José C. Campos-Barba MD, Dorita Chumbes-Aguirre MD, Consuelo Orihuela-Sandoval MD
{"title":"Clarifying the Geometry: Reassessing the Right Ventricular Eccentricity Index","authors":"José C. Campos-Barba MD, Dorita Chumbes-Aguirre MD, 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}
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
{"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/m<sup>2</sup>, followed by CMR-LVEF > or ≤ 56% in patients with Echo-indLVESD ≥ 18 mm/m<sup>2</sup>, 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}
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
{"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}
Jaehyun Lim, Soongu Kwak, Min-Ha Jeong, Jae Yeong Cho, Chan-Soon Park, Jiesuck Park, Hong-Mi Choi, Ga Hui Choi, Jihoon Kim, Jin-Oh Na, Sun Hwa Lee, Mi-Hyang Jung, Hae Ok Jung, Sang-Chol Lee, Hyung-Kwan Kim, Kye Hun Kim, Goo-Yeong Cho
{"title":"The Effect of Mavacamten on Left Atrial Strain Dynamics in Obstructive Hypertrophic Cardiomyopathy.","authors":"Jaehyun Lim, Soongu Kwak, Min-Ha Jeong, Jae Yeong Cho, Chan-Soon Park, Jiesuck Park, Hong-Mi Choi, Ga Hui Choi, Jihoon Kim, Jin-Oh Na, Sun Hwa Lee, Mi-Hyang Jung, Hae Ok Jung, Sang-Chol Lee, Hyung-Kwan Kim, Kye Hun Kim, Goo-Yeong Cho","doi":"10.1016/j.echo.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182284","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}
Nathanael Tran, Shani Dahan, Jagdip Kang, Michael H Picard, Jacob P Dal-Bianco, Judy Hung
{"title":"Left Ventricular Global Longitudinal Strain: An Imaging Marker Associated with Outcomes in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis.","authors":"Nathanael Tran, Shani Dahan, Jagdip Kang, Michael H Picard, Jacob P Dal-Bianco, Judy Hung","doi":"10.1016/j.echo.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.012","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180350","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 \"Intraoperative Factors Should Be Considered in Assessing the Association Between 3D RVEF and Early Postoperative Outcomes\".","authors":"Posada-Martinez Edith L, Ivey-Miranda Juan B","doi":"10.1016/j.echo.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.011","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180333","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 Factors Should Be Considered in Assessing the Association Between 3D RV EF and Early Postoperative Outcomes.","authors":"Aibek Mirrakhimov","doi":"10.1016/j.echo.2025.08.029","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.029","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180302","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}
Xi Zhang, Yuxin Zhang, Bijun Tan, Han Li, Ying Hou, Pingan Zhou, Lijun Yuan, Changyang Xing
{"title":"A Revised Grading Scheme for Secondary Tricuspid Valve Regurgitation.","authors":"Xi Zhang, Yuxin Zhang, Bijun Tan, Han Li, Ying Hou, Pingan Zhou, Lijun Yuan, Changyang Xing","doi":"10.1016/j.echo.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.010","url":null,"abstract":"<p><strong>Background: </strong>The conventional three-grade scheme recommended by American Society of Echocardiography (ASE) for secondary tricuspid regurgitation (STR) are limited by the frequent disagreement between multiparametric and single-parameter classifications, and heterogeneous prognosis within the moderate group. We tested the hypothesis that the expert-recommended four-grade scheme has better inherent agreement compared to ASE scheme, and further improved it as a revised four-grade scheme using the corrected proximal isovelocity surface area (PISA) method to calculate effective orifice area (EROA) and regurgitant volume (RegVol), along with the integration of other quantitative parameters.</p><p><strong>Methods: </strong>A total of 178 patients with STR were included. The moderate grade according to the three-grade ASE-recommended scheme was split into mild-moderate and moderate-severe grades following the recent experts' suggestions. The agreement between the multiparametric and single-parameter grading in TR severity was analyzed using the weighted Kappa test. The structure and function of tricuspid valve and right heart, including the conventional parameters, strains, and the right ventricular‒pulmonary artery (RV-PA) coupling, were compared across grade severities. The partition values of quantitative regurgitation parameters were further determined by ROC curve analyses to develop the revised four-grade scheme with involvement of corrected proximal isovelocity surface area (PISA) method.</p><p><strong>Results: </strong>The expert-recommended four-grade scheme demonstrated better multiparametric and single-parameter agreement of RegVol (к=0.901) in TR grading compared to the ASE-recommended three grade scheme (к=0.506). Both RV strain and RV-PA coupling were significantly lower in patients with moderate-severe STR compared to those with mild-moderate STR (P < 0.05). The new cut-off values of EROA (0.34 cm<sup>2</sup>; AUC = 0.945) and RegVol (35 mL; AUC = 0.958), obtained using the corrected PISA method, demonstrated excellent accuracy in distinguishing mild-moderate from moderate-severe STR.</p><p><strong>Conclusions: </strong>The revised four-grade scheme for STR severity exhibited better inherent agreement than the ASE recommended scheme, and matching with the right heart functional variations.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139224","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}