Journal of the American Society of Echocardiography最新文献

{"title":"Development and Validation of a Novel Deep Learning Model to Predict Pharmacologic Closure of Patent Ductus Arteriosus in Premature Infants.","authors":"Puneet Sharma, Addison Gearhart, Guangze Luo, Anil Palepu, Cindy Wang, Joshua Mayourian, Kristyn Beam, Fotios Spyropoulos, Andrew J Powell, Philip Levy, Andrew Beam","doi":"10.1016/j.echo.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.echo.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. Although pharmacotherapy can be effective, it is difficult to predict whether a patient will respond, leading to delays in care. Machine learning has emerged as a powerful tool to interpret clinical data to predict clinical outcomes but has not yet been applied to this question. The aim of this study was to train and validate a novel deep learning model to predict the likelihood of PDA closure after an initial course of pharmacotherapy in preterm infants.</p><p><strong>Methods: </strong>A retrospective cohort of 174 preterm infants who received pharmacologic treatment for PDA was identified. After collecting relevant perinatal data and pretreatment echocardiograms, the subjects were randomized into training and validation sets in a 70:30 split. Two distinct convolutional neural networks (CNN) were trained, one based on echocardiograms alone and the other on both echocardiograms and perinatal data. The performance of the CNNs was compared against controls of random forest and logistic regression models trained on perinatal data alone.</p><p><strong>Results: </strong>The rate of PDA closure after an initial course of pharmacotherapy was 60% in this cohort. The 174 echocardiograms collected for all subjects included 1,926 clips. A total of 121 infants (1,387 clips) were successfully randomized into the training set and 53 (539 clips) into the validation set. The multimodal CNN had an area under the curve (AUC) of 0.82, outperforming the imaging-only model (AUC = 0.66). Additionally, the multimodal CNN outperformed logistic regression (AUC = 0.66) and random forest (AUC = 0.74) models.</p><p><strong>Conclusions: </strong>This novel, multimodal CNN shows promise for clinicians, who do not currently have a reliable tool to predict the success of PDA closure after an initial course of pharmacotherapy. This investigation represents the first attempt to use deep learning methodology to predict this outcome.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055847","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":"Dynamic Segmentation of Three-Dimensional Transesophageal Echocardiography Using an Automated Neural Network for Transcatheter Edge-to-Edge Repair.","authors":"Charlotte L Frost, Mahesh Vidula, Ray Hu, Howard C Herrmann, Alison M Pouch, Tiffany Chen","doi":"10.1016/j.echo.2025.04.004","DOIUrl":"10.1016/j.echo.2025.04.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029963","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":"Imaging of Left Ventricular Diastolic Function: Do We Need Both Left Atrial Volume and Reservoir Strain?","authors":"Otto A Smiseth, John M Aalen","doi":"10.1016/j.echo.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.echo.2025.04.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052135","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":"Application of an Artificial Intelligence Model to Detect Heart Failure With Preserved Ejection Fraction to Handheld Ultrasound Imaging.","authors":"Jose K James, Geoffrey Huntley, Ayana Z Arystan, Claire Cassianni, Christopher G Scott, Halley Davison, Ashley Akerman, Will Hawkes, Jorge Oliveria, Agis Chartsias, Alberto Gomez, Ross Upton, Patricia A Pellikka","doi":"10.1016/j.echo.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.echo.2025.03.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054510","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 Elusive Nature of “Simple” D-Transposition During Perinatal Transition","authors":"Rajesh Punn MD ,&nbsp;Anita J. Moon-Grady MD","doi":"10.1016/j.echo.2025.02.002","DOIUrl":"10.1016/j.echo.2025.02.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 340-341"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415850","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":"Systolic Function in the Fontan Circulation Is Exercise, but Not Preload, Recruitable","authors":"Simone Goa Diab MD ,&nbsp;Assami Rösner MD, PhD ,&nbsp;Gaute Døhlen MD, PhD ,&nbsp;Henrik Brun MD, PhD ,&nbsp;Guro Grindheim MD, PhD ,&nbsp;Kanyalak Vithessonthi MD ,&nbsp;Mark K. Friedberg MD, PhD ,&nbsp;Henrik Holmstrøm MD, PhD ,&nbsp;Thomas Möller MD, PhD","doi":"10.1016/j.echo.2024.11.005","DOIUrl":"10.1016/j.echo.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Fontan circulatory failure with impaired systolic function is well documented; however, its mechanisms are not fully understood. The aim of this study was to explore myocardial functional reserve in adolescent patients with Fontan circulation in response to exercise or acute preload increase.</div></div><div><h3>Methods</h3><div>The study included 32 patients (median age, 16.7 years; range, 15.4–17.9 years; 12 female patients) with Fontan circulation. Echocardiographic imaging was performed during exercise using a recumbent cycle ergometer and during heart catheterization with a rapid infusion of 0.9% saline infusion at 5 mL/kg body weight. Myocardial peak longitudinal strain (LS) was measured in a four-chamber view during specific time intervals before, during, and after exercise (LS_stress) and volume load (LS_cath). During catheterization, central venous pressure and ventricular end-diastolic pressure were simultaneously recorded. A control group of 16 healthy individuals participated in the exercise test.</div></div><div><h3>Results</h3><div>Mean LS_stress was less negative for patients than for control subjects (<em>P</em> ≤ .001 at all stages); however, it significantly improved from −18.4 ± 5.5% at baseline to −22.0 ± 6.5% (<em>P</em> = .004) at maximal loading. LS_stress at maximal loading did not correlate with changes in heart rate. During catheterization, mean LS_cath was −19.6 ± 6.0% at baseline and did not improve significantly at 1.00 to 2.00 minutes and at 4.00 to 6.00 minutes after saline infusion. In more than half of the patients, LS_cath worsened or improved by less than −2% after saline infusion. Worsening of LS_cath correlated with central venous pressure and ventricular end-diastolic pressure in all conditions (<em>P</em> ≤ .017). There was no difference in LS_stress or LS_cath between the morphologic right ventricle and the morphologic left ventricle.</div></div><div><h3>Conclusions</h3><div>Patients with Fontan circulation demonstrate systolic myocardial functional reserve that can be recruited with exercise stress but not with an acute increase in preload.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 342-352"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645106","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":"Role of Quantitative Assessment of Atrial Functional Mitral Regurgitation","authors":"Jwan A. Naser MBBS,&nbsp;Serena J. Rahme MD,&nbsp;Hossam Ibrahim MBBCh,&nbsp;Christopher G. Scott MS,&nbsp;Hector I. Michelena MD,&nbsp;Barry A. Borlaug MD,&nbsp;Austin M. Kennedy BS,&nbsp;Mackram F. Eleid MD,&nbsp;Vuyisile T. Nkomo MD, MPH,&nbsp;Patricia A. Pellikka MD,&nbsp;Maurice Enriquez-Sarano MD,&nbsp;Sorin V. Pislaru MD, PhD","doi":"10.1016/j.echo.2024.12.005","DOIUrl":"10.1016/j.echo.2024.12.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 353-355"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839644","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":"Reevaluating Normal-Flow Low-Gradient Severe Aortic Stenosis: Clinical Phenotypes and Outcomes in Severe Aortic Stenosis Among Transcatheter Aortic Valve Replacement Patients","authors":"Amro Badr MD ,&nbsp;Mustafa Suppah MD ,&nbsp;Kamal Awad MD ,&nbsp;Juan Farina MD ,&nbsp;Bobbi Jo Heon RCDS ,&nbsp;Rachel Wraith RCDS ,&nbsp;Bishoy Abraham MD ,&nbsp;Sara Kaldas MD ,&nbsp;Vuyisile Nkomo MD, MPH ,&nbsp;Reza Arsanjani MD ,&nbsp;Chieh-Ju Chao MD ,&nbsp;David Holmes MD ,&nbsp;Said Alsidawi MD","doi":"10.1016/j.echo.2024.12.010","DOIUrl":"10.1016/j.echo.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is a complex condition with various hemodynamic subtypes, each with distinct clinical profiles and outcomes. The aim of this study was to assess the characteristics and outcomes of different AS phenotypes on the basis of flow and gradient patterns.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 930 patients who underwent transcatheter aortic valve replacement for severe symptomatic AS at Mayo Clinic sites from 2012-2017 were included. Patients were classified into three groups: high gradient (HG), low-flow low-gradient (LFLG), and normal-flow low-gradient (NFLG). Baseline clinical, echocardiographic, and computed tomographic characteristics, including aortic valve area, aortic valve calcium score, left ventricular ejection fraction, and the prevalence of tricuspid regurgitation, and atrial fibrillation were analyzed. One- and 5-year all-cause mortality outcomes were compared using Kaplan-Meier analysis and Cox proportional-hazards models.</div></div><div><h3>Results</h3><div>The final cohort included 273 patients in the NFLG group (29.4%), 563 in the HG group (60.5%), and 94 in the LFLG group (10.1%). After reevaluation and careful review of the echocardiograms, 41 patients with NFLG AS were reclassified into the LFLG group. Patients with LFLG AS had the highest prevalence of atrial fibrillation or flutter (60%) and tricuspid regurgitation (17%). Aortic valve calcium score was significantly lower in the NFLG group compared with the HG and LFLG groups. One-year mortality was highest in the LFLG group (17.4%), followed by the HG (13.9%) and NFLG (10.9%) groups, but the difference was not statistically significant (<em>P</em> = .20). The 5-year mortality rate was higher in the LFLG group (55.6%) compared with the NFLG (47.2%) and HG (47.9%) groups but did not reach statistical significance (<em>P</em> = .20).</div></div><div><h3>Conclusions</h3><div>LFLG AS was associated with more comorbidities and higher mortality compared with HG and NFLG AS, though differences in mortality were not statistically significant. The NFLG group, after close review and reclassification, showed the least significant AS. Randomized trials are needed to clarify the prognosis and management of NFLG AS.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 310-319"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957969","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":"Designing a Tailored Career Path: A Guide to Creating Flexible Career Ladders","authors":"","doi":"10.1016/j.echo.2025.02.007","DOIUrl":"10.1016/j.echo.2025.02.007","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages A18-A22"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746707","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":"Normal Fetal Ventricular Strain Pilot Study","authors":"Carol McFarland MD,&nbsp;Cathleen Pruitt MD,&nbsp;Mary T. Donofrio MD,&nbsp;Lindsay R. Freud MD,&nbsp;Leo Lopez MD,&nbsp;L. LuAnn Minich MD,&nbsp;Anita J. Moon-Grady MD,&nbsp;Zhining Ou MS,&nbsp;Rajesh Punn MD,&nbsp;Theresa A. Tacy MD,&nbsp;Oluwatosin Fatusin MD,&nbsp;Nelangi Pinto MD,&nbsp;the Fetal Heart Society Research Collaborative","doi":"10.1016/j.echo.2024.10.020","DOIUrl":"10.1016/j.echo.2024.10.020","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 4","pages":"Pages 361-363"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631312","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}