Journal of the American Society of Echocardiography最新文献

{"title":"Elevated Systolic Blood Pressure and Hemodynamic Parameters in Patients with Aortic Stenosis Undergoing Echocardiography in Real-World Practice.","authors":"Jaiveer Singh, Samuel W Reinhardt, David J Hur, Lissa Sugeng, Emmanuel Akintoye, Bernardo Lombo, Lavanya Bellumkonda, Evgeny Shkolnik, Robert L McNamara, Kamil F Faridi","doi":"10.1016/j.echo.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.echo.2025.01.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068811","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":"Unveiling the Left Atrioventricular Coupling Index: A Promising Marker for Diastolic Dysfunction and Prognosis.","authors":"Yong-Huai Wang, Yu Dong, Guang-Yuan Li, Chun-Yan Ma","doi":"10.1016/j.echo.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.echo.2024.12.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068997","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 with Outcome of the Regurgitant-Volume Adjusted Right Ventricular Ejection Fraction in Secondary Tricuspid Regurgitation.","authors":"Alexandra Clement, Michele Tomaselli, Luigi P Badano, Diana R Hadareanu, Noela Radu, Marco Penso, Sergio Caravita, Claudia Baratto, Samantha Fisicaro, Caterina Delcea, Alessandra Rota, Radu Sascau, Denisa Muraru","doi":"10.1016/j.echo.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.echo.2025.01.008","url":null,"abstract":"<p><strong>Background: </strong>In patients with secondary tricuspid regurgitation (STR), right ventricular ejection fraction (RVEF) may not accurately reflect the actual RV systolic performance since a considerable amount of the RV stroke volume (SV) is regurgitated back into the right atrium. To overcome this limitation, we explored the association with the outcome of the effective RVEF (eRVEF), which accounts for the tricuspid regurgitant volume (RegVol).</p><p><strong>Methods: </strong>513 patients with STR (mean age 75±13 years, 39% atrial STR, 58% severe) underwent complete two-, three-dimensional, and Doppler echocardiography. eRVEF was computed as RV forward SV/RV end-diastolic volume, where forward SV was obtained by subtracting the tricuspid RegVol from the total RVSV. The endpoint was a composite of all-cause death and heart failure hospitalization.</p><p><strong>Results: </strong>After a mean follow-up of 18±15 months, 195 patients (38%) reached the composite endpoint. At time-dependent receiver operating characteristic analysis, eRVEF (AUC 0.72, 95%CI 0.68-0.77) showed a stronger association with outcome than RVEF (AUC 0.65, 95%CI 0.59-0.70, p=0.006), tricuspid annular plane systolic excursion (AUC 0.64, 95%CI 0.59-0.69, p= 0.01), RV free-wall longitudinal strain (AUC 0.63, 95%CI 0.58-0.68, p= 0.003), and RV fractional area change (AUC 0.55, 95%CI 0.50-0.60, p<0.001). The eRVEF cut-off associated with an excess event rate was 20% on spline curve modeling. Patients with eRVEF <20% demonstrated a higher rate of events at 2 years (65 ± 6%) than those having an eRVEF ≥20% (22 ±7%, log-rank <0.0001). eRVEF <20% was associated with a 3-fold increased risk of experiencing the composite endpoint (HR: 3.54 [2.61-4.79], p<0.001). On different models of multivariable analysis, eRVEF as a continuous variable remained independently associated with the combined endpoint (HR: 0.96; 95% CI= 0.94-0.98; p<0.001).</p><p><strong>Conclusions: </strong>In patients with STR, eRVEF was more closely associated with all-cause mortality and heart failure hospitalizations than RVEF and other conventional echocardiographic indices of RV function.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030098","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":"Diastolic Dysfunction and Survival in Patients With Preserved or Mildly Reduced Left Ventricular Ejection Fraction Following Myocardial Infarction.","authors":"Nicole Ivy Chan, John J Atherton, Anish Krishnan, Christopher Hammett, Peter Stewart, Michael Mallouhi, William Vollbon, Liza Thomas, Sandhir B Prasad","doi":"10.1016/j.echo.2025.01.007","DOIUrl":"10.1016/j.echo.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular ejection fraction (LVEF) is relatively indiscriminate for prognosis in patients with preserved or mildly reduced LVEF (>40%) following myocardial infarction (MI). This study sought to determine the value of guideline-based assessment of diastolic dysfunction (DD) in predicting long-term all-cause and cardiac mortality in patients with a first-ever MI and LVEF >40%.</p><p><strong>Methods: </strong>A retrospective single-center study involving 2,234 patients with a first-ever MI (ST elevation MI or non-ST elevation MI) with LVEF >40% was performed. Clinical, angiographic, echocardiographic, and outcomes data were obtained from prospectively maintained institutional and statewide databases. Echocardiography was performed early postadmission for all patients. Significant DD was defined was grade 2 and 3 DD.</p><p><strong>Results: </strong>The mean age of patients was 61.4 ± 12.3 years, 70.7% were male, and 12.1% had 3-vessel disease. The mean LVEF was 55.8% ± 7.2%, and 14.1% had significant DD. At a median follow-up of 4.5 years, there were 219 deaths (46 cardiac deaths). On Cox proportional hazards multivariable analyses incorporating significant clinical, angiographic, and echocardiographic variables, significant DD was an independent predictor of both all-cause (hazard ratio = 2.01; 95% CI, 1.37-2.94; P < .001) and cardiac (hazard ratio = 3.97; 95% CI, 1.98-7.99; P < .001) mortality. Bootstrapping and calculation of Harrel's C confirmed the independent association of significant DD with outcomes.</p><p><strong>Conclusions: </strong>Significant DD is an independent predictor of all-cause and cardiac mortality following MI in patients with preserved or mildly reduced LVEF and thus effectively reclassifies prognosis in a subgroup where the LVEF is relatively indiscriminate for survival. The benefit of further investigation and/or treatment in this subgroup needs further study.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014999","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 Impaired Relaxation Mitral Inflow Pattern (Grade 1 Diastolic Function) With Long-Term Noncardiovascular and Cardiovascular Mortality.","authors":"Kathleen A Young, Richard J Rodeheffer, Jared G Bird, William R Miranda, Horng H Chen, Jae K Oh, Garvan C Kane","doi":"10.1016/j.echo.2025.01.005","DOIUrl":"10.1016/j.echo.2025.01.005","url":null,"abstract":"<p><strong>Background: </strong>Abnormalities of left ventricular diastolic function are established independent predictors of heart failure and mortality. The aim of this study was to determine whether the association of diastolic function with all-cause mortality is driven by cardiovascular or noncardiovascular death and if impaired relaxation mitral inflow filling pattern is a risk marker.</p><p><strong>Methods: </strong>Diastolic function was graded by the Mayo Clinic algorithm using the well-characterized prospective Olmsted County Heart Function Study. Those with reduced left ventricular ejection fraction, moderate or greater valve disease, clinical diagnosis of heart failure, or indeterminate diastolic function were excluded. Notably, all patients with an impaired relaxation pattern (E/A ratio < 0.8) were classified as abnormal (grade 1) regardless of ejection fraction and clinical or other echocardiographic abnormalities. Individuals were followed for a median of 19.7 years (interquartile range, 18.9-20.6 years) for mortality outcomes.</p><p><strong>Results: </strong>In a community cohort of 1,005 subjects 63 years (interquartile range, 57-71 years) of age, grade 1 diastolic function was common (26%) and associated with all-cause mortality (hazard ratio [HR], 4.05; 95% CI, 3.22-5.09; P < .0001). This association persisted in a subgroup of those with impaired myocardial relaxation and no other clinical or echocardiographic abnormalities (HR, 2.71; 95% CI, 1.89-3.88; P < .0001). The association of diastolic function with noncardiovascular death was not significant after adjustment for age, sex, and comorbidities, though there was an association with grade 1 diastolic function and risk for death of dementia (age- and sex-adjusted HR, 2.30; 95% CI, 1.54-3.45; P < .001). The association of diastolic function and cardiovascular mortality persisted in multivariable model, including for grade 1 diastolic function (HR, 2.43; 95% CI, 1.16-5.05; P = .02).</p><p><strong>Conclusions: </strong>Impaired relaxation mitral inflow pattern (grade 1) is common in older adults in the community and found to be associated with cause-specific death, highlighting this simple echocardiographic finding as a potential biomarker of cardiovascular and cognitive risk and not necessarily a benign finding that is normal with age.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014947","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":"Optimal Cut Plane for Tricuspid Annular Plane Systolic Excursion Measurement.","authors":"Michito Murayama, Sanae Kaga, Hisao Nishino, Yusuke Yanagi, Mana Goto, Fuka Ando, Shinobu Yokoyama, Marina Yamaguchi, Kazunori Okada, Masahiro Nakabachi, Makoto Kambayashi, Yui Shimono, Kosuke Nakamura, Yoji Tamaki, Suguru Ishizaka, Hiroyuki Iwano, Toshiyuki Nagai, Toshihisa Anzai","doi":"10.1016/j.echo.2024.12.013","DOIUrl":"10.1016/j.echo.2024.12.013","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015010","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":"Left Ventricular Elastance With Resting Volumetric Transthoracic Echocardiography Identifies Different Phenotypes in Heart Failure With Preserved Ejection Fraction: A Retrospective Analysis of a Multicenter Prospective Observational Study.","authors":"Yi Wang, Quirino Ciampi, Lauro Cortigiani, Angela Zagatina, Ratnasari Padang, Garvan C Kane, Hector R Villarraga, Jesus Peteiro Vazquez, Elena Kalinina, Alla Boshchenko, Tamara Ryabova, Fiore Manganelli, Hugo Rodriguez-Zanella, Jelena Celutkiene, Elisa Merli, Clarissa Borguezan-Daros, Jorge Lowenstein, Rosina Arbucci, Diego M Lowenstein Haber, Sofia Marconi, Pablo M Merlo, Karina Wierzbowska-Drabik, Ayten Safarova, Tatiana Timofeeva, Ariel Saad, Francesca Bursi, Jaroslaw D Kasprzak, Ana Djordjevic-Dikic, Sergio Kobal, Dimitrios Soulis, Nicola Gaibazzi, Nithima Chaowalit Ratanasit, Rodolfo Citro, Albert Varga, Marco Fabio Costantino, Fausto Rigo, Aleksandra Nikolic, Giovanni Benfari, Miguel Amor, Ana Cristina Camarozano, Rosangela Cocchia, Attila Palinkas, Antonello D'Andrea, Miodrag Ostojic, Tamara Kovačević Preradović, Iana Simova, Federica Re, Paolo Colonna, Maria Grazia D'Alfonso, Fabio Mori, Claudio Dodi, Filipa Xavier Valente, Giovanni Tripepi, Lixue Yin, Mauro Pepi, Scipione Carerj, Patricia A Pellikka, Eugenio Picano","doi":"10.1016/j.echo.2024.12.012","DOIUrl":"10.1016/j.echo.2024.12.012","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous entity including different phenotypes of near normal, normal, and supernormal left ventricular (LV) function. The aim of this study was to assess the value of resting LV elastance (also known as force) using transthoracic echocardiography to identify HFpEF phenotypes.</p><p><strong>Methods: </strong>In a prospective, observational, multicenter study, 2,380 patients with HFpEF were recruited from July 2016 to May 2024. Systolic blood pressure (SBP) was measured. LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV ejection fraction, force (SBP/LVESV), stroke volume (SV), arterial elastance, ventricular-arterial coupling, and left atrial volume index were assessed. Global longitudinal strain was available in 1,164 patients (48.9%). Six hundred eighty patients finished follow-up with a composite endpoint of major adverse cardiac events (MACEs). Patients were divided into three groups: group 1, low force (<25th percentile, <3.24 mm Hg/mL); group 2, intermediate force (≥25th percentile and ≤75th percentile, 3.24-5.48 mm Hg/mL); and group 3, high force (>75th percentile, >5.48 mmHg/mL).</p><p><strong>Results: </strong>The three groups showed a gradient with descending values (group 3 > group 2 > group 1) for SBP, LV ejection fraction, global longitudinal strain, arterial elastance, and ventricular-arterial coupling, with the opposite gradient (group 1 > group 2 > group 3) for LVEDV, LVESV, SV, and left atrial volume index values (P < .01 for all). After a median follow-up period of 16 months, 205 MACEs occurred in 138 patients. The cumulative MACE rate was lowest in group 2 (14.7% person-years) and higher in groups 1 (16.1% person-years) and 3 (22.9% person-years; log-rank P = .036).</p><p><strong>Conclusions: </strong>Patients with HFpEF present with different LV contractile phenotypes, easily identified with resting LV force and volumetric transthoracic echocardiography. The dominant hemodynamic feature of hypocontractile phenotype is a preload recruitment with larger LVEDV and normal SV, while the hypercontractile phenotype is characterized by a small left ventricle with reduced SV. The hypercontractile and hypocontractile phenotypes are associated with a higher risk for subsequent events.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015031","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":"Establishing dosing parameters for the use of maternal hyperoxygenation to affect fetal cardiovascular physiology.","authors":"Michelle Kaplinski, Aaron A Phillips, Megha D Tandel, Yingjie Weng, Kelly Thorson, Katie Jo Stauffer, Sandra Moon, Adam Frymoyer, Virginia D Winn, Theresa A Tacy, Shiraz A Maskatia","doi":"10.1016/j.echo.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.echo.2025.01.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973026","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":"Blood Pressure and Echocardiographic Interpretation: Guideline Revision Needed.","authors":"Christopher Lee, Theodore P Abraham, Nelson B Schiller","doi":"10.1016/j.echo.2025.01.003","DOIUrl":"10.1016/j.echo.2025.01.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973025","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":"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, Mustafa Suppah, Kamal Awad, Juan Farina, Bobbi Jo Heon, Rachel Wraith, Bishoy Abraham, Sara Kaldas, Vuyisile Nkomo, Reza Arsanjani, Chieh-Ju Chao, David Holmes, Said Alsidawi","doi":"10.1016/j.echo.2024.12.010","DOIUrl":"10.1016/j.echo.2024.12.010","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (P = .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 (P = .20).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-06","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}