Journal of the American Society of Echocardiography最新文献

{"title":"In Response to: “Clarifying the Geometry: Reassessing the Right Ventricular Eccentricity Index”","authors":"Monica Mukherjee MD, MPH, Benjamin H. Freed MD, Luna Gargani MD, PhD, Lawrence G. Rudski MD","doi":"10.1016/j.echo.2025.07.001","DOIUrl":"10.1016/j.echo.2025.07.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 982-983"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610209","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":"Regional Right Ventricular Remodeling in Hypoplastic Left Heart Syndrome Across Staged Surgical Palliation and Its Association With Global Right Ventricular Function and Clinical Outcomes","authors":"Kana Yazaki MD, PhD ,&nbsp;Chun-Po Steve Fan PhD ,&nbsp;Swapna Sivadas Thilakam MD ,&nbsp;Wei Hui MD ,&nbsp;Andreea Dragulescu MD, PhD ,&nbsp;Luc Mertens MD, PhD ,&nbsp;Bart Bijnens PhD ,&nbsp;Mark K. Friedberg MD, PhD","doi":"10.1016/j.echo.2025.05.021","DOIUrl":"10.1016/j.echo.2025.05.021","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) remodeling and (mal)adaptation contribute to high morbidity and mortality in children with hypoplastic left heart syndrome (HLHS). The mechanisms are incompletely understood. The authors hypothesized that apical hypertrophy leads to a loss of RV volume, necessitating basal functional compensation, which determines RV function and outcomes. Consequently, the aim of this study was to examine regional patterns of RV hypertrophic remodeling and their relationships to RV function in HLHS.</div></div><div><h3>Methods</h3><div>Longitudinal clinical and echocardiographic parameters in 111 children with HLHS and 56 age-matched control subjects were retrospectively analyzed. To evaluate RV regional remodeling over time, six echocardiograms were analyzed for each patient: (1) after birth, (2) after stage 1 surgery, (3) before stage 2 surgery, (4) after stage 2 surgery, (5) before stage 3 surgery, and (6) the last echocardiogram or before heart transplantation or death. Global and regional RV hypertrophy, geometry, function, and strain were measured. To evaluate the relative contribution of basal vs apical shortening to overall RV ejection, we calculated the ratio of basal to apical fractional area change (FAC).</div></div><div><h3>Results</h3><div>Before stage 1, apical function was impaired compared with basal function. After stage 1, RV sphericity (mid/basal ratio; <em>P</em> &lt; .001) and hypertrophy (<em>P</em> &lt; .001) increased, particularly at the apex (apical/basal ratio; <em>P</em> = .010). At the same time, global RV dilatation and dysfunction worsened, driven predominantly by decreased basal function. Patients with the lowest basal/apical FAC ratios (≤1.04) after birth tended to need transplantation (<em>P</em> = .07). After stage 2, RV hypertrophy (<em>P</em> &lt; .001) and dilatation improved, accompanied by reduced shortening (RV FAC; <em>P</em> &lt; .001) and longitudinal strain (<em>P</em> = .004), mainly at the base (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Patients with decreased RV basal function concomitantly with decreased apical function before stage 1 or loss of RV volume secondary to RV apical hypertrophy may be at higher risk for transplantation. The present results advance understanding of RV dysfunction in HLHS and may aid in serial assessment of these high-risk patients.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 932-945"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509194","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":"Predictors of Postoperative Atrial Fibrillation in Patients Undergoing Stress Echocardiography Before Noncardiac Surgery","authors":"Kevin M. Stanko MD,&nbsp;Toby N. Weingarten MD,&nbsp;Garvan C. Kane MD, PhD,&nbsp;Patricia A. Pellikka MD,&nbsp;Robert B. McCully MD,&nbsp;Karen F. Mauck MD,&nbsp;Darrell R. Schroeder MS,&nbsp;Michael W. Cullen MD","doi":"10.1016/j.echo.2025.06.008","DOIUrl":"10.1016/j.echo.2025.06.008","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 972-975"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369471","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":"Variability in Residual Left Atrial Appendage Anatomy After Surgical Exclusion","authors":"Blair Tilkens DO,&nbsp;Patrycja Galazka MD,&nbsp;Nicholas Beaudrie DO,&nbsp;Stacie Kroboth BS,&nbsp;Scott Johnson MD,&nbsp;Priscilla Wessly MD,&nbsp;Renuka Jain MD","doi":"10.1016/j.echo.2025.06.004","DOIUrl":"10.1016/j.echo.2025.06.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 971-972"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303441","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":"Suboptimal Interrater Reliability Limits Predictive Value of Fetal Echocardiography for Neonatal Balloon Atrial Septostomy in Fetuses With Dextro-Transposition of the Great Arteries","authors":"Hamsika Chandrasekar MD ,&nbsp;Shiraz A. Maskatia MD ,&nbsp;Meaghan J. Beattie MD ,&nbsp;Michelle A. Kaplinski MD, MPH ,&nbsp;Rajesh Punn MD ,&nbsp;Charitha D. Reddy MD ,&nbsp;Alexandria Jensen PhD ,&nbsp;Theresa A. Tacy MD","doi":"10.1016/j.echo.2025.05.017","DOIUrl":"10.1016/j.echo.2025.05.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Neonates with dextro-transposition of the great arteries (d-TGA) require adequate mixing at the atrial level. Without this, they experience severe cyanosis, necessitating balloon atrial septostomy (BAS). Multiple studies have identified various fetal echocardiogram (FE) findings as risk factors for postnatal BAS. The predictive value of these findings remains poor in clinical use.</div></div><div><h3>Hypothesis</h3><div>We aimed to determine the relationship between interrater reliability (IRR) of FE BAS predictors and postnatal BAS, as well as postnatal markers of hypoxia/hypoxemia. We hypothesized that poor IRR may contribute to limited FE predictive value.</div></div><div><h3>Methods</h3><div>We identified d-TGA pregnancies followed at our institution between 2012 and 2022, excluding fetuses with large ventricular septal defects and pregnancies terminated or lost to follow-up. Two groups of 3 independent readers blinded to BAS outcome assessed 7 FE predictors: peak pulmonary vein Doppler velocity &gt;41 cm/sec, reverse flow in patent ductus arteriosus (PDA), restrictive PDA, restrictive patent foramen ovale (PFO), bidirectional PFO flow, flat septum primum, and hypermobile septum primum. Interrater reliability was determined with the S metric. Clinical information before BAS was collected to evaluate postnatal physiology. A multivariable logistic regression was used to determine significant associations between FE findings and postnatal BAS. Multivariable linear regressions were also used to determine significant associations between FE findings and indicators of hypoxia/hypoxemia.</div></div><div><h3>Results</h3><div>Fifty-two fetuses were included, of whom 25 (48%) underwent BAS. Fetal echocardiograms were performed at a mean gestational age of 34.02 weeks (SD = 2.14 weeks). Interrater reliability was lowest for PFO flow direction and highest for restrictive PDA, likely due to its rarity. The remainder of FE predictors had either moderate or substantial IRR. Five FE characteristics could be included in the regression analysis, and none were significantly associated with odds of BAS, postnatal pH, or postnatal oxygen saturation. Reverse PDA flow was statistically significantly associated with lower postnatal pre-BAS paO₂.</div></div><div><h3>Conclusions</h3><div>Our results demonstrate substantial but not excellent IRR for current FE BAS predictors. There was no significant association between these predictors and postnatal BAS or postnatal hypoxia/hypoxemia in d-TGA patients, except for reverse PDA flow and lower postnatal paO₂. Additional work is needed to identify more reliable FE predictors of postnatal d-TGA physiology.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 916-923"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250581","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":"Clarifying the Geometry: Reassessing the Right Ventricular Eccentricity Index","authors":"José C. Campos-Barba MD,&nbsp;Dorita Chumbes-Aguirre MD,&nbsp;Consuelo Orihuela-Sandoval MD","doi":"10.1016/j.echo.2025.05.022","DOIUrl":"10.1016/j.echo.2025.05.022","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Pages 981-982"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610208","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.2025.08.001","DOIUrl":"10.1016/j.echo.2025.08.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 10","pages":"Page A10"},"PeriodicalIF":6.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190111","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":"Optimizing Clinical Applicability of Left Atrial Strain Index in Patients with Heart Failure with Preserved Ejection Fraction.","authors":"Chuanwei Zhao","doi":"10.1016/j.echo.2025.08.030","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.030","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214302","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 of Preoperative Cardiac Magnetic Resonance and Echocardiography with Post-Operative Left Ventricular Dysfunction in Primary Mitral Regurgitation.","authors":"Alexandre Altes, Valentine Pécriaux, Paulin Hanvi, Vincent Hanet, Inès Belhakia, Noémie Selin, David Vancraeynest, Agnès Pasquet, François Delelis, Manuel Toledano, Valentina Silvestri, Bernhard L Gerber, Sylvestre Maréchaux","doi":"10.1016/j.echo.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.015","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the relationship between preoperative left ventricular (LV) structural and functional characteristics assessed by echocardiography (Echo) and cardiac magnetic resonance (CMR), and the risk of post-operative left ventricular (LV) dysfunction in patients with primary mitral regurgitation (MR) undergoing mitral valve (MV) repair surgery.</p><p><strong>Methods: </strong>We retrospectively studied 223 patients (median age 60 years, 21% women) with chronic primary MR who underwent preoperative Echo and CMR before MV repair surgery. The primary endpoint was post-operative LV dysfunction, defined as LV ejection fraction (EF) < 50% on follow-up Echo.</p><p><strong>Results: </strong>Post-operative LV dysfunction occurred in 41 patients (18%) after a median follow-up of 8.7 [IQR: 6.7-12.5] months. These patients had higher absolute and indexed (ind) LV end-systolic diameters (ESD) and volumes (ESV) (all p≤0.009), lower CMR-LVEF (p=0.003), and a trend towards lower Echo-LVEF (p=0.072). Individually, Echo and CMR parameters showed modest discriminative ability (areas under the curve from 0.59 [0.49-0.68] for Echo-LVEF - to 0.70 [0.61-0.78] for Echo-indLVESD). Strain imaging, whether assessed by Echo or CMR, did not improve risk stratification. Echo-indLVESD and CMR-LVEF were the most contributive LV characteristics. A two-step approach based on Echo-indLVESD < or ≥ 18 mm/m², followed by CMR-LVEF > or ≤ 56% in patients with Echo-indLVESD ≥ 18 mm/m², identified three subgroups with distinct rates of post-operative LV dysfunction (9%, 20% and 41%, respectively).</p><p><strong>Conclusion: </strong>In patients with primary MR undergoing MV surgery, preoperative LV characteristics assessed by Echo and CMR showed only moderate ability to identify those at higher risk of post-operative LV dysfunction. A stepwise approach using Echo-indLVESD followed by CMR-LVEF may help identify subgroups at differing risk levels. These exploratory findings require confirmation in larger prospective studies.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208462","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":"Outcomes of Fetuses with Mild Aortic Stenosis: A Multicenter Study.","authors":"Koyelle Papneja, Wayne Tworetzky, Jack Rychik, Shobha Natarajan, Zhiyun Tian, Erin Madriago, Amy Zhang, Meaghan Beattie, Doff McElhinney, Shiraz Arif Maskatia, Theresa Ann Tacy, Rajesh Punn, Michelle Kaplinski","doi":"10.1016/j.echo.2025.08.031","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.031","url":null,"abstract":"<p><strong>Background: </strong>Severe fetal aortic stenosis (AS) has been studied extensively; however, outcomes of fetuses with mild AS are unknown. With improvements in fetal imaging, more of these patients will be identified. This is the first retrospective cohort study evaluating outcomes in mild AS on initial fetal echocardiogram.</p><p><strong>Methods: </strong>Patients with an initial fetal echocardiogram at four centers between January 2009 to January 2019 with mild AS (peak aortic valve velocity > 1 m/sec, antegrade aortic arch flow, and mild or no left ventricular [LV] systolic dysfunction) were included. Fetuses with worse than mild LV hypoplasia or other heart defects were excluded. Data were collected from the initial and final fetal echocardiogram, initial postnatal echocardiogram, and the echocardiogram prior to either the first aortic valve intervention or at one year of life. The primary outcome was aortic valve intervention at one year. Investigators compared echocardiographic measures for those who did and did not undergo intervention using the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>At the 4 participating centers over 10 years, there were 22 patients, with a median gestational age of 24.7 weeks (22.9, 27.3). Eight patients (36.4%) underwent a postnatal aortic valve intervention within the first year of life. Among these, 4 (50%) were considered to have critical (ductal-dependent) AS. There was a significant difference in aortic valve peak gradient (PG) between those who did and did not require an intervention on the initial fetal echocardiogram (p 0.0017) and the final fetal echocardiogram (p 0.0016). All patients with an aortic valve PG > 12.5 mmHg on the initial fetal echocardiogram underwent intervention during the first year of life. Patients who underwent intervention also had a lower sphericity index on the initial fetal echocardiogram than those who did not (p 0.045).</p><p><strong>Conclusion: </strong>Mild fetal AS is uncommon and has variable outcomes. Approximately one third of our cohort underwent aortic valve intervention by one year of life. Aortic valve PG and LV sphericity index, a relatively novel marker, appear useful in identifying fetal patients that may require intervention during infancy.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208431","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}