Journal of the American Society of Echocardiography最新文献

{"title":"Real-Time Global Longitudinal Strain During Echocardiography: A Deep Learning Platform for Improved Workflow.","authors":"Vegard Holmstrøm, Erik Smistad, Stian Stølen, Espen Holte, Lasse Løvstakken, Håvard Dalen, Andreas Østvik, Bjørnar Grenne","doi":"10.1016/j.echo.2025.08.015","DOIUrl":"10.1016/j.echo.2025.08.015","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) global longitudinal strain (GLS) offers advantages over LV ejection fraction, including improved diagnostic sensitivity, reproducibility, and prognostic value. However, current semiautomatic analyses are time-consuming and operator dependent, impeding widespread adoption of GLS in routine clinical practice.</p><p><strong>Objectives: </strong>We aimed to assess the feasibility, precision, and time efficiency of GLS measurements using a deep learning (DL) platform that performs real-time GLS analysis during image acquisition and incorporates DL tools to support standardization, to evaluate whether DL-assisted acquisitions can enhance image quality metrics relevant to strain analyses.</p><p><strong>Methods: </strong>A DL platform was developed for fully automated real-time GLS analysis, including tools that detect and alert the operator to foreshortening or baseline drift. In this controlled prospective study, 50 patients (mean age, 56 years; 64% male) were included. Two image sets were acquired by different operators using the DL platform and a conventional workflow, and GLS and image quality were compared.</p><p><strong>Results: </strong>Overall feasibility of DL-based GLS measurements was 94%. Absolute GLS was 14.8 ± 3.2 using the DL platform workflow and 16.2 ± 3.3 with manual reference measurements, with a bias of -1.3 and limits of agreement ranging from -3.5 to 0.8. Correlation was excellent (r = 0.94). Images acquired with the DL platform showed significantly less baseline drift and borderline improved territorial strain agreement than the reference acquisition. The median time obtaining GLS with the DL platform was reduced by 57% compared to the conventional workflow, from 4 minutes and 48 seconds to 2 minutes and 4 seconds.</p><p><strong>Conclusion: </strong>The DL platform for fully automated real-time GLS measurements was feasible, precise, and time efficient. Real-time DL-based feedback allows operators to optimize images during acquisition, thus improving quality metrics relevant to GLS analyses. Implementing this method in clinical practice could streamline workflow and improve efficiency in the echocardiographic laboratory.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976901","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 Applications of Strain Echocardiography: A Clinical Consensus Statement From the American Society of Echocardiography Developed in Collaboration With the European Association of Cardiovascular Imaging of the European Society of Cardiology.","authors":"James D Thomas, Thor Edvardsen, Theodore Abraham, Vinesh Appadurai, Luigi Badano, Jose Banchs, Goo-Yeong Cho, Bernard Cosyns, Victoria Delgado, Erwan Donal, Maurizio Galderisi, Roberto M Lang, Thomas H Marwick, Luc Mertens, Margaret Park, Bogdan A Popescu, Zoran Popovic, Marielle Scherrer-Crosbie, Partho P Sengupta, Sanjiv Shah, Peter Søgaard, Masaaki Takeuchi, Frank Weidemann, Jens-Uwe Voigt","doi":"10.1016/j.echo.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.echo.2025.07.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976847","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":"Echocardiographic and Pathophysiologic Insights Into Mitral Regurgitation, Mitral Annular Disjunction, and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse.","authors":"Jeffrey J Silbiger, Oksana Marchenko, Lucy Safi, Priya Panday","doi":"10.1016/j.echo.2025.08.014","DOIUrl":"10.1016/j.echo.2025.08.014","url":null,"abstract":"<p><p>Mitral valve prolapse affects approximately 2.5% of the population and represents the most common cause of primary mitral regurgitation. Mitral regurgitation is related to increased leaflet size, prolapse asymmetry, long clefts, calcification, and restricted leaflet motion. Chordal abnormalities, including increased length and rupture, also play a role. Mitral valve prolapse is also recognized as an important cause of ventricular arrhythmias and sudden arrhythmic death. Patients with arrhythmic mitral valve prolapse commonly exhibit an echocardiographic phenotype characterized by thick, long mitral leaflets with multisegment bileaflet prolapse and mitral annular disjunction, with or without significant mitral regurgitation. This review discusses the pathophysiology and echocardiographic features of these abnormalities.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976866","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 for Identifying Dynamic Left Ventricular Outflow Tract Obstruction.","authors":"Sherif F Nagueh","doi":"10.1016/j.echo.2025.08.013","DOIUrl":"10.1016/j.echo.2025.08.013","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976929","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":"Modified Venous Excess Ultrasound: A Dynamic Tool to Predict Mortality in Acute Decompensated Heart Failure.","authors":"Marina Petersen Saadi, Gustavo Paes Silvano, Guilherme Pinheiro Machado, Renato Ferraz Almeida, Fernando Luis Scolari, Andreia Biolo, Hatem Soliman Aboumarie, Guilherme Heiden Telo, Anderson Donelli da Silveira","doi":"10.1016/j.echo.2025.08.011","DOIUrl":"10.1016/j.echo.2025.08.011","url":null,"abstract":"<p><strong>Background: </strong>Quantifying systemic venous congestion in acute decompensated heart failure (ADHF) is challenging. The Venous Excess Ultrasound (VExUS) score has emerged as a noninvasive tool for assessing venous congestion. Although higher VExUS values are linked to cardiorenal syndrome, its prognostic role in ADHF remains unclear. This study evaluated whether repeated VExUS measurements, obtained at 2 time points, predict in-hospital mortality in ADHF.</p><p><strong>Methods: </strong>In this prospective cohort study, 104 patients with ADHF and left ventricular ejection fraction <50% were admitted to a cardiovascular intensive care unit between October 2022 and January 2024. Modified VExUS was assessed within 24 hours of admission and repeated at 72 hours using a modified protocol (mVExUS). ΔVExUS was defined as the 72-hour score minus the baseline score; improvement was defined as ΔVExUS ≥1. Complementary point-of-care ultrasound (POCUS) parameters and clinical markers of decongestion were also evaluated. Of the total, 97 patients had complete follow-up and were included in the ΔVExUS analysis. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Patients with ΔVExUS ≥1 had greater urine output, more pronounced weight loss, and greater reduction in serum creatinine and clinical congestion score (all P < .05). In-hospital mortality was significantly lower in patients with mVExUS improvement (11.1% vs 36.4%, P = .007). ΔVExUS ≥ 1 remained independently associated with lower in-hospital mortality after adjustment for clinical and echocardiographic variables (adjusted odds ratio, 0.31; 95% CI, 0.14-0.68; P = .004). In multivariable analysis using least absolute shrinkage and selection operator regression, ΔVExUS emerged as an independent predictor of in-hospital mortality (odds ratio, 0.32; 95% CI, 0.13-0.74).</p><p><strong>Conclusions: </strong>A reduction of ≥1 point in the mVExUS score over the first 72 hours (ΔVExUS ≥ 1) was independently associated with lower in-hospital mortality and was accompanied by favorable clinical and laboratory markers of decongestion. This is the first study to identify ΔVExUS as a dynamic prognostic marker in ADHF, reinforcing its value as a practical tool for routine bedside application. These findings support the incorporation of repeated mVExUS assessments into standard practice to enhance risk stratification in patients with ADHF.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976877","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":"Right Atrial Strain-Normal Values in Relation to Right Atrial Volumes.","authors":"Christopher Lee, Qizhi Fang, Sachiyo Igata, Dwight Bibby, Theodore P Abraham, Nelson B Schiller","doi":"10.1016/j.echo.2025.08.004","DOIUrl":"10.1016/j.echo.2025.08.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976869","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":"Rethinking Routine: The Value of Surveillance Echocardiography in Adults After Arterial Switch Operation.","authors":"Ritu Sachdeva","doi":"10.1016/j.echo.2025.08.009","DOIUrl":"10.1016/j.echo.2025.08.009","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876445","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":"Single-View Echocardiographic Analysis for Left Ventricular Outflow Tract Obstruction Prediction in Hypertrophic Cardiomyopathy: A Deep Learning Approach.","authors":"Jiesuck Park, Jiyeon Kim, Jaeik Jeon, Yeonyee E Yoon, Yeonggul Jang, Hyunseok Jeong, Seung-Ah Lee, Hong-Mi Choi, In-Chang Hwang, Goo-Yeong Cho, Hyuk-Jae Chang","doi":"10.1016/j.echo.2025.08.008","DOIUrl":"10.1016/j.echo.2025.08.008","url":null,"abstract":"<p><strong>Background: </strong>Accurate left ventricular outflow tract obstruction (LVOTO) assessment is crucial for hypertrophic cardiomyopathy (HCM) management and prognosis. Traditional methods, requiring multiple views, Doppler, and provocation, is often infeasible, especially where resources are limited. This study aimed to develop and validate a deep learning (DL) model capable of predicting severe LVOTO in HCM patients using only the parasternal long-axis (PLAX) view from transthoracic echocardiography (TTE).</p><p><strong>Methods: </strong>A DL model was trained on PLAX videos extracted from TTE examinations (developmental dataset, n = 1,007) to capture both morphological and dynamic motion features, generating a DL index for LVOTO (DLi-LVOTO; range 0-100). Performance was evaluated in an internal test dataset (ITDS; n = 87) and externally validated in the distinct hospital dataset (DHDS; n = 1,334) and the LVOTO reduction treatment dataset (n = 156).</p><p><strong>Results: </strong>The model achieved high accuracy in detecting severe LVOTO (pressure gradient 50 mm Hg), with area under the receiver operating characteristics curve of 0.97 (95% CI, 0.92-1.00) in ITDS and 0.93 (0.92-0.95) in DHDS. At a DLi-LVOTO threshold of 70, the model demonstrated a specificity of 97.3% and negative predictive value of 96.1% in ITDS. In DHDS, a cutoff of 60 yielded a specificity of 94.6% and negative predictive value of 95.5%. The DLi-LVOTO also decreased significantly after surgical myectomy or Mavacamten treatment, correlating with reductions in peak pressure gradient (P < .001 for all).</p><p><strong>Conclusions: </strong>Our DL-based approach predicts severe LVOTO using only the PLAX view from TTE, serving as a complementary tool when Doppler assessment is unavailable and for monitoring treatment response.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876446","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 Pregnancy on the Progression of Aortic and Aortic Valve Disease in Patients With Bicuspid Aortic Valves.","authors":"Kathia Abdoun, Michelle Fortin, Laurence Brunet, Mylène Shen, Élisabeth Bédard, Philippe Chetaille, Marie-Annick Clavel","doi":"10.1016/j.echo.2025.08.006","DOIUrl":"10.1016/j.echo.2025.08.006","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862628","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 Functional Reserve and Recurrence of Atrial Arrhythmias in Patients With Persistent Atrial Fibrillation.","authors":"Yuriko Yoshida, Koki Nakanishi, Masao Daimon, Kazutoshi Hirose, Kentaro Iwama, Yasuhiro Mukai, Yuko Yamamoto, Hikari Seki, Megumi Hirokawa, Tomoko Nakao, Tsukasa Oshima, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Toshiya Kojima, Eriko Hasumi, Katsuhito Fujiu, Hiroyuki Morita, Makoto Kurano, Norihiko Takeda","doi":"10.1016/j.echo.2025.08.005","DOIUrl":"10.1016/j.echo.2025.08.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862629","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}