Journal of the American Society of Echocardiography最新文献

{"title":"Utility of an Echocardiographic Machine Learning Model to Predict Outcomes in Intensive Cardiac Care Unit Patients","authors":"Samy Aghezzaf MD ,&nbsp;Augustin Coisne MD, PhD ,&nbsp;Kenza Hamzi MSc ,&nbsp;Solenn Toupin PhD ,&nbsp;Claire Bouleti MD, PhD ,&nbsp;Charles Fauvel MD ,&nbsp;Jean-Baptiste Brette MD ,&nbsp;David Montaigne MD, PhD ,&nbsp;Reza Rossanaly Vasram MD ,&nbsp;Antonin Trimaille MD ,&nbsp;Gilles Lemesle MD, PhD ,&nbsp;Guillaume Schurtz MD ,&nbsp;Edouard Gerbaud MD, PhD ,&nbsp;Clément Delmas MD, PhD ,&nbsp;Marc Bedossa MD ,&nbsp;Jean-Claude Dib MD ,&nbsp;Vincent Roule MD, PhD ,&nbsp;Etienne Puymirat MD, PhD ,&nbsp;Martine Gilard MD, PhD ,&nbsp;Marouane Boukhris MD ,&nbsp;Theo Pezel MD, PhD","doi":"10.1016/j.echo.2024.11.014","DOIUrl":"10.1016/j.echo.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>The risk stratification at admission to the intensive cardiac care unit (ICCU) is crucial and remains challenging.</div></div><div><h3>Objectives</h3><div>We aimed to investigate the accuracy of a machine learning (ML)-model based on initial transthoracic echocardiography (TTE) to predict in-hospital major adverse events (MAEs) in a broad spectrum of patients admitted to ICCU.</div></div><div><h3>Methods</h3><div>All consecutive patients hospitalized in ICCUs with a complete TTE performed within the first 24 hours of admission were included in this prospective multicenter study (39 centers). Sixteen TTE parameters were evaluated. The ML model involved automated feature selection by random survival forest and model building with an extreme gradient boosting (XGBoost) algorithm. The primary outcome was in-hospital MAEs defined as all-cause death, resuscitated cardiac arrest, or cardiogenic shock.</div></div><div><h3>Results</h3><div>Of 1,499 consecutive patients (63 ± 15 years, 70% male), MAEs occurred in 67 patients (4.5%). The 5 TTE parameters selected in the model were left ventricular outflow tract velocity-time integral, E/e’ ratio, systolic pulmonary artery pressure, tricuspid annular plane systolic excursion, and left ventricular ejection fraction. Using the XGBoost, the ML model exhibited a higher area under the receiver operating curve compared with any existing scores (ML model, 0.83 vs logistic regression, 0.76, ACUTE-HF score:,0.66; thrombolysis in myocardial infarction score, 0.60; Global Registry of Acute Coronary Events score, 0.58, all <em>P</em> &lt; .001). The ML model had an incremental prognostic value for predicting MAE over a traditional model including clinical and biological data (<em>C</em> index 0.80 vs 0.73, <em>P</em> = .012; chi-square 59.7 vs 32.4; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The ML model based on initial TTE exhibited a higher prognostic value to predict in-hospital MAEs compared with existing scores or clinical and biological data in the ICCU.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 320-330"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839656","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":"Limited Concordance of Left Ventricular Ejection Fraction and Chamber Dimensions With Automated Assessments in Hypertrophic Cardiomyopathy: A Substudy From VALOR-HCM","authors":"Gary Parizher MD,&nbsp;Alice Haouzi MD,&nbsp;Wael A. Jaber MD,&nbsp;Anjali Owens MD,&nbsp;Kathy Wolski MPH,&nbsp;Jeffrey B. Geske MD,&nbsp;Sara Saberi MD, MS,&nbsp;Andrew Wang MD,&nbsp;Mark Sherrid MD,&nbsp;Neal K. Lakdawala MD,&nbsp;Albree Tower-Rader MD,&nbsp;David Fermin MD,&nbsp;Srihari S. Naidu MD,&nbsp;Zoran B. Popovic MD, PhD,&nbsp;Nicholas G. Smedira MD, MBA,&nbsp;Hartzell Schaff MD,&nbsp;Ellen McErlean RN, MSN,&nbsp;Christina Sewell RN,&nbsp;Kathy Lampl MD,&nbsp;Amy J. Sehnert MD,&nbsp;Paul C. Cremer MD, MS","doi":"10.1016/j.echo.2024.12.009","DOIUrl":"10.1016/j.echo.2024.12.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 356-358"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903994","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":"Blood Pressure and Echocardiographic Interpretation: Guideline Revision Needed","authors":"Christopher Lee MD,&nbsp;Theodore P. Abraham MD,&nbsp;Nelson B. Schiller MD","doi":"10.1016/j.echo.2025.01.003","DOIUrl":"10.1016/j.echo.2025.01.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Page 364"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973025","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":"Thank You, JASE Reviewer Team!","authors":"Patricia A. Pellikka MD (Editor-in-Chief)","doi":"10.1016/j.echo.2025.02.009","DOIUrl":"10.1016/j.echo.2025.02.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 295-299"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748686","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":"Height-Based Pediatric Echocardiographic Z Scores Are Valid in Patients With Normal Body Mass Index and May Be Advantageous in Obese Patients","authors":"David Ezon MD,&nbsp;Son Q. Duong MD, MS,&nbsp;Guillaume Stoffels PhD,&nbsp;Leo Lopez MD,&nbsp;Joseph Mahgerefteh MD","doi":"10.1016/j.echo.2024.10.021","DOIUrl":"10.1016/j.echo.2024.10.021","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 358-361"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640105","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":"Continuing Education and Meeting Calendar","authors":"","doi":"10.1016/j.echo.2025.02.003","DOIUrl":"10.1016/j.echo.2025.02.003","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Page A23"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746708","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":"Integrating Left Atrial Reservoir Strain Into the First-Line Assessment of Diastolic Function: Prognostic Implications in a Community-Based Cohort With Normal Left Ventricular Systolic Function.","authors":"Máté Tolvaj, Fjolla Zhubi Bakija, Alexandra Fábián, Andrea Ferencz, Bálint Lakatos, Zsuzsanna Ladányi, Ádám Szijártó, Borbála Edvi, Loretta Kiss, Zsolt Szelid, Pál Soós, Béla Merkely, Zsolt Bagyura, Márton Tokodi, Attila Kovács","doi":"10.1016/j.echo.2025.03.012","DOIUrl":"10.1016/j.echo.2025.03.012","url":null,"abstract":"<p><strong>Background: </strong>Left atrial (LA) reservoir strain (LASr) has emerged as a sensitive marker of LA function and elevated filling pressures, even though its role in detecting diastolic dysfunction (DD) and the subsequent risk stratification has remained relatively underexplored. Accordingly, we aimed to investigate the prognostic implications of replacing LA volume index (LAVi) with LASr in the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) algorithm for diagnosing DD, compared to the 2024 British Society of Echocardiography (BSE) algorithm, in individuals with normal left ventricular (LV) systolic function.</p><p><strong>Methods: </strong>We retrospectively identified 1,180 volunteers from a population-based screening program with normal LV systolic function and no evidence of myocardial disease. Echocardiographic measurements comprised recommended parameters of diastolic function and LASr by speckle-tracking. Diastolic function was assessed using the BSE algorithm and the modified ASE/EACVI algorithm, in which LAVi >34 mL/m² was replaced with LASr <23%. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization.</p><p><strong>Results: </strong>During a median follow-up of 11 years, 133 (11%) individuals met the primary endpoint. Using the BSE algorithm, there was no difference in the risk of meeting the primary endpoint between individuals with normal diastolic function and those with impaired diastolic function with normal filling pressures. In univariable analysis, individuals having impaired diastolic function with elevated filling pressures exhibited a significantly higher risk than those in the other 2 groups (unadjusted hazard ratios = 4.408 [95% CI, 2.376-8.179], P < .001; and 5.137 [95% CI, 1.138-23.181], P = .033, respectively). However, these differences were no longer significant after adjusting for relevant covariates. In contrast, the modified ASE/EACVI algorithm identified 3 groups with distinct risk profiles, and even in multivariable analysis, individuals with DD had a higher risk of meeting the primary endpoint than those with normal diastolic function (adjusted hazard ratio = 3.199 [95% CI, 1.534-6.671], P = .002).</p><p><strong>Conclusion: </strong>In a community-based cohort with normal LV function, integrating LASr into the first-line echocardiographic assessment of diastolic function improved both classification and subsequent risk stratification.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744193","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 Doppler Angle Effect Needs to Be Considered Wherever in the Heart the Proximal Isovelocity Surface Area Method Is Utilized.","authors":"Curt G DeGroff","doi":"10.1016/j.echo.2025.02.018","DOIUrl":"10.1016/j.echo.2025.02.018","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694266","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 \"The Doppler Angle Effect Needs to Be Considered Wherever in the Heart the Proximal Isovelocity Surface Area Method Is Utilized\".","authors":"Luigi P Badano, Michele Tomaselli, Denisa Muraru","doi":"10.1016/j.echo.2025.03.009","DOIUrl":"10.1016/j.echo.2025.03.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694263","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":"Calculation of Regurgitant Volume Using Echocardiographic Volumetric Method for Accurate Diagnosis of Severe Mitral Regurgitation.","authors":"Ga Yun Kim, Ha Hye Jo, So-Min Lim, Dayoung Pack, Hye Soo Lee, Jong En Lee, Hyun Jung Koo, Ji Sung Lee, Sahmin Lee, Byung Joo Sun, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song","doi":"10.1016/j.echo.2025.02.012","DOIUrl":"10.1016/j.echo.2025.02.012","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have shown suboptimal results of the proximal isovelocity surface area (PISA) method and the American Society of Echocardiography (ASE) algorithm for diagnosing severe primary mitral regurgitation (MR). The aim of this study was to evaluate the accuracy of regurgitant volume (RegVol) calculated using volumetric transthoracic echocardiography (TTE) for diagnosing severe primary MR.</p><p><strong>Methods: </strong>A total of 74 patients with primary MR due to prolapse or flail leaflet were prospectively recruited for both TTE and cardiac magnetic resonance (CMR) imaging. RegVol was calculated using PISA (RegVol__PISA) or the volumetric method (left ventricular total stroke volume - systolic forward outflow volume; RegVol__TTE). According to the ASE algorithm, patients with four or more parameters were diagnosed with severe MR. RegVol__CMR ≥ 60 mL was used as the gold standard for diagnosing severe MR.</p><p><strong>Results: </strong>All subjects had at least moderate to severe MR according to ASE guidelines. CMR imaging confirmed that 30 patients (41%) had severe MR. The concordance correlation coefficient between RegVol__TTE and RegVol__CMR (0.809; 95% CI, 0.715-0.893) was higher than that between RegVol__PISA and RegVol__CMR (0.468; 95% CI, 0.323-0.576). The overall accuracy of RegVol__TTE for the diagnosis of severe MR was 90.5% (95% CI, 81.5-96.1), which was significantly higher than that of RegVol__PISA (64.9%; 95% CI, 52.9-75.6; P < .001) and the ASE algorithm (77.0%; 95% CI, 65.8-86.0; P = .004). The area under the curve for RegVol__TTE (0.95; 95% CI, 0.90-1.00) was significantly larger than that for RegVol__PISA (0.88; 95% CI, 0.80-0.96; P = .028).</p><p><strong>Conclusions: </strong>RegVol__TTE showed better diagnostic performance than the PISA method and the ASE algorithm in diagnosing severe MR. Further investigations are necessary to evaluate the clinical usefulness of the routine use of RegVol__TTE.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671573","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}