-one patients with 56 evaluations for DSO were included, 24 of whom underwent DSO. Echocardiographic LVEF correlated well with cMRI LVEF (r = 0.79), and Bland-Altman analysis slightly overestimated cMRI LVEF (mean difference, +3%). Echocardiographic LVEF had a moderate ability to identify normal cMRI LVEF (area under the curve, 0.80) and at an optimal cut point of echocardiographic LVEF threshold of 61%, there was 71% sensitivity and 76% specificity to detect cMRI LVEF ≥ 55%. Echocardiographic LV:RVp correlated well with LV/RVp by catheterization (r = 0.77) and slightly underestimated the catheterization value (mean difference, -0.11). Echocardiographic LV:RVp had a good ability to identify adequate LV:RVp by catheterization (area under the curve, 0.95) and at an optimal echocardiography cut point of 0.75 had 100% sensitivity and 85% specificity to detect a catheterization LV:RVp &gt;0.9. Echocardiography-based criteria for DSO readiness (echocardiographic LVEF of 61% and LV:RVp of 0.75) demonstrated specificity of 97% and positive predictive value of 96% for published criteria of DSO readiness (cMRI LVEF of 55% and catheterization LV:RVp of 0.9). EES and EFPR correlated with post-DSO LVEF (ρ = 0.72 and ρ = 0.60, respectively). EFPR of 0.51 demonstrated 78% sensitivity and 100% specificity for post-DSO LV dysfunction (LVEF &lt; 55%). Age at first PAB also strongly correlated with post-DSO LVEF (ρ = 0.75). No patient with first PAB at &lt;1 year of age exhibited post-DSO LV dysfunction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Echocardiographic measures of LVEF and LV:RVp are reliable indicators of reference standard modalities and can guide management d","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114233","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":"Improving Prenatal Detection of Congenital Heart Disease With a Scalable Composite Analysis of 6 Fetal Cardiac Ultrasound Biometrics.","authors":"Aneela Reddy, Sara Rizvi, Anita J Moon-Grady, Rima Arnaout","doi":"10.1016/j.echo.2024.08.007","DOIUrl":"10.1016/j.echo.2024.08.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114235","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":"Lowering Mechanical Index Reduces B-Lines: Balancing Safety With Accuracy in Lung Ultrasound.","authors":"David Reza Mittelstein, Keshav R Nayak, Pamela M Resnikoff, Samantha R Spierling Bagsic, Bruce J Kimura","doi":"10.1016/j.echo.2024.08.008","DOIUrl":"10.1016/j.echo.2024.08.008","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114236","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.2024.05.015","DOIUrl":"10.1016/j.echo.2024.05.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"37 8","pages":"Page A17"},"PeriodicalIF":5.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0894731724002669/pdfft?md5=0b456852cbf9db0e1d9b8f70cd9bb423&pid=1-s2.0-S0894731724002669-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951507","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":"Beyond the Binary: Cardiovascular Risk Prediction With Echocardiographic Stress Testing","authors":"","doi":"10.1016/j.echo.2024.05.016","DOIUrl":"10.1016/j.echo.2024.05.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"37 8","pages":"Pages 749-751"},"PeriodicalIF":5.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184843","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":"Prognostic Implications of Left Ventricular Hypertrophy and Mechanical Function in Fabry Disease: A Longitudinal Cohort Study","authors":"","doi":"10.1016/j.echo.2024.04.010","DOIUrl":"10.1016/j.echo.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>The prognostic value of different grades of left ventricular hypertrophy (LVH) and left ventricular (LV) mechanical function in Fabry disease is unclear. We aimed to evaluate the association between the severity of LVH, LV mechanical function, and clinical outcomes in Fabry disease.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study from a single-center registry of adult patients with Fabry disease. Left ventricular mass index (LVMI) was measured by echocardiography. The severity of LVH was categorized by LVMI using the sex-specific cutoff values. Left ventricular mechanical function was measured as LV global longitudinal strain (GLS) by speckle-tracking analysis. The primary outcome was a composite of major adverse cardiovascular events (MACE) at 5 years, including heart failure hospitalization, sustained ventricular tachycardia, acute ischemic stroke, and all-cause mortality.</p></div><div><h3>Results</h3><p>The study included 268 patients (age 50.4 ± 15.4 years, men 46.6%) with Fabry disease (83.2% IVS4+919G &gt; A mutation), and 106 patients (39.6%) had LVH. Patients with mild, moderate, or severe LVH had 5-year MACE rates of 7.4%, 10%, and 30.5%, respectively (<em>P</em> &lt; .001). Moreover, patients with impaired LV GLS (&lt;14.1%) had a higher 5-year MACE rate than those with preserved LV GLS (32.1% vs 2.4%, <em>P</em> &lt; .001). Severe LVH was an independent predictor of MACE compared with absence of LVH (adjusted hazard ratio, 12.73; 95% CI, 1.3-124.71; <em>P</em> = .03), after adjusting for age, sex, hypertension, hyperlipidemia, atrial fibrillation, renal function, average E/e’, enzyme replacement therapy, and LV GLS. Patients with severe LVH and impaired LV GLS had the highest incidence for MACE (log-rank <em>P</em> &lt; .05), irrespective of sex, genotypes, and whether receiving enzyme replacement therapy or not.</p></div><div><h3>Conclusions</h3><p>Sex-specific grading of LVH by LVMI is practical for risk stratification in patients with Fabry disease, and impaired LV GLS further refines the prognostication.</p></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"37 8","pages":"Pages 787-796"},"PeriodicalIF":5.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0894731724002001/pdfft?md5=337a97a23fe1dc2cef7e658f6e962d20&pid=1-s2.0-S0894731724002001-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859831","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":"Beyond Years: Is Artificial Intelligence Ready to Predict Biological Age and Cardiovascular Risk Using Echocardiography?","authors":"","doi":"10.1016/j.echo.2024.05.013","DOIUrl":"10.1016/j.echo.2024.05.013","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"37 8","pages":"Pages 736-739"},"PeriodicalIF":5.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141209","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":"Accuracy of Shunt Volume Measured by Three-Dimensional Echocardiography and Cardiac Magnetic Resonance in Patients With an Atrial Septal Defect and a Dilated Right Ventricle","authors":"","doi":"10.1016/j.echo.2024.04.016","DOIUrl":"10.1016/j.echo.2024.04.016","url":null,"abstract":"<div><h3>Background</h3><p><span><span>The accuracy of right ventricular (RV) quantification by three-dimensional echocardiography (3DE) has been reported mainly in patients with a normal right ventricle (RV). However, there are no data regarding the accuracy of 3DE in patients with a dilated RV, as in shunt diseases. In this study, we evaluated the accuracy of 3DE and that of volumetric (Vol) </span>cardiac magnetic resonance (CMR) for assessment of RV and left ventricular (LV) stroke volume (SV) and the pulmonary (</span><em>Q</em>_<em>p</em>)/systemic (<em>Q</em>_<em>s</em><span>) blood flow ratio in patients with an atrial septal defect (ASD) using the two-dimensional phase contrast (2DPC) method as the gold standard.</span></p></div><div><h3>Methods</h3><p>We retrospectively investigated 83 patients with ASD who underwent transcatheter closure and clinically indicated CMR and 3DE examinations. The ratio <em>Q</em>_<em>p</em><em>/Q</em>_<em>s</em> was calculated using RV and LV SV measured by full-volume volumetric 3DE (Vol-3DE) and CMR (Vol-CMR) and by two-dimensional pulsed Doppler quantification (2D-Dop); the parameters were compared using 2DPC-CMR as the gold standard.</p></div><div><h3>Results</h3><p>There was no significant difference in the <em>Q</em>_<em>p</em><em>/Q</em>_<em>s</em> value between 2DPC-CMR and Vol-3DE (2.29 ± 0.70 vs 2.21 ± 0.63, <em>P</em> = .79) and 2D-Dop (vs 2.21 ± 0.65, <em>P</em> = 1.00); however, a significant difference was found between 2DPC-CMR and Vol-CMR (<em>P</em> &lt; .001). The <em>Q</em>_<em>p</em><em>/Q</em>_<em>s</em> value obtained using Vol-3DE showed the best correlation with 2DPC-CMR (<em>r</em> = 0.93, <em>P</em> &lt; .001). The RV and LV SV values obtained by Vol-3DE showed the best correlation with 2DPC-CMR (RV SV, <em>r</em> = 0.82, <em>P</em> &lt; .001; LV SV, <em>r</em> = 0.73, <em>P</em> &lt; .001), although the absolute values were underestimated.</p></div><div><h3>Conclusion</h3><p><em>Q</em>_<em>p</em><em>/Q</em>_<em>s</em> was more accurately evaluated by Vol-3DE than by Vol-CMR or 2D-Dop. Three-dimensional echocardiography assessment was feasible and reproducible even in a dilated RV.</p></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"37 8","pages":"Pages 797-805"},"PeriodicalIF":5.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960406","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}