Journal of the American Society of Echocardiography最新文献

{"title":"Sex-based Differences in Mitral Annular Disjunction Severity and Arrhythmic Risk in Mitral Valve Prolapse.","authors":"Luca Cristin, Lionel Tastet, Rohit Jhawar, Amy B Rich, Janet J Tang, Dwight Bibby, Qizhi Fang, Farzin Arya, Francesca N Delling","doi":"10.1016/j.echo.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.026","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmic mitral valve prolapse (AMVP), a condition with known female predominance, has been linked to mitral annular disjunction (MAD), yet the relationship between MAD, sex, body size and arrhythmic events remains unclear.</p><p><strong>Objectives: </strong>To determine whether MAD exhibits sex-based differential effects on arrhythmic risk and explore the implications of indexing MAD measurements.</p><p><strong>Methods: </strong>We examined 682 consecutive MVPs at the University of California San Francisco (2013-2023) with detailed clinical, rhythmic and echocardiographic data. MAD was indexed to body surface area, resulting in the identification of 3 distinct groups: no MAD, indexed MAD (iMAD) below and iMAD above the median. AMVP was defined as MVP with frequent and/or complex ventricular ectopy, including severe arrhythmic events such as sustained ventricular tachycardia, ventricular fibrillation/sudden cardiac arrest or death.</p><p><strong>Results: </strong>Among 682 MVPs (48% females, mean age 58±17 years), 35% had AMVP and 41% had MAD, with a median iMAD of 4 mm. Compared to females, males had greater absolute MAD length (9.0 ± 3.2 mm vs 7.3 ± 2.6, p<0.001). Sex-based differences in MAD length were no longer appreciated after indexing for BSA (p = 0.33). In multivariable analyses, iMAD >4 mm was significantly associated with arrhythmic events in males but not in females (p=0.02 vs p=0.63). Bileaflet MVP had a direct effect on severe arrhythmic events in females (p=0.04 for MVP, p= 0.39 in mediation analysis), but in males this association was mediated by iMAD length (p=0.03).</p><p><strong>Conclusion: </strong>In a large MVP cohort, males exhibit greater MAD length and a stronger association between iMAD length and arrhythmic events. In contrast, iMAD length in females may be less important for arrhythmic risk stratification compared to other imaging parameters such as bileaflet involvement. Further studies are needed to confirm alternative mechanisms beyond localized MAD-related myocardial traction in females with MVP.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082229","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":"INFLUENCE OF MICROBUBBLE PROPERTIES AND CARRIER FREQUENCY ON ULTRASOUND CAVITATION-INDUCED FLOW AUGMENTATION.","authors":"J Todd Belcik, Aris Xie, Yue Qie, David Giraud, Ruei-Jen Abraham-Fen, Onur Varli, Jeffry Powers, Jonathan R Lindner","doi":"10.1016/j.echo.2025.09.004","DOIUrl":"10.1016/j.echo.2025.09.004","url":null,"abstract":"<p><strong>Background: </strong>Cavitation of microbubble (MB) contrast agents produces shear-mediated vasodilation and an increase in tissue perfusion. These effects are mediated through endothelial and erythrocyte shear-sensitive pathways. Our aim was to determine whether augmentation of tissue perfusion produced by cavitation is influenced by the deformability of MBs, MB charge-mediated interaction with vascular cells, or ultrasound frequency which affects MB resonance.</p><p><strong>Methods: </strong>In mice, highly-deformable lipid-stabilized decafluorobutane MBs with neutral or cationic charge, as well as less-deformable MBs (Sonazoid) were administered intravenously during proximal hindlimb ultrasound (1.3 MHz, mechanical index 1.3) for ten minutes. In separate experiments, high-frequency US (7.0 MHz) was compared to low frequency US. Conditional variables were compared using quantitative contrast-enhanced ultrasound perfusion imaging, as well as bioluminescence assays of shear-mediated ATP release. Beam spatial characteristics and passive cavitation detection (PCD) response for each MB agent were assessed by calibrated hydrophone.</p><p><strong>Results: </strong>PCD confirmed intended differences in MB deformability. Cavitation at 1.3 MHz increased perfusion in the ultrasound-exposed limb by 6-8-fold for highly-deformable MBs. There were no differences according to MB charge despite evidence for interaction with vascular endothelial cells on intravital microscopy. Cavitation-mediated flow augmentation was lower 4-fold) for less-deformable MBs (p<0.05 vs other agents). Flow-augmentation was attributable to increases in microvascular flux rate (β-value). Despite producing less flow augmentation, cavitation with the less-deformable MBs produced equivalent endothelial ATP release. Using high-frequency US for cavitation resulted in a 60-70% loss of flow augmentation response.</p><p><strong>Conclusions: </strong>Factors that affect MB resonance such as ultrasound frequency and MB deformability influence the degree of flow augmentation achieved by MB cavitation. Alteration of MB charge which enhances interaction with the endothelial cells does not influence cavitation-mediated flow augmentation.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076420","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":"Right and Left Atrial Strain by Speckle Tracking Echocardiography: Sex Differences and Correlation with Cardiorespiratory Fitness in Olympic Athletes.","authors":"Giuseppe Di Gioia, Armando Ferrera, Maria Rosaria Squeo, Francesco Raffaele Spera, Viviana Maestrini, Sara Monosilio, Federica Mango, Giulia Paoletti, Andrea Serdoz, Antonio Pelliccia","doi":"10.1016/j.echo.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>Physiological cardiac remodeling in elite athletes has been extensively described for the ventricles, but less is known regarding atrial function and its relationship with cardiorespiratory fitness.</p><p><strong>Objectives: </strong>This study aimed to evaluate right (RA) and left atrial (LA) strain in Olympic athletes, exploring sex and sport-specific differences and correlations with VO₂ max.</p><p><strong>Methods: </strong>We enrolled 657 Olympic athletes (mean age 25.5±5.3 years; 51.7% male). All athletes underwent transthoracic echocardiography, including atrial strain analysis by 2D-STE and cardiopulmonary exercise test (CPET). Atrial reservoir (S_R), conduit (S_Cd) and contraction (S_Co) strain were measured. Athletes were grouped by sport discipline (skill, power, mixed, endurance).</p><p><strong>Results: </strong>Endurance athletes exhibited the largest atrial dimensions and the highest VO₂ max (p<0.0001), and showed reduced RA S_R (34.9±9.1%, p<0.0001), S_Cd (-25.7±8.1%, p=0.0001) and S_Co (-9±4.4%, p=0.0006) and LA S_R (38±7.5%, p=0.048) compared to skill, power and mixed. No differences in LA S_Cd (p=0.07) and S_Co emerged (p=0.111). RA strain inversely correlated with VO₂ max (p<0.0001), while no such relationship was observed for LA. Sex differences were observed, with males displaying larger atria (LAVi 23.9±7.8 ml/m² vs. 22.3±6.3 ml/m², p=0.004) but lower S_R and S_Cd compared to females (p<0.05).</p><p><strong>Conclusions: </strong>Functional atrial indexes (S_R, S_Cd and S_Co) appear more markedly altered in the atria of the less remodeled ventricles (more in skill than in endurance athletes) and even more in RA than in LA. Furthermore, male athletes demonstrated higher reservoir and conduit strain values, while females exhibited enhanced contractile function. Our results should be viewed in conjunction with the extent of ventricular remodeling, i.e., the more enlarged and performant (suction and contraction) the ventricular cavity is, the less relevant is the atrial contribution to filling.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066308","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":"When LARS Met LASi-Did Left Atrial Strain Index Trump Reservoir Strain?","authors":"Liza Thomas, Lieng-Hsi Ling","doi":"10.1016/j.echo.2025.09.001","DOIUrl":"10.1016/j.echo.2025.09.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066347","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":"Non-Invasive Methods to Assess Vascular Health in Children and Adolescents: Current State-of-the-Art and Future Perspectives.","authors":"Raphael Joye, Nairy Khodabakhshian, Emmanuelle Fournier, Wei Hui, Cheryl Fackoury, Alice Pozza, Josh Gopaul, Olivier Villemain, Barbara Cifra, Vitor Guerra, Luc L Mertens","doi":"10.1016/j.echo.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.echo.2025.09.003","url":null,"abstract":"<p><p>Vascular remodeling, which occurs with normal aging and several pathological states, has emerged as a critical factor in assessing cardiovascular health in children. Changes in vascular structure, stiffness, and function have been shown to be associated with different diseases in children and adolescents, including metabolic syndrome, congenital heart disease, and childhood cancer. However, there is a lack of data on the ability of these vascular parameters to predict outcomes and guide therapy in the pediatric population. This paper provides an overview of the physiological principles related to pediatric vascular health and the available noninvasive methods for the measurement of arterial structure, stiffness, and function. The normal variation of these parameters during childhood and their clinical relevance in pathological conditions are discussed, with an emphasis on current knowledge gaps the need for future research.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066281","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":"Effect of Mavacamten on Serial Speckle-Tracking Strain in Patients with Hypertrophic Cardiomyopathy.","authors":"Kifah Hussain, Danish Saleh, Maxine Tang, Carol Garcia, Olga Kislitsina, Zhiying Meng, Abigail Baldridge, Jyothy J Puthumana, Paul C Cremer, Vera H Rigolin, Lubna Choudhury","doi":"10.1016/j.echo.2025.08.024","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.024","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034403","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":"Optimal Left Atrium Strain Acquisition and Measurement in Clinical Practice.","authors":"Saki Ito, Victoria R Jones, Michael D Martineau, Joshua G Fosland, Noweeda N Mirza, Cristina Pislaru, Garvan C Kane, Jeremy J Thaden","doi":"10.1016/j.echo.2025.08.012","DOIUrl":"10.1016/j.echo.2025.08.012","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034379","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":"Predicting CRT Response with Speckle Tracking Echocardiography: A Systematic Review and Meta-analysis.","authors":"Wilbert Huang, Apridya Nurhafizah, Alya Roosrahima Khairunnisa, Rivera Adenia Firza Zahrani, Intan Aulia Retnoningrum, Alvin Frederich, Pirel Aulia Baravia Borneo D A, Robert Fitryno, Cynthia Parameswari, Bambang Budi Siswanto","doi":"10.1016/j.echo.2025.08.025","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.025","url":null,"abstract":"<p><p>Nearly 30% of patients with cardiac resynchronization therapy (CRT) are non- responders. Speckle tracking echocardiography (STE) parameters are able to evaluate electromechanical dyssynchrony that could improve outcomes. We aim to examine the association between various STE parameters with CRT response and clinical outcomes in heart failure patients. Searching was done on three medical databases. STE parameters assessed are dyssynchrony index (time delay of peak strain between walls > 130ms), myocardial work indices (global constructive and wasted work - GCC and GWW, etc) and strain patterns. Meta- analysis with random effect model was used to pool the effect sizes. Fifty-one observational studies comprising of 11491 patients ranging from 63 - 71 years old were included. Dyssynchrony index with radial strain is not associated with CRT response but with risk reduction of clinical outcome (HR 0.51, CI: 0.39 - 0.67). This association is also found in unfavorable ECG (HR 0.77), and non-LBBB (HR 0.47) populations. Meta-regression result did not show the association of LBBB, ischemic heart disease and QRS duration as covariates to the outcomes. GWW is associated with an increased odds of CRT response (OR 4.78) and risk reduction of clinical outcomes (HR 0.44). Deformation strain pattern 1/2 and typical LBBB strain are associated with increased odds of CRT response (OR 8.26 and 5.07) while deformation pattern 3 and absence of typical LBBB strain pattern with increased risk of clinical outcome (HR 3.22 and 2.77). Various STE parameters could be used to improve CRT response and clinical outcome in heart failure patients.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034399","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":"Impaired Pulmonary Vascular Reserve in Adults with Repaired Coarctation of Aorta: Prevalence, Correlates, and Association with Disease Severity.","authors":"Alexander C Egbe, Yogesh N V Reddy, Patricia A Pellikka, Barry A Borlaug","doi":"10.1016/j.echo.2025.08.022","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.022","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension is associated with cardiovascular events, but when assessed at rest, it has limited sensitivity. Pulmonary vascular reserve can be assessed noninvasively using exercise echocardiography, but this has not been studied in adults with coarctation of aorta (COA). We hypothesized that adults with COA had worse pulmonary vascular reserve compared to controls, and that impaired pulmonary vascular reserve was associated with clinical indices of disease severity independent right ventricular (RV) indices at rest.</p><p><strong>Method: </strong>We assessed pulmonary vascular reserve using mean pulmonary artery pressure/cardiac output (mPAP/CO) slope derived from exercise echocardiogram in 41 COA patients and 41 controls. RV contractility was assessed using RV end-systolic pressure-area ratio (RVESPAR), and RV contractile reserves was assessed as ratio of RVESPAR at peak exercise versus rest (RVESPAR_peak/rest).</p><p><strong>Results: </strong>COA group had impaired pulmonary vascular reserve (i.e., higher mPAP/CO slope, 2.49±1.02 versus 1.03±0.59 mmHg/l/min, p<0.001) compared to controls. Impaired pulmonary vascular reserve was associated with worse aerobic capacity (lower peak oxygen consumption), neurohormonal activation (higher NT-proBNP), and worse RV contractile (lower RVESPAR_peak/rest), independent of echocardiographic indices at rest. Echocardiographic estimation of mPAP/CO slope was feasible in 85% [35/41]. Of note, the assessment of RV afterload at rest was feasible in 39 (95%) and 33 (81%) patients in the COA and control groups, respectively, but decreased to 32 (78%) and 26 (63%) patients at peak exercise in the COA and control groups, respectively, due to inability to measure tricuspid regurgitation velocity at peak exercise in some patients.</p><p><strong>Conclusions: </strong>Patients with COA had impaired pulmonary vascular reserve, as defined by mPAP/CO slope, and higher mPAP/CO slope was associated with worse indices of disease severity.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016577","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":"Aortic valve function and aortic dilatation associated with bicuspid aortic valve in early childhood.","authors":"Jakob Boesgaard Norsk, Anne-Sophie Sillesen, Maria Munk Pærregaard, Sofie Dannesbo, Magdalena Hansson, Thilde Olivia Kock, R Ottilia Vøgg, Niels Vejlstrup, Kasper Iversen, Henning Bundgaard, Anna Axelsson Raja","doi":"10.1016/j.echo.2025.08.023","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.023","url":null,"abstract":"<p><strong>Introduction: </strong>The natural history of bicuspid aortic valve (BAV) remains inadequately characterized, leaving uncertainties regarding whether associated aortic dilatation arises from an inherent susceptibility or primarily results from altered flow dynamics across the aortic valve. We aimed to describe the evolution of valve function and aortic dilatation at preschool-age in children diagnosed with BAV neonatally.</p><p><strong>Methods: </strong>The population study, Copenhagen Baby Heart Study (n >25,000) performed in 2016-2018, diagnosed 196 newborns (0.8%) with BAV. In the present follow-up study, children with BAV were re-examined with echocardiography at three years of age and compared with controls with tricuspid aortic valves. Aortic diameters were normalized using Z-scores.</p><p><strong>Results: </strong>At follow-up, 128 children with BAV (36±13 months, 70% males) and 88 controls (43±10 months, 70% males) were examined. Children with BAV were significantly younger (p<0.001) and had a smaller body surface 0.65 (±0.10) vs. 0.70 (±0.07), p<0.001) area compared to controls. The prevalence of aortic valve regurgitation increased from 15.6% neonatally to 24.2% at follow-up (p<0.05) in cases, compared to 0% in controls. Flow velocities across the aortic valve did not differ between cases and controls at follow-up. The diameters of the sinuses of Valsalva, sinotubular junction, and ascending aorta were all significantly larger in cases compared to controls neonatally (Z-score 0.90 vs. 0.008, p<0.001; 0.24 vs. -0.09, p<0.05; 1.33 vs. 0.06, p<0.001, respectively) as well as at follow-up (Z-score 0.84 vs. 0.004, p<0.001; 0.42 vs. 0.09, p<0.05; 1.34 vs. -0.04, p<0.001, respectively). At follow-up, 68 (53.1%) children with BAV and 7 (8.0%) controls had at least one aortic diameter with a Z-score ≥2 (p<0.001).</p><p><strong>Conclusions: </strong>At three years of age, one in four children diagnosed with BAV neonatally, exhibited aortic valve regurgitation, and more than half demonstrated aortic dilatation with a Z-score ≥2. The results support the hypothesis that the dilatation of the proximal aorta is not solely secondary to altered flow dynamics across the valve but also an inherent susceptibility of the aortic wall.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016510","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}