Journal of the American Society of Echocardiography最新文献

{"title":"Clinical Risk Predictors for Abnormal Left Ventricular and Atrial Function in Lupus Erythematosus","authors":"Matteo Morello MD ,&nbsp;Bethany Gholson RCS, ACS ,&nbsp;Weiting Huang MD ,&nbsp;William Lain BS ,&nbsp;Maxwell Malter BS ,&nbsp;Antonio Abbate MD, PhD ,&nbsp;Brittany N. Weber MD, PhD ,&nbsp;Jonathan R. Lindner MD","doi":"10.1016/j.echo.2025.03.001","DOIUrl":"10.1016/j.echo.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>In systemic lupus erythematosus (SLE), ventricular dysfunction can occur from primary immune injury or secondarily from SLE-related comorbidities. The aim of this study was to determine clinical predictors of reduced left ventricular (LV) systolic and diastolic function in an effort to understand potentially mitigating strategies.</div></div><div><h3>Methods</h3><div>The authors retrospectively studied 76 patients with SLE who underwent comprehensive transthoracic echocardiography within 3 months of an appointment with a rheumatologist to correlate clinical, laboratory, and echocardiographic features. All key echocardiographic measurements were reviewed and remeasured, when appropriate, by an expert blinded to other study data. Abnormal LV systolic function was defined as a global longitudinal strain threshold of −18.0%. Hierarchical cluster analysis was used to define feature interaction.</div></div><div><h3>Results</h3><div>The mean age of the population was 49 ± 15 years, and 83% were women. Reduced GLS was found in 24% of the population, of whom 44% had LV ejection fractions &lt;50%. Previously documented heart failure symptoms were more prevalent in the reduced GLS cohort (50% vs 12%, <em>P</em> = .002). Those with reduced GLS had clinical features indicating greater SLE severity over time, including reduced renal function and prior pericardial involvement. GLS was strongly associated with right ventricular free wall strain (<em>r</em> = 0.67, <em>P</em> &lt; .01) and degree of LV diastolic dysfunction. Worsening grades of diastolic dysfunction, like GLS, were associated with renal disease and pericardial involvement. Patients with SLE with reduced GLS and diastolic function also had abnormal left atrial reservoir strain (LASr). Hierarchical cluster analysis segregated populations with reduced GLS, reduced LASr, pericardial and renal involvement, and an additional feature of C-reactive protein known to be associated with chronic disease activity.</div></div><div><h3>Conclusions</h3><div>Reduced GLS is common in patients with SLE and is associated with heart failure symptoms and markers of increased disease activity over time, particularly pericardial involvement, suggesting common immune mechanisms. The associations of GLS with right ventricular function, diastolic dysfunction, and impairment in LASr suggests a common mechanistic basis involving immune injury.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 486-497"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598185","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":"Stress Echocardiography in Patients With Moderate or Severe Myocardial Ischemia: Insights From the ISCHEMIA Trial","authors":"Michael H. Picard MD ,&nbsp;Kyle Saysana MD ,&nbsp;Derek D. Cyr PhD ,&nbsp;Xin Zeng MD, PhD ,&nbsp;Marielle Scherrer-Crosbie MD, PhD ,&nbsp;Leslee J. Shaw PhD ,&nbsp;Roxy Senior MD, DM ,&nbsp;Kian Keong Poh MD ,&nbsp;Sripal Bangalore MD, MHA ,&nbsp;Jonathon A. Leipsic MD ,&nbsp;GB John Mancini MD ,&nbsp;Matthew J. Budoff MD ,&nbsp;Cameron J. Hague MD ,&nbsp;James K. Min MD ,&nbsp;Sean M. O'Brien Ph.D ,&nbsp;Judith S. Hochman MD ,&nbsp;David J. Maron MD ,&nbsp;Harmony R. Reynolds MD ,&nbsp;ISCHEMIA Research Group","doi":"10.1016/j.echo.2025.03.006","DOIUrl":"10.1016/j.echo.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>This study examined stress echocardiography in relation to coronary artery anatomy and outcome in subjects randomized in the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial.</div></div><div><h3>Methods</h3><div>Of 5,179 patients randomized to initial invasive or conservative strategy, stress echocardiography was performed in 1,079. Coronary computed tomographic angiogram (CCTA) excluded left main disease and quantified coronary lesions. Degree of ischemia was defined by number of segments with stress-induced wall motion abnormalities (mild &lt; 3, moderate = 3, and severe &gt; 3). Transient ischemic dilation was defined as a 10% increase in stress left ventricular end-systolic volume. Primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest.</div></div><div><h3>Results</h3><div>On CCTA, 607/715 (84%) with CCTA evaluable for ≥70% lesion had 1 such lesion. Features associated with coronary lesions ≥70% were number of ischemic/infarcted segments, 3 or more ischemic segments in the anterior territory, and inability to augment left ventricular ejection fraction 10 percentage points. Transient ischemic dilation, present in 28.5% of cases, was significantly associated with severity of ischemia. For every 0.10 increase in peak wall motion score index, there was a 12% increased risk of cardiovascular death or myocardial infarction (adjusted hazard ratio = 1.12; 95% CI, 1.04, 1.21; <em>P</em> = .003).</div></div><div><h3>Conclusion</h3><div>In patients with chronic coronary disease and moderate or severe myocardial ischemia receiving contemporary therapies, stress echocardiography identified subjects with significant coronary artery disease and wall motion score index provided prognostic value.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 465-481"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671446","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":"Safety of Transesophageal Echocardiography Guided Cardioversion Among Patients With Left Atrial Appendage Occlusion Without Anticoagulation","authors":"Sachin K. Aggarwal MD,&nbsp;M. Brett Bowling MD,&nbsp;Gregory G. Jackson MD,&nbsp;Tuna Ustunkaya MD,&nbsp;Edward Qian MD, MS,&nbsp;Christopher R. Ellis MD,&nbsp;T. Lee Richardson MD,&nbsp;Michael T. Baker MD","doi":"10.1016/j.echo.2025.03.015","DOIUrl":"10.1016/j.echo.2025.03.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 511-514"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054970","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 MD ,&nbsp;Michele Tomaselli MD ,&nbsp;Luigi P. Badano MD, PhD ,&nbsp;Diana R. Hadareanu MD, PhD ,&nbsp;Noela Radu MD ,&nbsp;Marco Penso BME ,&nbsp;Sergio Caravita MD, PhD ,&nbsp;Claudia Baratto MD, PhD ,&nbsp;Samantha Fisicaro RDCS ,&nbsp;Caterina Delcea MD, PhD ,&nbsp;Alessandra Rota MD ,&nbsp;Radu Sascau MD, PhD ,&nbsp;Denisa Muraru MD, PhD","doi":"10.1016/j.echo.2025.01.008","DOIUrl":"10.1016/j.echo.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>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).</div></div><div><h3>Methods</h3><div>Five hundred thirteen patients with STR (mean age 75 ± 13 years, 39% atrial STR, 58% severe) underwent complete two-, three-dimensional, and Doppler echocardiography. The 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 end point was a composite of all-cause death and heart failure hospitalization.</div></div><div><h3>Results</h3><div>After a mean follow-up of 18 ± 15 months, 195 patients (38%) reached the composite end point. At time-dependent receiver operating characteristic analysis, eRVEF (area under the curve [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; <em>P</em> = .006), tricuspid annular plane systolic excursion (AUC = 0.64; 95% CI, 0.59-0.69; <em>P</em> = .01), RV free-wall longitudinal strain (AUC = 0.63; 95% CI, 0.58-0.68; <em>P</em> = .003), and RV fractional area change (AUC = 0.55; 95% CI, 0.50-0.60; <em>P</em> &lt; .001). The eRVEF cutoff associated with an excess event rate was 20% on spline curve modeling. Patients with eRVEF &lt;20% demonstrated a higher rate of events at 2 years (65% ± 6%) than those having an eRVEF ≥20% (22% ± 7%, log-rank &lt;0.0001). An eRVEF &lt;20% was associated with a 3-fold increased risk of experiencing the composite end point (hazard ratio = 3.54 [2.61-4.79], <em>P</em> &lt; .001). On different models of multivariable analysis, eRVEF as a continuous variable remained independently associated with the combined end point (hazard ratio = 0.96; 95% CI, 0.94-0.98; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 451-464"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","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":"Are AI Foundation Models Efficient for Segmentation of Echocardiograms?","authors":"Danielle L. Ferreira PhD,&nbsp;Rima Arnaout MD","doi":"10.1016/j.echo.2025.02.001","DOIUrl":"10.1016/j.echo.2025.02.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 514-516"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392357","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":"Leveraging Natural Language Processing for Echocardiographic Data Extraction in Hypoplastic Left Heart Syndrome","authors":"Zachary Girvin MD,&nbsp;Srushti Gangireddy MS,&nbsp;Andersen Coleman MD,&nbsp;Henry Ong PhD,&nbsp;Wei-Qi Wei MD, PhD,&nbsp;Prince J. Kannankeril MD, MSCI,&nbsp;Sudeep D. Sunthankar MD, MSCI","doi":"10.1016/j.echo.2025.02.010","DOIUrl":"10.1016/j.echo.2025.02.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 529-531"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670162","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":"Intraoperative Transesophageal Echocardiography in Acute Type A Aortic Dissection: Contemporary Approach","authors":"Marta Kelava MD, MS ,&nbsp;Andrej Alfirevic MD ,&nbsp;Mariya Geube MD ,&nbsp;Andrew Bauer MD ,&nbsp;Nikolaos J. Skubas MD ,&nbsp;Luai Zakaria MD ,&nbsp;Eric E. Roselli MD ,&nbsp;Patrick R. Vargo MD ,&nbsp;Faisal G. Bakaeen MD ,&nbsp;Xiaoying Lou MD ,&nbsp;Lars G. Svensson MD ,&nbsp;Marijan Koprivanac MD, MS","doi":"10.1016/j.echo.2025.03.017","DOIUrl":"10.1016/j.echo.2025.03.017","url":null,"abstract":"<div><div>Acute type A aortic dissection represents a critical cardiac surgical emergency and carries a significant mortality risk. While computed tomography angiography is the standard for initial diagnosis, transesophageal echocardiography (TEE) is indispensable in the intraoperative setting. This article discusses intraoperative TEE findings in patients undergoing surgery for type A aortic dissection, emphasizing the necessity of real-time imaging to detect complications and guide surgical management. The use of TEE is important in confirming diagnoses, monitoring hemodynamics, evaluating the function of the aortic valve, pericardial, and pleural spaces, and potentially assessing abdominal branch vessel flow, thus ultimately facilitating informed surgical decisions. Moreover, intraoperative TEE use enables differentiation between true and false lumens and facilitates central aortic cannulation guidance via the Seldinger technique. Post–cardiopulmonary bypass, TEE is used to assess surgical results and guide further interventions if necessary. This comprehensive review aims to disseminate essential echocardiographic insights, advocating for greater awareness and utilization of TEE in the surgical management of aortic dissection to improve patient outcomes.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 498-508"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055628","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.2025.05.005","DOIUrl":"10.1016/j.echo.2025.05.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Page A17"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195803","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":"Mitral Annular Disjunction Is Associated With Ventricular Arrhythmias in Children With Marfan Syndrome","authors":"Carlos A. Sanchez Parra MD,&nbsp;Ruthie M. Vaughan MD,&nbsp;Alejandra Iturralde Chavez MD ,&nbsp;Christina Y. Miyake MD, MS,&nbsp;Santiago O. Valdes MD,&nbsp;Ricardo H. Pignatelli MD,&nbsp;Anitha Parthiban MD,&nbsp;Shaine A. Morris MD, MPH,&nbsp;Tam T. Doan MD, MS","doi":"10.1016/j.echo.2025.02.014","DOIUrl":"10.1016/j.echo.2025.02.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 525-526"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587867","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 Rotational Indices in Children With Hypertrophic Cardiomyopathy: Unique Characteristics in Children and Differences From Adults","authors":"Andrea E. Montero MD,&nbsp;Ryusuke Numata MD, PhD,&nbsp;Hunter Kauffman BS,&nbsp;Renzo Calderon-Anyosa MD, MSc, PhD,&nbsp;Putri Yubbu MBBS,&nbsp;Tomoyuki Sato MD, PhD,&nbsp;Anirban Banerjee MD","doi":"10.1016/j.echo.2025.03.003","DOIUrl":"10.1016/j.echo.2025.03.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 6","pages":"Pages 527-529"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631011","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}