Journal of the American Society of Echocardiography最新文献

{"title":"Rethinking Cardiac Size Indexing for the Precision Medicine Era.","authors":"Dan Dyar, Erik Echegaray, Laith Alshawabkeh","doi":"10.1016/j.echo.2025.08.003","DOIUrl":"10.1016/j.echo.2025.08.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859770","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":"Letter to the Editor: Cardioversion Safety After Left Atrial Appendage Occlusion - Evidence-Based Insights to Inform Clinical Practice.","authors":"Jianguo Xu, Emilie P Belley-Cote, Richard P Whitlock","doi":"10.1016/j.echo.2025.07.014","DOIUrl":"10.1016/j.echo.2025.07.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785809","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":"Reply to Letter to the Editor: The Need for Obesity-Specific Considerations in the Updated American Society of Echocardiography Recommendations for Evaluation of Diastolic Function and Heart Failure With Preserved Ejection Fraction Assessment by Echocardiography.","authors":"Sherif F Nagueh, Danita Y Sanborn, Jae K Oh, Bonita Anderson, Kristen Billick, Genevieve Derumeaux, Allan Klein, Konstantinos Koulogiannis, Carol Mitchell, Amil Shah, Kavita Sharma, Otto A Smiseth, Teresa S M Tsang","doi":"10.1016/j.echo.2025.07.016","DOIUrl":"10.1016/j.echo.2025.07.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805156","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 Need for Obesity-Specific Considerations in the Updated American Society of Echocardiography Recommendations for Evaluation of Diastolic Function and Heart Failure With Preserved Ejection Fraction Assessment by Echocardiography.","authors":"Jie Fen Chin, Praveen A Motiram, Bas M van Dalen","doi":"10.1016/j.echo.2025.07.015","DOIUrl":"10.1016/j.echo.2025.07.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805157","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":"Obstruction in Hypertrophic Cardiomyopathy: Don't Forget Midventricular Obstruction","authors":"Kendra M. Gilreath BS , Jeffrey B. Geske MD","doi":"10.1016/j.echo.2025.05.014","DOIUrl":"10.1016/j.echo.2025.05.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Pages 710-713"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200705","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 MD ,&nbsp;Michele Tomaselli MD ,&nbsp;Leonardo Portolan MD ,&nbsp;Marco Penso MS ,&nbsp;Jessica Pizzini MD ,&nbsp;Denis Leonardi MD ,&nbsp;Alexandra Clement MD ,&nbsp;Luca Ciceri MD ,&nbsp;Noela Radu MD ,&nbsp;Giorgia Benzoni MD ,&nbsp;Roberto Scarsini MD, PhD ,&nbsp;Flavio Ribichini MD ,&nbsp;Denisa Muraru MD, PhD ,&nbsp;Giovanni Benfari MD, PhD ,&nbsp;Luigi P. Badano MD, PhD","doi":"10.1016/j.echo.2025.02.017","DOIUrl":"10.1016/j.echo.2025.02.017","url":null,"abstract":"<div><h3>Background</h3><div>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, is limited.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate the association of transaortic FR with outcomes in patients with moderate AS.</div></div><div><h3>Methods</h3><div>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 SV/ejection time (FR_dir). The primary study end point was a composite of all-cause mortality and hospitalization for heart failure (HHF).</div></div><div><h3>Results</h3><div>After median follow-up of 19.3 (interquartile range, 12.3-26.0) months, 73 patients reached the primary end point (22 HHF and 51 deaths). Patients who met the primary end point had a lower transaortic FR_der value compared to those not experiencing events (201 ± 47 mL/sec vs 225 ± 48 mL/sec). The transaortic FR_der presented excellent correlation with FR_dir (<em>R</em>² = 0.93, <em>P</em> &lt; .0001). The transaortic FR_der threshold for excess risk of adverse outcome was approximately 218 mL/sec. Below this value, the risk increased steeply, showing no plateau effect. Several factors were independently associated with transaortic FR_der &lt; 218 mL/sec, including female sex, renal insufficiency, previous myocardial infarction, SV index, and at least moderate tricuspid regurgitation (all <em>P</em> &lt; .02). After comprehensive adjustment, transaortic FR_der &lt; 218 mL/sec turned out to be independently associated with events (adjusted hazard ratio, 2.17 [95% CI, 1.14-4.12], <em>P</em> = .018).</div></div><div><h3>Conclusions</h3><div>Transaortic FR_der &lt; 218 mL/sec is independently associated with adverse outcomes in moderate AS. Further research is needed to determine whether patients with moderate AS and impaired transaortic FR would benefit from more intensive monitoring or earlier aortic valve replacement.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Pages 643-654"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","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":"Association Between Three-Dimensional Right Ventricular Ejection Fraction and In-Hospital Outcomes in Patients Undergoing Cardiac Surgery: A Multicenter Study","authors":"Edith L. Posada-Martinez MD ,&nbsp;Juan B. Ivey-Miranda MD, PHD ,&nbsp;Xochitl A. Ortiz-Leon MD ,&nbsp;Jose A. Arias-Godinez MD ,&nbsp;Juan F. Fritche-Salazar MD ,&nbsp;Hugo G. Rodriguez-Zanella MD ,&nbsp;Maria E. Ruiz Esparza-Dueñas MD ,&nbsp;Diana Romero-Zertuche MD ,&nbsp;Ivan I. Silvestre-Flores MD ,&nbsp;Julieta Morales-Portano MD ,&nbsp;Arturo Orea-Tejeda MD, PHD ,&nbsp;Jorge Rojas-Serrano MD, PHD ,&nbsp;Robert L. McNamara MD, MHS ,&nbsp;Pedro A. Reyes Lopez MD, PHD ,&nbsp;Lissa Sugeng MD, MPH","doi":"10.1016/j.echo.2025.02.008","DOIUrl":"10.1016/j.echo.2025.02.008","url":null,"abstract":"<div><h3>Aims</h3><div>Cardiac surgery is the cornerstone of treatment of several heart conditions, but accurate risk stratification is critical. Commonly used scores do not include right ventricular (RV) function. We aimed to evaluate whether three-dimensional (3D) RV ejection fraction (RVEF) predicts outcomes in patients undergoing cardiac surgery after adjusting for the EuroSCORE II.</div></div><div><h3>Methods and results</h3><div>This is a prospective multicenter study of adult patients undergoing cardiac surgery at 3 centers. Right ventricular function parameters were analyzed with transesophageal echocardiogram before the surgery. We evaluated the association of 3D RVEF with the primary outcome (composite of in-hospital mortality or need of temporary ventricular assist device) after adjusting for the EuroSCORE II. Exploratory end points were time on mechanical ventilation and time on inotropes. We included 248 patients (median age, 69 years; 43% female). Sixty-nine percent had normal RVEF (≥45%). Right ventricular function parameters (tricuspid annular plane systolic excursion, fractional area change, and RV free-wall longitudinal strain) were lower in the group of decreased RVEF (<em>P</em> &lt; .001 for all). The primary outcome occurred in 28 patients (11%). After adjusting for the EuroSCORE II, decreased RVEF was independently associated with the primary outcome (hazard ratio = 2.46; 95% CI, 1.10, 5.50; <em>P</em> = .028). Importantly, 3D RVEF was superior to all other parameters of RV systolic function to predict the primary outcome (<em>P</em> = .006). At 30 days, survival free of the primary end point was 72% ± 8% versus 93% ± 3% (<em>P</em> &lt; .001) in decreased versus normal RVEF, respectively. Right ventricular ejection fraction was associated with shorter time on mechanical ventilation (<em>r</em> = −0.27, <em>P</em> &lt; .001) and shorter time on inotropes (<em>r</em> = −0.20, <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Among the RV function parameters, 3D RVEF is the strongest predictor of in-hospital mortality or need of temporary ventricular assist device in patients undergoing cardiac surgery. This multicenter study suggests that 3D RVEF should be included in the evaluation of patients undergoing surgery because it might improve stratification.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Pages 685-693"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473085","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":"Flow State in Aortic Stenosis: “Whatever the Parameters, as Long as We Identify the Risk”","authors":"Marie-Annick Clavel DVM, PhD,&nbsp;Lionel Tastet PhD","doi":"10.1016/j.echo.2025.04.014","DOIUrl":"10.1016/j.echo.2025.04.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Pages 655-657"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029431","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 Joy of Being an Active Member and Volunteer for ASE","authors":"David H. Wiener MD, FASE","doi":"10.1016/j.echo.2025.06.005","DOIUrl":"10.1016/j.echo.2025.06.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Page A11"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766683","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":"Impact of Renal Function on Myocardial Remodeling and Outcomes in Patients With Moderate Aortic Stenosis","authors":"Hyun-Jung Lee MD, PhD,&nbsp;Kyu Kim MD,&nbsp;Seo-Yeon Gwak MD,&nbsp;Iksung Cho MD, PhD,&nbsp;Geu-Ru Hong MD, PhD,&nbsp;Jong-Won Ha MD, PhD,&nbsp;Chi Young Shim MD, PhD","doi":"10.1016/j.echo.2025.04.008","DOIUrl":"10.1016/j.echo.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients with moderate aortic stenosis (AS) and cardiac damage have poor prognosis, and whether early aortic valve replacement benefits these patients is under investigation. However, besides valvular hemodynamics, comorbidities such as chronic kidney disease (CKD) can contribute to myocardial damage and affect prognosis. The aim of this study was to investigate the impact of renal function on myocardial remodeling and outcomes in patients with moderate AS.</div></div><div><h3>Methods</h3><div>The study cohort included 865 consecutive patients diagnosed with moderate AS (aortic valve area &gt; 1.0 and ≤1.5 cm², mean gradient &gt; 20 mmHg) between 2008 and 2020. Patients were categorized into five stages of CKD according to estimated glomerular filtration rate. Echocardiographic measures of myocardial remodeling and the composite outcome of all-cause mortality and heart failure hospitalization were assessed.</div></div><div><h3>Results</h3><div>Higher CKD stage was associated with greater valvuloarterial impedance, as well as greater left ventricular (LV) hypertrophy, worse LV diastolic function, and lower LV and left atrial strain, despite similar AS severity. These associations were independent of age, sex, comorbidities, and LV pressure overload. During a median follow-up period of 4.0 years, 310 composite outcome events (39.3%) occurred, including 258 deaths (32.7%). Severe CKD (stage 4 or 5) and myocardial dysfunction were independent predictors of the composite outcome, after adjustment for key clinical variables including aortic valve replacement. Mediation analysis showed that myocardial dysfunction partially mediated the impact of renal function on outcome.</div></div><div><h3>Conclusions</h3><div>In patients with moderate AS, renal dysfunction was independently associated with adverse myocardial remodeling and dysfunction, irrespective of valvular hemodynamics. The role of earlier intervention in patients with moderate AS whose cardiac damage is driven by comorbidities, rather than AS itself, warrants further investigation.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 8","pages":"Pages 658-667"},"PeriodicalIF":6.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039816","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}