Journal of the American Society of Echocardiography最新文献

{"title":"Perinatal Cardiac Functional Adaptation in Hypoplastic Left Heart Syndrome: A Longitudinal Analysis","authors":"","doi":"10.1016/j.echo.2024.06.020","DOIUrl":"10.1016/j.echo.2024.06.020","url":null,"abstract":"<div><h3>Background</h3><div>The perinatal transition is characterized by acute changes in cardiac loading. Compared with normal newborn combined cardiac output (CCO), single right ventricular (RV) output of neonates with hypoplastic left heart syndrome (HLHS) is markedly greater. The aim of this study was to examine the mechanisms of cardiac adaptation that facilitate this perinatal transition from late fetal to early neonatal life in HLHS.</div></div><div><h3>Methods</h3><div>Prospectively recruited pregnancies complicated by fetal HLHS (<em>n</em> = 35) and healthy control subjects (Ctrl; <em>n</em> = 17) underwent serial echocardiography in late gestation (38 ± 1 weeks) and 6, 24, and 48 hours after birth. Cardiac function was assessed using conventional, Doppler tissue, and speckle-tracking echocardiography.</div></div><div><h3>Results</h3><div>Term fetuses with HLHS had RV output comparable with Ctrl CCO via higher stroke volume. Compared with both left ventricular and RV indices of Ctrl, they exhibited globular and dilated right ventricles with reduced relative wall thickness (0.40 ± 0.08 vs 0.49 ± 0.10, <em>P</em> &lt; .01), increased Tei index′ (HLHS vs Ctrl left ventricle/Ctrl right ventricle: sphericity index, 0.9 ± 0.25 vs 0.5 ± 0.10/0.6 ± 0.11; RV area index, 28 ± 6 vs 15 ± 3/17 ± 5 cm²/m²; Tei index′, 0.65 ± 0.11 vs 0.43 ± 0.07/0.45 ± 0.09; <em>P</em> &lt; .0001 for all). Neonates with HLHS generated elevated RV cardiac output compared with Ctrl CCO via higher heart rate and stroke volume, with further RV dilatation, increased longitudinal systolic strain at 48 hours (−17 ± 4% vs −14 ± 3%/ 14 ± 5%) with reduced circumferential and rotational myocardial deformation and altered diastolic function. Neonates with HLHS also demonstrated right atrial enlargement with increased longitudinal strain: 6 hours (33 ± 12% vs 26 ± 6%), 24 hours (37 ± 15% vs 26 ± 13%), and 48 hours (38 ± 11% vs 24 ± 13%) (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>Term fetuses with HLHS exhibit altered RV geometry and RV systolic and diastolic functional parameters. After birth, further alterations in these cardiac parameters likely reflect adaptation to acutely altered RV loading from increasing cardiac output and pulmonary artery flow demands.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601998","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":"A Comparison of Perinatal Circulatory Transition in Critical Right and Left Heart Obstructive Lesions","authors":"Proscovia M. Mugaba MD ,&nbsp;Lisa K. Hornberger MD ,&nbsp;Angela McBrien MBBCh, MD ,&nbsp;Lindsay Mills MD ,&nbsp;Luke G. Eckersley MBBS, PhD","doi":"10.1016/j.echo.2024.07.007","DOIUrl":"10.1016/j.echo.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>During perinatal transition in hypoplastic left heart syndrome (HLHS), reduced systemic blood flow (Qs) and cerebral blood flow and increased pulmonary blood flow (Qp) are observed, contributing to hemodynamic instability. The aim of the present study was to explore whether similar or discordant perinatal changes occur in critical pulmonary outflow tract obstruction (POFO) compared with HLHS and healthy control subjects.</div></div><div><h3>Methods</h3><div>Echocardiography was prospectively performed at 36 to 39 gestational weeks and then serially from 6 to 96 hours after birth, before cardiac intervention. Combined cardiac output (CCO), superior vena cava (SVC) flow rate, Qs and Qp, and resistance indices (RIs) in the middle cerebral artery (MCA), celiac artery, and superior mesenteric artery were compared among the three groups.</div></div><div><h3>Results</h3><div>In fetal POFO (<em>n</em> = 19) and HLHS (<em>n</em> = 31), CCO was comparable with that in control subjects (<em>n</em> = 21) because of elevated stroke volume, but CCO in POFO was lower compared with HLHS (<em>P</em> &lt; .01). Compared with control subjects, POFO CCO was lower at 6 hours after delivery but comparable at 24 to 96 hours. In contrast, from 6 to 96 hours, the HLHS group had higher CCO than POFO and control subjects. Compared with control subjects, both neonates with POFO and those with HLHS had lower Qs and SVC flow (POFO at 24 hours, <em>P</em> &lt; .001; HLHS 6-hour Qs and 6- to 24-hour SVC flow). Compared with control subjects, Qp was increased in POFO at 48 to 96 hours (<em>P</em> &lt; .05) and in HLHS at all time points (<em>P</em> &lt; .001). Compared with fetal MCA RI, postnatal MCA RI was acutely higher in both POFO and HLHS, whereas in control subjects, it tended to decrease postnatally. Celiac artery RI and superior mesenteric artery pulsatility index were higher in POFO and HLHS from 6 to 48 hours vs control subjects.</div></div><div><h3>Conclusions</h3><div>POFO and HLHS demonstrate divergent acute hemodynamic changes in the early neonatal period, with early decreased CCO in POFO and increased CCO in HLHS. Both demonstrate early compromise in Qs and SVC (cerebral flow) and ongoing altered splanchnic flow.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635558","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":"Diastolic Myocardial Stiffness Assessed by Shear Wave Elastography in Children With a Fontan Circulation","authors":"Thomas Salaets MD, PhD,&nbsp;Maëlys Venet MD,&nbsp;Aimen Malik MSc,&nbsp;Jerome Baranger PhD,&nbsp;Luc Mertens MD, PhD,&nbsp;Olivier Villemain MD, PhD","doi":"10.1016/j.echo.2024.07.010","DOIUrl":"10.1016/j.echo.2024.07.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749537","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":"Left Atrioventricular Coupling Index: When Minimal Left Atrial Volume Is Actually ‘More’ Than Maximal Left Atrial Volume","authors":"Lior Zornitzki MD ,&nbsp;Yan Topilsky MD","doi":"10.1016/j.echo.2024.09.001","DOIUrl":"10.1016/j.echo.2024.09.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299721","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":"Dobutamine in low-flow, low-gradient severe aortic stenosis with preserved ejection fraction: Is exercise testing the key?","authors":"Eirini Beneki, Kyriakos Dimitriadis, Konstantinos Zisimos, Argyro Kalompatsou, Konstantinos Tsioufis, Constantina Aggeli","doi":"10.1016/j.echo.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.echo.2024.09.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564774","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":"Mortality Based Right Ventricle Functional Echocardiographic Cutoffs in Patients With Compared to Without Tricuspid Regurgitation.","authors":"Lior Zornitzki, Ophir Freund, Shir Frydman, Zach Rozenbaum, Yoav Granot, Shmuel Banai, Yan Topilsky","doi":"10.1016/j.echo.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.012","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid-annular-plane-systolic-excursion (TAPSE) and peak-lateral-tricuspid-annular-systolic-velocity (S') are echocardiographic indices of right-ventricle (RV) function. The abnormality thresholds for these parameters are based on data obtained from healthy adults, rather than outcome data.</p><p><strong>Objectives: </strong>We aimed to re-examine the abnormality thresholds for these parameters based on their association with mortality in consecutive patients, stratified to with, or without, significant tricuspid regurgitation (TR).</p><p><strong>Methods: </strong>We performed a retrospective analysis of consecutive patients undergoing echocardiography between 2011-2021. TR was assessed using a semi-quantitative method. Cut-off values associated with excess mortality were assessed using spline curves in univariate, and multivariate Cox analyses.</p><p><strong>Results: </strong>A total of 24717 subjects were included in the current analysis. 1143 (4.6%) subjects had clinically significant (≥moderate) TR. In the entire cohort, TAPSE<20.9 mm and S' <10.9 cm/s were associated with excess mortality. In sub-group analysis, among subjects with significant TR, TAPSE<18.0 mm and S'<10.0 cm/s was the cutoff associated with excess mortality, while subjects without TR had a higher cutoff of TAPSE<21.5 mm and S'<10.9 cm/s. In a multivariate model adjusted for the presence of TR and baseline characteristics, TAPSE<20.9 mm (HR 1.16, 95% CI 1.10-1.23; p<0.001) and S'<10.9 cm/s (HR 1.09, 95% CI 1.04-1.20; p=0.01) were independently associated with mortality.</p><p><strong>Conclusion: </strong>TAPSE and S' thresholds associated with excess mortality are higher than those reported in healthy adults. The TAPSE and S' cutoffs associated with excess mortality were lower in patients with significant TR compared to patients without, suggesting that a personalized approach for their interpretation is needed.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564833","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":"Machine Learning to Stratify Risk in Low-Gradient Aortic Stenosis Among Medicare Beneficiaries.","authors":"Sean W Dooley, Naveena V K Yanamala, Nora Al-Roub, Nicholas Spetko, Madeline Cassidy, Constance Angell-James, Partho P Sengupta, Jordan B Strom","doi":"10.1016/j.echo.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.010","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559260","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":"Clinical and Echocardiographic Features of Individuals with Cardiac Amyloidosis at Risk for Future Thrombus Formation.","authors":"Cristiane C Singulane, Jeremy A Slivnick, Kenneth C Bilchick, Maryam E Neyestanak, Jonathan R Lindner, Mohammad Abuannadi, Steven T Philips, Aditya M Sharma, Karima Addetia, Nitasha Sarswat, Ryan R Yang, Yu Wang, Roberto M Lang, Amit R Patel","doi":"10.1016/j.echo.2024.10.008","DOIUrl":"10.1016/j.echo.2024.10.008","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559259","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":"Targeted Neonatal Echocardiography Based Hemodynamic Consultation in the Neonatal Intensive Care Unit: Subspecialty Evolution in Neonatology.","authors":"Rachael M Hyland, Philip T Levy, Wyman W Lai, Patrick J McNamara","doi":"10.1016/j.echo.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.echo.2024.09.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548631","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":"Hemodynamic Performance of the SAPIEN 3 Ultra Resilia Valve: Insights from a Propensity-Matched Analysis.","authors":"Marisa Avvedimento, Carlos Giuliani, Antonela Zanuttini, Siddartha Mengi, Silvia Mas-Peiro, Anthony Poulin, Frederic Beaupré, Jean-Michel Paradis, Jean Porterie, Dimitri Kalavrouziotis, Eric Dumont, Siamak Mohammadi, Mélanie Côté, Philippe Pibarot, Josep Rodés-Cabau","doi":"10.1016/j.echo.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569574","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}