Journal of the American Society of Echocardiography最新文献

{"title":"Mechanical Adaptation of the Right Ventricle to Secondary Tricuspid Regurgitation and Its Association With Patient Outcomes","authors":"Zsuzsanna Ladányi MD ,&nbsp;Bálint Károly Lakatos MD, PhD ,&nbsp;Alexandra Clement MD, PhD ,&nbsp;Michele Tomaselli MD, PhD ,&nbsp;Alexandra Fábián MD, PhD ,&nbsp;Noela Radu MD, PhD ,&nbsp;Tímea Katalin Turschl MD ,&nbsp;Andrea Ferencz MD ,&nbsp;Béla Merkely MD, PhD ,&nbsp;Elena Surkova MD, PhD ,&nbsp;Attila Kovács MD, PhD ,&nbsp;Denisa Muraru MD, PhD ,&nbsp;Luigi P. Badano MD, PhD","doi":"10.1016/j.echo.2025.02.011","DOIUrl":"10.1016/j.echo.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Data regarding right ventricular (RV) mechanical adaptation to secondary tricuspid regurgitation (STR) are scarce.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate changes in RV contraction pattern in patients with different degrees of STR severity and etiologies and their association with outcomes.</div></div><div><h3>Methods</h3><div>A total of 205 patients with STR (60% women; mean age, 77 ± 12 years) were enrolled in a single-center prospective observational study. Three-dimensional echocardiography was used to measure RV ejection fraction (RVEF); the absolute contributions of the longitudinal component of RVEF (LEF), the radial component of RVEF (REF), and the anteroposterior component of RVEF (AEF); and their relative contributions by indexing to global RVEF (LEF/RVEF, REF/RVEF, and AEF/RVEF, respectively). Patients were followed for a median of 9 months. The primary outcome was heart failure hospitalization or all-cause death.</div></div><div><h3>Results</h3><div>Patients with different degrees of STR severity did not differ in terms of RVEF (mild vs moderate vs severe: 50 ± 11% vs 49 ± 9% vs 50 ± 10%, respectively, <em>P</em> = .085). However, LEF/RVEF was significantly lower in patients with severe STR (0.39 ± 0.08 vs 0.39 ± 0.09 vs 0.35 ± 0.10, respectively, <em>P</em> = .049). Patients with ventricular STR had lower global RVEF (48 ± 10% vs 53 ± 8%, <em>P</em> = .001), LEF (18 ± 6% vs 20 ± 5%, <em>P</em> = .043), REF (23 ± 9% vs 28 ± 8%, <em>P</em> = .002), and REF/RVEF (0.48 ± 0.012 vs 0.52 ± 0.09, <em>P</em> = .040) than patients with atrial STR. In a multivariable Cox regression model, REF/RVEF was a significant and independent predictor of outcomes in the entire cohort (hazard ratio, 0.980 [95% CI, 0.961-1.000] per 0.01-unit change, <em>P</em> = .047), whereas global RVEF was not.</div></div><div><h3>Conclusions</h3><div>Patients with STR demonstrate significant functional RV remodeling. Patients with severe STR show a significant decrease in RV longitudinal shortening. Apart from STR severity, STR etiology also influences the RV contraction pattern, which was associated with outcomes in our cohort.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 601-612"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494531","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 “The Doppler Angle Effect Needs to Be Considered Wherever in the Heart the Proximal Isovelocity Surface Area Method Is Utilized”","authors":"Luigi P. Badano MD, PhD,&nbsp;Michele Tomaselli MD, PhD,&nbsp;Denisa Muraru MD, PhD","doi":"10.1016/j.echo.2025.03.009","DOIUrl":"10.1016/j.echo.2025.03.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Page 637"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694263","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 Estimate of Pulmonary Capillary Wedge Pressure Improves Outcome Prediction in Heart Failure Patients With Reduced and Mildly Reduced Ejection Fraction","authors":"Lorenzo Bazan MD ,&nbsp;Francesco Gentile MD ,&nbsp;Paolo Sciarrone MD ,&nbsp;Francesco Buoncristiani MD ,&nbsp;Giorgia Panichella MD ,&nbsp;Simone Gasparini MD ,&nbsp;Claudia Taddei MSc ,&nbsp;Elisa Poggianti MSc ,&nbsp;Iacopo Fabiani MD, PhD ,&nbsp;Christina Petersen MD ,&nbsp;Giuseppe Emanuele Lio PhD ,&nbsp;Patrizio Lancellotti MD, PhD ,&nbsp;Claudio Passino MD ,&nbsp;Michele Emdin MD, PhD ,&nbsp;Vladislav Chubuchny MD ,&nbsp;Alberto Giannoni MD, PhD","doi":"10.1016/j.echo.2025.04.005","DOIUrl":"10.1016/j.echo.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>An echocardiographic algorithm to estimate pulmonary capillary wedge pressure (ePCWP) and pulmonary vascular resistance (ePVR) has been recently validated versus right heart catheterization.</div></div><div><h3>Objective</h3><div>To assess the prognostic significance of these measures in heart failure (HF) patients with reduced and mildly reduced ejection fraction.</div></div><div><h3>Methods</h3><div>Consecutive outpatients with HF and left ventricular ejection fraction (LVEF) &lt;50% undergoing echocardiography were selected and followed up for the composite end point of all-cause death or HF hospitalization.</div></div><div><h3>Results</h3><div>Out of 2,214 patients (71 ± 12 years, 76% males, LVEF 35% ± 9%), ePCWP (16 ± 6 mm Hg) was elevated (&gt;15 mm Hg) in 52% of cases and ePVR (1.7 ± 0.7 Wood units) was elevated (&gt;2 Wood units) in 25% of cases. Patients with increased ePCWP were older and had a higher New York Heart Association class, more pronounced cardiac remodeling, systolic/diastolic dysfunction, and neurohormonal activation, particularly when ePVR was also elevated (<em>P</em> &lt; .001). Over a median follow-up of 33 (17-48) months, both measures stratified patients for the risk of the primary end point (log-rank 151 for ePCWP and 60 for ePVR; <em>P</em> &lt; .001). At adjusted regression analysis, ePCWP (hazard ratio for 1 mm Hg increase 1.03 [95% CI, 1.01-1.04]; <em>P</em> &lt; .001) but not ePVR (<em>P</em> = .07) predicted the primary end point, even in patients with atrial fibrillation (<em>P</em> = .019), outperforming current diastolic dysfunction grading (<em>P</em> &lt; .001) and both E/e’ and left atrial volume index (<em>P</em> &lt; .001). The addition of ePCWP to a multivariable prognostic model improved the accuracy of risk prediction (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The echocardiographic estimates of PCWP retained clinical and prognostic significance in a large contemporary cohort of patients with chronic HF and LVEF &lt;50%.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 586-598"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042861","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":"Imaging of Left Ventricular Diastolic Function: Do We Need Both Left Atrial Volume and Reservoir Strain?","authors":"Otto A. Smiseth MD, PhD ,&nbsp;John M. Aalen MD, PhD","doi":"10.1016/j.echo.2025.04.001","DOIUrl":"10.1016/j.echo.2025.04.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 583-585"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052135","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":"Integrating Left Atrial Reservoir Strain Into the First-Line Assessment of Diastolic Function: Prognostic Implications in a Community-Based Cohort With Normal Left Ventricular Systolic Function","authors":"Máté Tolvaj MD ,&nbsp;Fjolla Zhubi Bakija MD ,&nbsp;Alexandra Fábián MD, PhD ,&nbsp;Andrea Ferencz MD ,&nbsp;Bálint Lakatos MD, PhD ,&nbsp;Zsuzsanna Ladányi MD ,&nbsp;Ádám Szijártó MSc ,&nbsp;Borbála Edvi MD ,&nbsp;Loretta Kiss MD, PhD ,&nbsp;Zsolt Szelid MD, PhD ,&nbsp;Pál Soós MD, PhD ,&nbsp;Béla Merkely MD, PhD ,&nbsp;Zsolt Bagyura MD, PhD ,&nbsp;Márton Tokodi MD, PhD ,&nbsp;Attila Kovács MD, PhD","doi":"10.1016/j.echo.2025.03.012","DOIUrl":"10.1016/j.echo.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial (LA) reservoir strain (LASr) has emerged as a sensitive marker of LA function and elevated filling pressures, even though its role in detecting diastolic dysfunction (DD) and the subsequent risk stratification has remained relatively underexplored. Accordingly, we aimed to investigate the prognostic implications of replacing LA volume index (LAVi) with LASr in the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) algorithm for diagnosing DD, compared to the 2024 British Society of Echocardiography (BSE) algorithm, in individuals with normal left ventricular (LV) systolic function.</div></div><div><h3>Methods</h3><div>We retrospectively identified 1,180 volunteers from a population-based screening program with normal LV systolic function and no evidence of myocardial disease. Echocardiographic measurements comprised recommended parameters of diastolic function and LASr by speckle-tracking. Diastolic function was assessed using the BSE algorithm and the modified ASE/EACVI algorithm, in which LAVi &gt;34 mL/m² was replaced with LASr &lt;23%. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization.</div></div><div><h3>Results</h3><div>During a median follow-up of 11 years, 133 (11%) individuals met the primary endpoint. Using the BSE algorithm, there was no difference in the risk of meeting the primary endpoint between individuals with normal diastolic function and those with impaired diastolic function with normal filling pressures. In univariable analysis, individuals having impaired diastolic function with elevated filling pressures exhibited a significantly higher risk than those in the other 2 groups (unadjusted hazard ratios = 4.408 [95% CI, 2.376-8.179], <em>P</em> &lt; .001; and 5.137 [95% CI, 1.138-23.181], <em>P</em> = .033, respectively). However, these differences were no longer significant after adjusting for relevant covariates. In contrast, the modified ASE/EACVI algorithm identified 3 groups with distinct risk profiles, and even in multivariable analysis, individuals with DD had a higher risk of meeting the primary endpoint than those with normal diastolic function (adjusted hazard ratio = 3.199 [95% CI, 1.534-6.671], <em>P</em> = .002).</div></div><div><h3>Conclusion</h3><div>In a community-based cohort with normal LV function, integrating LASr into the first-line echocardiographic assessment of diastolic function improved both classification and subsequent risk stratification.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 570-582"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744193","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":"Application of an Artificial Intelligence Model to Detect Heart Failure With Preserved Ejection Fraction to Handheld Ultrasound Imaging","authors":"Jose K. James MD, PhD,&nbsp;Geoffrey Huntley MD,&nbsp;Ayana Z. Arystan MD,&nbsp;Claire Cassianni MD,&nbsp;Christopher G. Scott MS,&nbsp;Halley Davison MA,&nbsp;Ashley Akerman PhD,&nbsp;Will Hawkes PhD,&nbsp;Jorge Oliveria PhD,&nbsp;Agis Chartsias PhD,&nbsp;Alberto Gomez PhD,&nbsp;Ross Upton PhD,&nbsp;Patricia A. Pellikka MD","doi":"10.1016/j.echo.2025.03.016","DOIUrl":"10.1016/j.echo.2025.03.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 633-635"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054510","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":"Development and Validation of a Novel Deep Learning Model to Predict Pharmacologic Closure of Patent Ductus Arteriosus in Premature Infants","authors":"Puneet Sharma MD ,&nbsp;Addison Gearhart MD ,&nbsp;Guangze Luo BS ,&nbsp;Anil Palepu MS, PhD ,&nbsp;Cindy Wang AB ,&nbsp;Joshua Mayourian ME, MD, PhD ,&nbsp;Kristyn Beam MD, MPH ,&nbsp;Fotios Spyropoulos MD ,&nbsp;Andrew J. Powell MD ,&nbsp;Philip Levy MD ,&nbsp;Andrew Beam PhD","doi":"10.1016/j.echo.2025.03.018","DOIUrl":"10.1016/j.echo.2025.03.018","url":null,"abstract":"<div><h3>Background</h3><div>Patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. Although pharmacotherapy can be effective, it is difficult to predict whether a patient will respond, leading to delays in care. Machine learning has emerged as a powerful tool to interpret clinical data to predict clinical outcomes but has not yet been applied to this question. The aim of this study was to train and validate a novel deep learning model to predict the likelihood of PDA closure after an initial course of pharmacotherapy in preterm infants.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 174 preterm infants who received pharmacologic treatment for PDA was identified. After collecting relevant perinatal data and pretreatment echocardiograms, the subjects were randomized into training and validation sets in a 70:30 split. Two distinct convolutional neural networks (CNN) were trained, one based on echocardiograms alone and the other on both echocardiograms and perinatal data. The performance of the CNNs was compared against controls of random forest and logistic regression models trained on perinatal data alone.</div></div><div><h3>Results</h3><div>The rate of PDA closure after an initial course of pharmacotherapy was 60% in this cohort. The 174 echocardiograms collected for all subjects included 1,926 clips. A total of 121 infants (1,387 clips) were successfully randomized into the training set and 53 (539 clips) into the validation set. The multimodal CNN had an area under the curve (AUC) of 0.82, outperforming the imaging-only model (AUC = 0.66). Additionally, the multimodal CNN outperformed logistic regression (AUC = 0.66) and random forest (AUC = 0.74) models.</div></div><div><h3>Conclusions</h3><div>This novel, multimodal CNN shows promise for clinicians, who do not currently have a reliable tool to predict the success of PDA closure after an initial course of pharmacotherapy. This investigation represents the first attempt to use deep learning methodology to predict this outcome.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages 624-632"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055847","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 2025-2026 Board of Directors","authors":"","doi":"10.1016/j.echo.2025.05.012","DOIUrl":"10.1016/j.echo.2025.05.012","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages A27-A29"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549021","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":"Guide for Authors","authors":"","doi":"10.1016/S0894-7317(25)00326-8","DOIUrl":"10.1016/S0894-7317(25)00326-8","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Pages A15-A24"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549025","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.2025.05.002","DOIUrl":"10.1016/j.echo.2025.05.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 7","pages":"Page A30"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549497","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}