Journal of the American Society of Echocardiography最新文献

{"title":"Left Atrial Mechanics in Isolated Total Anomalous Pulmonary Venous Connection After Repair.","authors":"Andrew Brennan, Seda Tierney, Kelly Thorson, Michael Ma, Deborah Y Ho, Elisabeth Martin, Rajesh Punn","doi":"10.1016/j.echo.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.021","url":null,"abstract":"<p><strong>Introduction: </strong>Repaired total anomalous pulmonary venous connection (TAPVC) patients with preoperative pulmonary venous obstruction (PVO) have reductions in echocardiographic metrics, such as left atrial reservoir function and pulmonary venous variability index (PVVI). We hypothesized reduced preoperative left atrial strain mechanics in isolated TAPVC patients serve as risk factors for postoperative PVO. We also evaluated echocardiographic metrics and clinical characteristics associated with preoperative and postoperative PVO, as well as compared these to healthy controls.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on 64 isolated TAPVC patients who underwent repair between 9/1/2003 and 12/31/2022 with an available preoperative, immediate postoperative, and follow-up echocardiogram (most recent or prior to reintervention). Twenty-five individual age and body surface area-matched healthy controls were compared at each echo time point. LA strain analysis was performed using TOMTEC software. Postoperative PVO was defined as peak Doppler velocity ≥1.2 m/s in an individual pulmonary vein or pulmonary venous confluence.</p><p><strong>Results: </strong>Thirty-seven (58%) TAPVC patients had preoperative PVO. Twenty-eight (44%) patients developed postoperative PVO, of which twelve (19%) required reintervention. Preoperative PVO increased the risk of postoperative PVO (78.6% vs 41.7%, p = 0.004) and reintervention (91.7% vs 50%, p = 0.001). This was no longer true when preoperative PVO was defined as peak velocity ≥1.2 m/s (p = 0.2362), although it remained associated with reintervention (p = 0.02). In TAPVC patients there were no other preoperative echocardiographic metrics, including LA strain measurements and PVVI, significantly associated with postoperative PVO or reintervention. Immediately postoperative LA volumes and mechanics demonstrated no difference between TAPVC patients with and without postoperative PVO or reintervention. Compared to healthy controls, pulmonary vein Doppler absolute velocities, left ventricle length, and LA mechanics were diminished in TAPVC patients at all echo time points (p = 0.0149 to <0.0001). In contrast LA two-dimensional volumes, left ventricular volumes, and LA dyssynchrony index normalized over time.</p><p><strong>Conclusions: </strong>Although preoperative pulmonary vein Doppler velocity ≥ 1.2 m/s increased the risk for reintervention in repaired isolated TAPVC patients, no preoperative LA mechanics or other echocardiographic metrics were associated with the development of postoperative PVO or reintervention. Immediately postoperative LA volumes do not appear to modify reintervention risk indicating pulmonary vein hypoplasia/stenosis is the primary driver for reintervention. Despite ongoing impaired LA mechanics and decreased LV length, LA and LV volumes normalize over time in repaired TAPVC patients.</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":"145016585","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":"Artificial Intelligence Safety in Echocardiography Interpretation Needs Two I(s).","authors":"Daniel M Gelfman","doi":"10.1016/j.echo.2025.08.020","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.020","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008598","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":"Evolving Paradigms in Quantifying Functional Tricuspid Regurgitation-The Doppler Shape Dimension.","authors":"Luigi P Badano, Denisa Muraru","doi":"10.1016/j.echo.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.echo.2025.07.017","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006712","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 Clinical Significance of Non-Ebsteinoid Fetal Tricuspid Valve Regurgitation.","authors":"Daniel O'Meara, Erik C Michelfelder, Andrew Jergel, Sanghee S Ro","doi":"10.1016/j.echo.2025.08.019","DOIUrl":"10.1016/j.echo.2025.08.019","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid regurgitation (TR) is commonly identified via fetal echocardiography (FE). The association of TR in the fetal heart with neonatal outcomes remains poorly understood. We aimed to assess the spectrum and evolution of non-Ebsteinoid TR in fetuses and to understand the associated clinical outcomes in the current era.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all fetuses diagnosed with non-Ebsteinoid TR at a single center from January 1, 2012, to October 1, 2023. Eligible fetuses were divided into 3 groups based on the severity of TR on initial FE: mild, moderate, and severe. Initial and serial FE were reviewed along with postnatal echocardiographic findings. Prenatal variables and neonatal outcomes were also collected.</p><p><strong>Results: </strong>A total of 67 fetuses met the inclusion criteria. Based on initial FE, 49 (73.1%) fetuses had mild TR, 15 (22.4%) had moderate TR, and 3 (4.5%) had severe TR, diagnosed at a median gestational age of 26.3 weeks [23.4, 32.3]. Of fetuses with mild TR that had worsening TR in utero (17.9%) or postnatally (17.6%), all had tricuspid valve (TV) dysplasia or right ventricle (RV) dysfunction noted prenatally. Compared to fetuses with mild TR and normal TV anatomy, fetuses with mild TR and TV dysplasia had larger TV annuli (1.12 cm vs 0.96 cm; P = .035) and RV internal diameter in diastole (1.59 cm vs 1.26 cm; P = .01). Newborns with prenatally diagnosed severe TR were more likely to require cardiac intensive care after birth (3/3 = 100%; P < .001) than those with mild (1/49 = 2%) or moderate TR (1/15 = 6.7%).</p><p><strong>Conclusions: </strong>In the absence of TV dysplasia or RV dysfunction, mild, non-Ebsteinoid fetal TR can be considered a benign finding in the current era. However, when these findings are present, or in the patient with limited imaging windows, postnatal evaluation should be performed to rule out other primary cardiac disease.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006720","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":"Quantitative Doppler Shape Analysis in Functional Tricuspid Regurgitation.","authors":"Arthur Iturriagagoitia, Simon Calle, Thomas Van Overmeiren, Marc Debuyzere, Erwan Donal, Frank Timmermans","doi":"10.1016/j.echo.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.echo.2025.08.018","url":null,"abstract":"<p><strong>Background: </strong>The shape of the continuous wave Doppler (CWD) envelope in functional tricuspid valve regurgitation (fTR) results from the dynamic interplay between flow, pressure gradient and impedance. Although the v-wave cut-off shape in fTR is a well-recognized feature of severe TR, the complete spectrum of TR CWD shapes across the different fTR severity ranges has not been thoroughly explored, which is the scope of the present study.</p><p><strong>Methods: </strong>In 245 patients with fTR, TR was graded with transthoracic echocardiography using the corrected proximal isovelocity surface area method and CWD shapes were scored, both qualitatively (using visual scoring into parabolic, triangular or v-wave cut-off categories) and quantitatively using a novel Vmax/Vmean parameter and time-to-peak velocity corrected for TR duration (TTP/TRD). Linear regression analysis was performed to identify associations of Vmax/Vmean and TTP/TRD. Vmax/Vmean was categorized into tertiles to assess its association with the composite endpoint of death and heart failure hospitalization. Survival analysis consisted of Kaplan-Meier curves with log-rank tests and a multivariate Cox regression model.</p><p><strong>Results: </strong>The Vmax/Vmean ratio as a surrogate value for fTR CWD shapes increases from a parabolic shape (1.26 ±0.07) towards a more triangular shape without v-wave (1.32 ±0.10) and eventually the v-wave cut-off sign (1.42 ±0.14, P<0.001) in most severe fTR. Vmax, EROA and RV function parameters are significantly associated with Vmax/Vmean and TTP/TRD. Vmax/Vmean is independently associated with the occurrence of the composite endpoint (adjusted HR 1.32, 95% CI: 1.09-1.60 (P = 0.004), log rank P = 0.004 between the second (1.27-1.33) and third tertile (>1.33)). Hierarchical Cox models show no incremental value on top of EROA (P = 0.2), whereas TTP/TRD was not associated with outcome.</p><p><strong>Conclusion: </strong>Vmax/Vmean reflects the hydraulic severity of fTR and is independently associated with adverse clinical outcomes, providing a simple tool for improved risk stratification in patients with fTR.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006725","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":"Is Body Surface Area a Good Anthropometric Scaling Variable for Detecting Differences in Right Atrial and Right Ventricular Structural Parameters in Adults Born Term Versus Preterm?","authors":"Curt G. DeGroff MD, MSEE","doi":"10.1016/j.echo.2025.04.015","DOIUrl":"10.1016/j.echo.2025.04.015","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 9","pages":"Page 873"},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023782","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":"Is Stress Echocardiography the Ugly Duckling of the Fontan Physiological Assessment?","authors":"Jacob Cao MBBS ,&nbsp;Rachael Cordina MBBS, PhD","doi":"10.1016/j.echo.2025.06.014","DOIUrl":"10.1016/j.echo.2025.06.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 9","pages":"Pages 855-858"},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530764","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":"ASE 36th Annual Scientific Sessions Scientific Research Abstracts","authors":"","doi":"10.1016/j.echo.2025.08.002","DOIUrl":"10.1016/j.echo.2025.08.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 9","pages":"Page 874"},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931873","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":"Feeding the Diagnostic Beast That Is Diastolic Dysfunction: Are Left Atrial Coupling and Stiffness Indices Core Nutrients or Impractical Supplements?","authors":"Bradley S. Lander MD ,&nbsp;Brian D. Hoit MD","doi":"10.1016/j.echo.2025.05.009","DOIUrl":"10.1016/j.echo.2025.05.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 9","pages":"Pages 804-806"},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183093","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":"Validation of Noninvasive Measures of Ventricular Diastolic Stiffness in Single Right Ventricle Patients: A Pilot Study","authors":"William A. Harris MD,&nbsp;Eric M. Graham MD,&nbsp;Carolyn L. Taylor MD,&nbsp;Andrew Savage MD,&nbsp;Kimberly E. McHugh MD,&nbsp;Stephanie Gaydos MD,&nbsp;Arni C. Nutting MD,&nbsp;Andrew M. Atz MD,&nbsp;Donald R. Menick PhD,&nbsp;Drew Bickel RDCS,&nbsp;Meara Walkley RDCS,&nbsp;Shahryar M. Chowdhury MD","doi":"10.1016/j.echo.2025.04.021","DOIUrl":"10.1016/j.echo.2025.04.021","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 9","pages":"Pages 867-869"},"PeriodicalIF":6.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020058","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}