Journal of the American Society of Echocardiography最新文献

{"title":"Artificial Intelligence–Based Detection of Tent-Like Signs in Intracardiac Echocardiography to Assist Transseptal Puncture","authors":"Ruoxi Zhang MD, Ganjun Zhang MCS, Longjun Li MCS, Simeng Liu MASc, Jihong Zhang ME, Ligang He MCS","doi":"10.1016/j.echo.2024.11.010","DOIUrl":"10.1016/j.echo.2024.11.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 291-292"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803065","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":"Simplifying the Echocardiographic Definition of Atrial Secondary Tricuspid Regurgitation: When Less Is More","authors":"Rebecca T. Hahn MD","doi":"10.1016/j.echo.2025.01.001","DOIUrl":"10.1016/j.echo.2025.01.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 224-227"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383841","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":"Guidelines for the Echocardiographic Assessment of the Right Heart in Adults and Special Considerations in Pulmonary Hypertension: Recommendations from the American Society of Echocardiography","authors":"Monica Mukherjee MD, MPH, FASE, Chair ,&nbsp;Lawrence G. Rudski MDCM, FASE, Co-Chair ,&nbsp;Karima Addetia MD, FASE ,&nbsp;Jonathan Afilalo MD, MSc ,&nbsp;Michele D’Alto MD, PhD ,&nbsp;Benjamin H. Freed MD, FASE ,&nbsp;Lynsy B. Friend ACS, RCS, FASE ,&nbsp;Luna Gargani MD, PhD ,&nbsp;Julia Grapsa MD, PhD, FASE ,&nbsp;Paul M. Hassoun MD ,&nbsp;Lanqi Hua RDCS, FASE ,&nbsp;Jiwon Kim MD, FASE ,&nbsp;Valentina Mercurio MD, PhD ,&nbsp;Rajan Saggar MD ,&nbsp;Anton Vonk-Noordegraaf MD, PhD,","doi":"10.1016/j.echo.2025.01.006","DOIUrl":"10.1016/j.echo.2025.01.006","url":null,"abstract":"<div><div>Right heart adaptation to pulmonary hypertension (PH) is a critical determinant of clinical outcomes, morbidity, and mortality in patients with or at risk for cardiopulmonary disease. The World Symposium on Pulmonary Hypertension recently redefined PH as a mean pulmonary arterial pressure &gt;20 mm Hg, based on a wealth of epidemiologic evidence underscoring the significant impact of even mildly elevated mean pulmonary artery pressures on major adverse clinical events. The lowered diagnostic threshold for PH has renewed interest in echocardiography and its critical role in early detection and screening, refined hemodynamic evaluation, and longitudinal monitoring. However, the systematic assessment of the right heart remains inconsistent, largely due to the predominant focus on left heart evaluation, limited familiarity with right heart ultrasound techniques, and a paucity of reference data defining normal right heart size and function. A systematic, comprehensive ultrasound-based assessment of the right heart offers valuable diagnostic insights for in screening at-risk populations, PH classification, risk stratification, monitoring therapeutic response, and informing prognostication, thereby improving clinical outcomes.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 141-186"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528699","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 Outcomes of Correcting the Proximal Isovelocity Surface Area Method to Quantitate Secondary Tricuspid Regurgitation","authors":"Michele Tomaselli MD ,&nbsp;Marco Penso BME ,&nbsp;Luigi P. Badano MD, PhD ,&nbsp;Alexandra Clement MD ,&nbsp;Noela Radu MD ,&nbsp;Francesca Heilbron MD ,&nbsp;Mara Gavazzoni MD ,&nbsp;Diana R. Hădăreanu MD, PhD ,&nbsp;Giorgio Oliverio MD ,&nbsp;Samantha Fisicaro RDCS ,&nbsp;Paolo Springhetti MD ,&nbsp;Cinzia Pece MD ,&nbsp;Caterina Delcea MD, PhD ,&nbsp;Denisa Muraru MD, PhD","doi":"10.1016/j.echo.2024.10.015","DOIUrl":"10.1016/j.echo.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>Although the correction of the proximal isovelocity surface area (PISA) method has been shown to improve the accuracy of assessing the severity of secondary tricuspid regurgitation (STR), its clinical impact remains to be investigated. The aim of this study was to compare the association of the quantitative parameters of STR severity obtained from the corrected and conventional PISA methods with outcomes.</div></div><div><h3>Methods</h3><div>Both conventional and corrected effective regurgitant orifice area (EROA) (EROA vs corrected EROA [EROAc]), regurgitant volume (RegVol) (RegVol vs corrected RegVol [RegVolc]), and regurgitant fraction (RegFr) (RegFr vs corrected RegFr [RegFrc]) were measured in 519 consecutive patients (mean age, 75 ± 12 years; 44% men; 74% with ventricular STR) with moderate and severe STR. The end point was a composite of heart failure hospitalization and death.</div></div><div><h3>Results</h3><div>EROAc, RegVolc, and RegFrc were significantly larger than EROA, RegVol, and RegFr (<em>P</em> &lt; .001 for all). After a mean follow-up period of 19 ± 15 months, 210 patients reached the end point. Using time-dependent receiver operating characteristic curves, the parameters obtained from the corrected PISA method were more closely associated with outcomes at 2 years than those obtained with the conventional PISA method: EROAc vs EROA (<em>P</em> &lt; .001), RegVolc vs RegVol (<em>P</em> = .001), and RegFrc vs RegFr (<em>P</em> &lt; .001) for ventricular STR. Conversely, no significant differences were detected for atrial STR. After multivariable adjustment, both uncorrected and corrected EROA, RegVol, and RegFr were independently associated with the end point. Using the new five-grade severity scheme, patients reclassified using the corrected PISA method had a significantly higher rate of events compared with those not reclassified among those with ventricular STR (<em>P</em> = .0086). Conversely, this relationship was not statistically significant in patients with atrial STR (<em>P</em> = .061).</div></div><div><h3>Conclusions</h3><div>Correcting the PISA method provides larger quantitative parameters of STR severity that are more closely associated with outcomes in patients with ventricular STR.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 195-207"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607295","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":"The Right Ventricle and Exercise Capacity in Adults with Repaired Tetralogy of Fallot: Passive Bystander or Active Participant?","authors":"Zachary Barrett-O’Keefe PhD, RDCS ,&nbsp;Chera L. Maarouf BS, RDCS ,&nbsp;Jessica A. Narum BS, RDCS ,&nbsp;Timothy J. Fuller BS, ACS ,&nbsp;James M. Welper RDCS ,&nbsp;William R. Miranda MD ,&nbsp;C. Charles Jain MD ,&nbsp;Heidi M. Connolly MD ,&nbsp;Luke J. Burchill MBBS ,&nbsp;Alexander C. Egbe MBBS, MPH","doi":"10.1016/j.echo.2024.12.008","DOIUrl":"10.1016/j.echo.2024.12.008","url":null,"abstract":"<div><div>Exercise intolerance is a hallmark symptom in adults with tetralogy of Fallot (TOF). This may be attributed to impairments in right ventricular (RV) function, augmentation in RV load, and their effect on left ventricular (LV) hemodynamics. To elucidate these mechanisms, we examined oxygen uptake (VO₂) and cardiac hemodynamics in TOF and healthy controls at rest and during exercise. At peak exercise, VO₂ was lower in TOF. This was partially attributed to lower heart rate in conjunction with a blunted exercise-induced change in LV stroke volume from rest to compensate for the chronotropic incompetence. Additionally, at peak exercise, pulmonary-RV was higher in TOF. Additionally, at peak exercise, in TOF, pulmonary-RV coupling negatively correlated with VO₂ , changes in LV end-diastolic volume, and changes in LV SV from rest. These findings reveal the reliance of LV hemodynamics on the interplay between RV systolic load and function during exercise in TOF.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 247-261"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856528","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":"Sex-Specific Differences in Echocardiographic Parameters of Risk Stratification in Pulmonary Arterial Hypertension","authors":"Nicola Benjamin Dr Sc Hum ,&nbsp;Veronika Schiffer ,&nbsp;Carolin Resag ,&nbsp;Panagiota Xanthouli MD ,&nbsp;Moritz Braun ,&nbsp;Satenik Harutyunova MD ,&nbsp;Christina A. Eichstaedt PhD ,&nbsp;Benjamin Egenlauf MD ,&nbsp;Alberto M. Marra MD ,&nbsp;Eduardo Bossone MD ,&nbsp;Antonio Cittadini MD ,&nbsp;David G. Kiely MD ,&nbsp;Ekkehard Grünig MD","doi":"10.1016/j.echo.2024.11.015","DOIUrl":"10.1016/j.echo.2024.11.015","url":null,"abstract":"<div><h3>Background</h3><div>In healthy subjects, sex differences in right heart function have been detected for various echocardiographic parameters. The objective of this study was to investigate sex differences in echocardiographic European Society of Cardiology (ESC)/European Respiratory Society (ERS) risk stratification parameters and their impact on survival estimation in patients with pulmonary arterial hypertension (PAH).</div></div><div><h3>Methods</h3><div>In this retrospective, cross-sectional study with a mean follow-up time of 3.2 ± 2.65 years (median, 2.78 years), clinical parameters including right atrial (RA) area, right ventricular area, and tricuspid annular plane systolic excursion (TAPSE) divided by systolic pulmonary artery pressure (sPAP) were assessed. Thresholds of ESC/ERS risk stratification were compared using multivariable Cox regression analysis.</div></div><div><h3>Results</h3><div>Of 748 patients with PAH (mean age, 65 ± 15 years; 63% women), men had significantly larger right heart size than women (RA area 21.76 ± 7.64 vs 17.65 ± 6.82 cm², <em>P</em> &lt; .001; right ventricular area 24.02 ± 7.15 cm² vs 18.41 ± 5.75 cm², <em>P</em> &lt; .001). This difference was consistent throughout all World Health Organization functional classes and cardiac index risk groups, except for the RA area in the cardiac index high-risk group and World Health Organization functional class IV. On multivariable analysis, indexed values showed more pronounced differences for age-adjusted survival analysis compared with ESC/ERS risk stratification thresholds. TAPSE/sPAP showed no significant sex differences, which makes this parameter a robust prognostic predictor.</div></div><div><h3>Conclusions</h3><div>This is the first study focusing on sex differences in right heart size obtained by echocardiography in patients with PAH. For risk stratification indexing RA area to body surface area could be more reflective of body composition. In contrast, TAPSE/sPAP values were not sex dependent and were a robust prognostic factor in patients with PAH.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 273-285"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Forgotten Truth About Proximal Isovelocity Surface Area Correction in Tricuspid Regurgitation","authors":"Ratnasari Padang MBBS, PhD,&nbsp;Jeremy J. Thaden MD","doi":"10.1016/j.echo.2024.11.007","DOIUrl":"10.1016/j.echo.2024.11.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 3","pages":"Pages 208-211"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752093","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":"Mechanical adaptation of the right ventricle to secondary tricuspid regurgitation, and its association with patients' outcomes.","authors":"Zsuzsanna Ladányi, Bálint Károly Lakatos, Alexandra Clement, Michele Tomaselli, Alexandra Fábián, Noela Radu, Tímea Katalin Turschl, Andrea Ferencz, Béla Merkely, Elena Surkova, Attila Kovács, Denisa Muraru, Luigi P Badano","doi":"10.1016/j.echo.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.echo.2025.02.011","url":null,"abstract":"<p><strong>Background: </strong>Data regarding the right ventricular (RV) mechanical adaptation to secondary tricuspid regurgitation (STR) is scarce.</p><p><strong>Objectives: </strong>We investigated the changes in RV contraction pattern in patients with different STR severity and etiology, and their association with outcomes.</p><p><strong>Methods: </strong>We enrolled 205 patients with STR (60% female, age: 77±12 years), in a single-center prospective observational study. We used three-dimensional echocardiography to measure RV ejection fraction (RVEF), the absolute contribution of the RV longitudinal (LEF), radial (REF), and anteroposterior (AEF) ejection fraction components, and their relative contribution by indexing to global RVEF (LEF/RVEF; REF/RVEF; AEF/RVEF). The patients were followed for a median of 9 months. The primary outcome was defined as heart failure hospitalization or all-cause death.</p><p><strong>Results: </strong>Patients with different STR severity did not differ in terms of RVEF (mild vs. moderate vs. severe, RVEF: 50±11 vs. 49±9 vs. 50±10%, respectively, p=0.085). However, LEF/RVEF was significantly lower in severe STR (0.39±0.08 vs. 0.39±0.09 vs. 0.35±0.10, respectively, p=0.049). Patients with ventricular STR had lower global RVEF (48±10% vs. 53±8%, p=0.001), LEF (18±6% vs. 20±5 %, p=0.043), REF (23±9% vs. 28±8%, p=0.002), and REF/RVEF (0.48±0.012 vs. 0.52±0.09; p=0.040) 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 [CI, 0.961-1.000] per 0.01 unit change, p=0.047), while global RVEF was not.</p><p><strong>Conclusions: </strong>Patients with STR demonstrate significant functional RV remodelling. Patients with severe STR show a significant decrease in the RV longitudinal shortening. Apart from STR severity, STR etiology also influences the RV contraction pattern, which was associated with outcomes in our cohort.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-22","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":"Association Between Three-Dimensional Right Ventricular Ejection Fraction and In-Hospital Outcomes in Patients Undergoing Cardiac Surgery: A Multicenter Study.","authors":"Edith L Posada-Martinez, Juan B Ivey-Miranda, Xochitl A Ortiz-Leon, Jose A Arias-Godinez, Juan F Fritche-Salazar, Hugo G Rodriguez-Zanella, Maria E Ruiz Esparza-Dueñas, Diana Romero-Zertuche, Ivan I Silvestre-Flores, Julieta Morales-Portano, Arturo Orea-Tejeda, Jorge Rojas-Serrano, Robert L McNamara, Pedro A Reyes Lopez, Lissa Sugeng","doi":"10.1016/j.echo.2025.02.008","DOIUrl":"10.1016/j.echo.2025.02.008","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac surgery is the cornerstone of treatment of several heart conditions, but accurate risk stratification is critical. Commonly used scores do not include right ventricular (RV) function. We aimed to evaluate whether three-dimensional (3D) RV ejection fraction (RVEF) predicts outcomes in patients undergoing cardiac surgery after adjusting for the EuroSCORE II.</p><p><strong>Methods and results: </strong>This is a prospective multicenter study of adult patients undergoing cardiac surgery at 3 centers. Right ventricular function parameters were analyzed with transesophageal echocardiogram before the surgery. We evaluated the association of 3D RVEF with the primary outcome (composite of in-hospital mortality or need of temporary ventricular assist device) after adjusting for the EuroSCORE II. Exploratory end points were time on mechanical ventilation and time on inotropes. We included 248 patients (median age, 69 years; 43% female). Sixty-nine percent had normal RVEF (≥45%). Right ventricular function parameters (tricuspid annular plane systolic excursion, fractional area change, and RV free-wall longitudinal strain) were lower in the group of decreased RVEF (P < .001 for all). The primary outcome occurred in 28 patients (11%). After adjusting for the EuroSCORE II, decreased RVEF was independently associated with the primary outcome (hazard ratio = 2.46; 95% CI, 1.10, 5.50; P = .028). Importantly, 3D RVEF was superior to all other parameters of RV systolic function to predict the primary outcome (P = .006). At 30 days, survival free of the primary end point was 72% ± 8% versus 93% ± 3% (P < .001) in decreased versus normal RVEF, respectively. Right ventricular ejection fraction was associated with shorter time on mechanical ventilation (r = -0.27, P < .001) and shorter time on inotropes (r = -0.20, P = .01).</p><p><strong>Conclusions: </strong>Among the RV function parameters, 3D RVEF is the strongest predictor of in-hospital mortality or need of temporary ventricular assist device in patients undergoing cardiac surgery. This multicenter study suggests that 3D RVEF should be included in the evaluation of patients undergoing surgery because it might improve stratification.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473085","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 Dynamics After Transcatheter Edge-to-Edge Repair for Functional Mitral Regurgitation: Comparison With Surgical Annuloplasty.","authors":"Mai Terada, Nobuyuki Kagiyama, Yuki Izumi, Ryosuke Higuchi, Mike Saji, Mitsunobu Kitamura, Itaru Takamisawa, Mamoru Nanasato, Tomohiro Iwakura, Mitsuaki Isobe","doi":"10.1016/j.echo.2025.02.005","DOIUrl":"10.1016/j.echo.2025.02.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469809","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}