Journal of the American Society of Echocardiography最新文献

{"title":"DAPAGLIFLOZIN EFFECTS ON LEFT VENTRICULAR REMODELING AND FILLING PRESSURES IN HEART FAILURE WITH REDUCED EJECTION FRACTION.","authors":"Mauro Acquaro, Laura Scelsi, Camilla Mascolo, Costantino Pelosi, Alessandra Greco, Annalisa Turco, Sandra Schirinzi, Mariangela Lattanzio, Tullia Resasco, Valentina Mercurio, Claudio Di Lorenzo, Edoardo Marovino, Leonardo De Luca, Stefano Ghio","doi":"10.1016/j.echo.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.009","url":null,"abstract":"<p><strong>Aims: </strong>The benefits of sodium glucose cotransporter 2 inhibitors in patients with heart failure with reduced ejection fraction (HFrEF) have been clearly demonstrated in randomized clinical trails. However, the mechanisms of the observed beneficial effects remain incompletely understood. This study aimed to assess morpho-functional cardiac changes following dapagliflozin introduction in stable outpatients with HFrEF and to investigate whether these changes were determinants of the improved clinical outcome.</p><p><strong>Methods and results: </strong>In this multicenter, prospective observational study, 300 consecutive HFrEF patients ≥ 18 years old on optimized medical therapy (OMT) and eligible for dapagliflozin therapy were enrolled between april 2022 and January 2023. Laboratory and echocardiographic assessments were performed at baseline and after a median of 6 months. Following dapagliflozin initiation, 47% of patients achieved a target of improvement in left ventricular end-diastolic volume (Δ EDVi < -10%) and/or end-systolic volume (Δ ESVi <-15%) and/or ejection fraction (Δ EF% > 10%) at 6 months. The proportion of patients with elevated left ventricular filling pressures decreased from 26% to 3% at 6 months (p<0.001). The combination of left ventricular remodeling (LVRR) and filling pressures improvements was associated with absence of HF-related hospitalizations and significant natriuretic peptides (NPs) reduction at 12 months.</p><p><strong>Conclusions: </strong>Dapagliflozin detemined LVRR and improved left ventricular filling pressures in a high proportion of patients with stable HFrEF patients already on OMT. These improvements were associated with absence of HF-related hospitalizations and a significant NPs reduction at 12 months.</p>","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":"142569572","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 \"Hemodynamic Consultation in the Neonatal Intensive Care Unit: Subspecialty Evolution in Neonatology\".","authors":"James N Kirkpatrick, Nova Panebianco, Jose L Diaz-Gomez, Jimmy C Lu","doi":"10.1016/j.echo.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.006","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":"142569585","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 leaflet separation revisited: a surrogate of mitral valve area in young people with rheumatic mitral regurgitation living in remote areas.","authors":"Jacqueline M Williamson, Bo Remenyi, Ari E Horton, Peter Morris, Gillian A Whalley","doi":"10.1016/j.echo.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569578","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":"Prevalence of Diastolic and Systolic Mitral Annular Disjunction in Patients with Mitral Valve Prolapse.","authors":"Giorgio Fiore, Vincenzo Rizza, Giacomo Ingallina, Francesco Ancona, Stefano Stella, Federico Biondi, Paola Cunsolo, Carlo Gaspardone, Davide Romagnolo, Annamaria Tavernese, Martina Belli, Davide Margonato, Anna Palmisano, Antonio Esposito, Francesco Maisano, Francesco Faletra, Eustachio Agricola","doi":"10.1016/j.echo.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.004","url":null,"abstract":"<p><strong>Backgrounds: </strong>Mitral annular disjunction (MAD) is commonly evaluated at end-systole. However, a systolic-only disjunction is merely apparent and two distinct phenotypes have been identified: True-MAD (atrial displacement of the posterior leaflet in diastole and systole) and Pseudo-MAD (apparent displacement in systole only). The prevalence of True-MAD and Pseudo-MAD in mitral valve prolapse (MVP) is not known. Aim of this study was to assess the prevalence of True-MAD and Pseudo-MAD in myxomatous MVP patients by transthoracic echocardiography (TTE) and to validate TTE compared to cardiac magnetic resonance (CMR) (reference standards).</p><p><strong>Methods: </strong>Consecutive patients who underwent TTE for MVP were included. Mitral annular phenotype was evaluated in TTE parasternal long-axis view. Accuracy (against CMR) and intra/inter rater reliability of TTE were also assessed.</p><p><strong>Results: </strong>Six-hundred-three consecutive patients were included. The prevalence of True-MAD and Pseudo-MAD was 7% (42) and 37% (221) (p<0.05), respectively. Accordingly, 221 of 263 (84%) patients classically classified as \"MAD\" would have been reclassified as Pseudo-MAD. Pseudo-MAD prevalence and systolic length increased with higher mitral regurgitation (MR) severity (23% for mild MR, 36% for moderate MR, 44% for severe MR (p<0.05); 6 ± 2 mm for mild MR; 8 ± 2 mm for moderate MR; 10 ± 2mm for severe MR (p<0.05), while True-MAD prevalence was consistent across MR grades. Pseudo-MAD was linked to systolic curling and Pickelhaube. TTE showed an overall accuracy of 0.89 (Cohen k 0.80), a substantial inter-rater agreement of 0.87 (k 0.76) and an almost perfect intra-rater agreement of 0.93 (k 0.85).</p><p><strong>Conclusion: </strong>True-MAD, unlike Pseudo-MAD, is rare in patients with MVP. Pseudo-MAD is associated with the grade of MR and other echocardiographic features of advanced myxomatous degeneration. TTE is an accurate and reliable first line method to assess mitral annulus morphology in MVP.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512050","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":"RATE OF ASCENDING AORTIC ENLARGEMENT IN A LARGE ECHOCARDIOGRAPHIC COHORT: ASSOCIATED RISK FACTORS AND ADVERSE AORTIC EVENTS.","authors":"Kristen Westenfield, Steven M Bradley, Larissa Stanberry, Kevin M Harris","doi":"10.1016/j.echo.2024.09.013","DOIUrl":"https://doi.org/10.1016/j.echo.2024.09.013","url":null,"abstract":"<p><strong>Background: </strong>Understanding ascending aortic aneurysm growth and associated risk factors is critical to advising appropriate echocardiographic follow-up intervals for patients. This study aimed to identify aortic aneurysm growth rate on serial echocardiograms as well as the clinical and demographic variables that contribute to baseline aortic size and subsequent aortic growth.</p><p><strong>Methods: </strong>Patients identified with ascending aortic aneurysm and undergoing serial echocardiograms within five years were evaluated. Ascending aortic size was measured as part of routine echocardiogram exams. Clinical and demographic variables including aortic valve type (trileaflet, bicuspid or prosthetic) were evaluated for association with baseline aortic size as well as with aortic progression rate. Clinical events including aortic dissection, elective or emergent surgical repair were recorded.</p><p><strong>Results: </strong>3639 patients were identified, (78% males, median age of 69 years, 175 (4.8%) with bicuspid valve, and 206 (5.6%) with prior aortic valve replacement (AVR). Patients with larger aorta at baseline were older with higher tobacco use and prior prosthetic valves. Over a mean of 2.4 years, aortic growth was observed and differed by valve type (trileaflet valve: 0.08 mm/year , bicuspid valve: 0.4 mm/year , p<0.001). In six patients who developed aortic dissection the estimated average annual growth rate was 0.98 mm/year.</p><p><strong>Conclusions: </strong>In a large echo cohort, aortic aneurysm growth rate was 0.08 mm/year though higher in those with bicuspid valves ( 0.4 mm/ year), but initial aortic size did not correlate with change in the aortic progression rate. This data may help inform recommended echocardiographic surveillance intervals.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479304","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 Efficacy of Goal-Directed Valsalva to Elicit Clinically Significant Gradients in Patients with Obstructive Hypertrophic Cardiomyopathy taking Mavacamten Therapy.","authors":"Cody Frye, Melissa Escudero, William Saunders, Olafunke Ajijola, George Mawardi, Shuktika Nandkeolyar, Noreen Kelly, Dermot Phelan","doi":"10.1016/j.echo.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479305","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":"Early Heart Checks: Harnessing Fetal Echocardiography, Genetic Insights, and the Role of Transvaginal Cardiac Imaging in Clinical Practice.","authors":"Flora Nuñez Gallegos, Anita J Moon-Grady","doi":"10.1016/j.echo.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.echo.2024.10.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479303","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":"Sustained Benefits of Mavacamten in Patients With Obstructive Hypertrophic Cardiomyopathy: Long-Term Assessment Using Artificial Intelligence-Electrocardiogram and Echocardiographic Data.","authors":"Mustafa Suppah, Hesham Abdalla, Kaitlin Roehl, Juan Farina, Reza Arsanjani, Jeffrey Geske, Steve Ommen, Said Alsidawi","doi":"10.1016/j.echo.2024.10.001","DOIUrl":"10.1016/j.echo.2024.10.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401785","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 Atrial Function and Incident Heart Failure in Older Adults.","authors":"Carlo Mannina, Kazato Ito, Zhezhen Jin, Yuriko Yoshida, Cesare Russo, Koki Nakanishi, Tatjana Rundek, Shunichi Homma, Mitchell S V Elkind, Marco R Di Tullio","doi":"10.1016/j.echo.2024.09.012","DOIUrl":"10.1016/j.echo.2024.09.012","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) prevalence is increasing, especially among older adults. Left atrial (LA) dysfunction is often associated with HF, but it is unclear whether it may contribute to its development. We investigated whether measures of LA function can predict the development of HF in older adults without a history of cardiovascular events.</p><p><strong>Methods and results: </strong>Seven hundred ninety-five participants from a triethnic (white, Black, Hispanic) community-based cohort of adults age ≥55 without a history of cardiovascular events underwent standard, three-dimensional, and speckle-tracking echocardiography. Left atrial volumes, LA strain, LA stiffness, and LA coupling index (LACI) were measured. Longitudinal follow-up was conducted, and new-onset HF was ascertained through standardized interviews, in-person visits, and active hospital surveillance of admission and discharge ICD-9 codes. Risk analysis with a cause-specific hazards regression model was used to assess the association of LA variables with incident HF, adjusting for other HF risk factors. The mean age was 70.9 ± 9.2 years (297 men, 498 women). During a mean follow-up of 11.4 years, new-onset HF occurred in 345 participants (43.4%). All measures of LA morphology and function were associated with incident HF (all P < .05). In multivariable analysis, LA stiffness and LACI (adjusted hazard ratio = 2.06; 95% CI, 1.08-3.94; adjusted hazard ratio = 1.25; 95% CI, 1.09-1.43, respectively) remained associated with incident HF. After further adjustment for left ventricular global longitudinal strain, only LACI remained associated with incident HF (adjusted hazard ratio = 1.22; 95% CI, 1.05-1.42).</p><p><strong>Conclusions: </strong>Left atrial coupling index is a stronger independent predictor for incident HF in older adults than LA volumes and strain and may improve HF risk stratification.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401774","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":"Reduction of Coronary Flow Velocity Reserve as the Main Driver of Prognostically Beneficial Coronary Revascularization.","authors":"Lauro Cortigiani, Nicola Gaibazzi, Quirino Ciampi, Fausto Rigo, Domenico Tuttolomondo, Francesco Bovenzi, Dario Gregori, Scipione Carerj, Mauro Pepi, Patricia A Pellikka, Eugenio Picano","doi":"10.1016/j.echo.2024.09.011","DOIUrl":"https://doi.org/10.1016/j.echo.2024.09.011","url":null,"abstract":"<p><strong>Background: </strong>Regional wall motion abnormality (RWMA) can be absent during stress echocardiography (SE) in patients with chronic coronary syndromes (CCS) and angiographically significant coronary artery disease (CAD) despite a reduction of coronary flow velocity reserve (CFVR).</p><p><strong>Objectives: </strong>To assess the value of a physiology-driven approach,based on CFVR, to coronary revascularization in patients with physiologically and anatomically significant disease of the left anterior descending (LAD) coronary artery.</p><p><strong>Methods: </strong>In a 3-center, observational study with retrospective analysis of prospectively acquired data, 749 patients with CCS, CFVR of the LAD <2.0, and ≥50% diameter stenosis of the LAD were enrolled. All patients were evaluated with dipyridamole (0.84 mg/kg in 6') SE. Patients were followed for 6.4±4.5 years for the outcome of all-cause death.</p><p><strong>Results: </strong>Inducible RWMA was present in 295 patients (39%). CFVR was lower in patients with inducible RWMA compared to those without (1.51±0.28 vs 1.65±0.25; p<00001). Coronary revascularization was performed in 514 (69%) patients (388 with percutaneous coronary intervention, 126 with coronary artery bypass surgery). Of them, 226 exhibited inducible RWMA and 288 isolated reduction of CFVR. During the follow-up, 185 (25%) deaths occurred. The 10-year survival in the entire study population was 70%. The survival at 10 years was markedly lower in conservatively treated patients compared to invasively treated patients (53 vs 76%; p<0.0001), with no significant difference between those with solitary reduction of CFVR and reduction of CFVR accompanied by concurrent inducible RWMA. Propensity Score weighted all-cause mortality risk resulted to be significantly higher for conservative than for invasive strategy (Propensity Score adjusted: HR 2.12, 95% CI 1.51-2.96; p<0.0001).</p><p><strong>Conclusions: </strong>In patients with CCS and physiologically and anatomically significant LAD disease, coronary revascularization driven by a reduction in CFVR is accompanied by a prognostic benefit independently of the presence of inducible RWMA.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401784","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}