Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques最新文献

{"title":"Early-Diastolic Right Ventricle-Pulmonary Artery Pressure Gradient by Doppler Echocardiography to Guide Cardiac Magnetic Resonance Assessment of Pulmonary Regurgitation after Right Ventricular Outflow Tract Reconstruction.","authors":"Junpei Kawamura, Kentaro Ueno, Tsubasa Shimozono, Yoshihiro Takahashi, Koji Nakae, Koji Takumi, Takashi Yoshiura, Yasuhiro Okamoto","doi":"10.1111/echo.70614","DOIUrl":"10.1111/echo.70614","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary regurgitation (PR) after right ventricular outflow tract (RVOT) reconstruction is a major driver of right ventricular (RV) remodeling. Cardiac magnetic resonance (CMR) is the reference standard for quantifying PR but is not routinely feasible in many pediatric follow-up settings. We evaluated whether an echocardiographic early-diastolic RV-pulmonary artery (PA) pressure gradient (Echo-EaDPG), derived from early-diastolic peak PR velocity (ΔP = 4v²), can serve as a practical complementary hemodynamic marker to guide CMR assessment.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with repaired tetralogy of Fallot or related conditions who underwent echocardiography, CMR, and cardiac catheterization within a 6-month interval of each other after RVOT reconstruction. Echo-EaDPG was compared with CMR-derived PR fraction (CMR-PRF) and catheter-measured early-diastolic RV-PA pressure gradient (Cathe-EaDPG). Clinically significant PR was operationally defined as CMR-PRF ≥ 25%. Correlation, multivariable analyses, receiver operating characteristic (ROC) analysis, and bootstrap internal validation were performed.</p><p><strong>Results: </strong>Forty patients were included. Echo-EaDPG correlated with CMR-PRF (r = 0.65, p < 0.001) and Cathe-EaDPG (r = 0.55, p < 0.001) and was independently associated with CMR-PRF ≥ 25% among tested echocardiographic indices. Echo-EaDPG demonstrated good discrimination for identifying CMR-PRF ≥ 25% on ROC analysis (AUC = 0.90), with bootstrap-supported robustness. Interobserver agreement for Echo-EaDPG was excellent (ICC = 0.96, 95% CI 0.82-0.99, p < 0.001).</p><p><strong>Conclusions: </strong>Echo-EaDPG is a simple Doppler-derived parameter associated with CMR-quantified PR and invasive early-diastolic RV-PA gradients after RVOT reconstruction. As an adjunct to integrated echocardiographic assessment, Echo-EaDPG may help identify patients who warrant CMR for quantitative PR evaluation, particularly when routine CMR is difficult to obtain.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":"e70614"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Echocardiography for Acute Coronary Syndromes: Current Evidence and Integration With Electrocardiography and Biomarkers.","authors":"Predrag Mitrovic, Dubravka Rajic, Nemanja Djordjevic","doi":"10.1111/echo.70610","DOIUrl":"10.1111/echo.70610","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of acute coronary syndromes (ACS) remains challenging because electrical, mechanical, and biochemical manifestations of myocardial ischemia evolve at different stages of the ischemic cascade. Although electrocardiography (ECG), cardiac biomarkers, and echocardiography are routinely used in clinical practice, these diagnostic modalities are commonly interpreted independently, potentially delaying recognition of myocardial ischemia. Recent advances in artificial intelligence (AI) offer new opportunities to improve diagnostic accuracy through multimodal integration, with echocardiography serving as the central imaging modality.</p><p><strong>Hypothesis: </strong>AI-enhanced echocardiography, integrated with electrocardiographic findings, cardiac biomarkers, and clinical information, may improve the early diagnosis, risk stratification, and clinical management of patients with suspected ACS compared with conventional sequential diagnostic approaches.</p><p><strong>Methods: </strong>A comprehensive narrative review of contemporary literature was performed to evaluate current evidence regarding AI applications in echocardiography and their integration with ECG and cardiac biomarkers for the diagnosis of ACS. Published studies addressing automated image acquisition, chamber quantification, myocardial deformation analysis, regional wall-motion assessment, multimodal machine-learning models, explainable AI, and clinical implementation were critically reviewed and synthesized.</p><p><strong>Results: </strong>AI has substantially expanded the capabilities of echocardiography by enabling automated image interpretation, quantitative assessment of ventricular function, myocardial strain analysis, and detection of regional wall-motion abnormalities with high reproducibility. When integrated with ECG, serial high-sensitivity cardiac troponin measurements, and clinical variables, multimodal AI systems demonstrate the potential to improve diagnostic accuracy, facilitate earlier identification of myocardial ischemia, reduce diagnostic uncertainty, and support individualized clinical decision-making. Nevertheless, widespread implementation requires prospective multicenter validation, standardized imaging protocols, explainable algorithms, regulatory oversight, and seamless integration into clinical workflows.</p><p><strong>Conclusions: </strong>AI-enhanced echocardiography represents a promising step toward precision cardiovascular imaging and may become the central imaging component of future multimodal diagnostic pathways for patients with suspected ACS. Integration of structural, functional, electrical, biochemical, and clinical information through AI-supported decision systems has the potential to improve diagnostic performance and optimize emergency cardiovascular care.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":"e70610"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration-Dependent Cardiac Effects of Anabolic-Androgenic Steroid Use in Strength-Trained Athletes: A Systematic Review and Meta-Analysis.","authors":"Matheus de Medeiros Fernandes, Pedro Gomes Batista, Camila Viviane Ribera Chagas, Railla Raquel Albino Dos Santos Silva, Fernanda Medeiros Santos, Miguel Chaves Lenzi, Felipe de Medeiros Fernandes, Ranna Santos Pessoa, Patrícia Jovelina de Freitas, Flávio Henrique Amaral Pires Véras, Stephan Barisic Junior, Douglas Nunes Cavalcante, Juliana Giorgi, Caroline Fischer-Bacca","doi":"10.1111/echo.70611","DOIUrl":"10.1111/echo.70611","url":null,"abstract":"<p><strong>Purpose: </strong>Nonmedical anabolic-androgenic steroid (AAS) use is increasing, and its duration-dependent cardiac effects remain unclear. We evaluated cardiac structure and function in AAS-using strength-trained athletes, overall and by exposure duration.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Central, and SCOPUS through November 2025 for observational studies comparing AAS-using and nonusing strength-trained athletes of either sex. Random-effects models pooled mean differences (MD) overall and across four exposure strata (<6 months, 6 months-3 years, 3-6 years, >6 years); meta-regression assessed duration as a continuous moderator.</p><p><strong>Results: </strong>Forty studies (1906 athletes; 95% male) were included. Overall, AAS users showed reduced left ventricular ejection fraction (LVEF; 29 studies; MD -2.84%; 95% CI -4.24 to -1.44; p < 0.01), impaired global longitudinal strain (GLS; MD +3.27%; p < 0.01), and increased left ventricular mass index (LVMI; MD +18.21 g/m²; p < 0.01). Septal thickening was detectable before six months, preceding functional impairment. LVEF, LVMI, and posterior wall thickness (PWT) differed significantly across strata (all p ≤ 0.03), with the largest LVEF reduction beyond six years (MD -7.39%; 95% CI -10.71 to -4.07). Meta-regression suggested that exposure duration was associated with variation in selected structural and functional outcomes, corroborating LVEF, LVMI, and PWT, while GLS, E/e', and E/A ratio showed no significant association. Right ventricular strain was impaired in an exploratory, non-stratified analysis.</p><p><strong>Conclusion: </strong>AAS use is associated with cardiac structural and functional abnormalities, with exposure duration associated with selected, but not all, outcomes. These cross-sectional comparisons do not establish within-person progression; longitudinal surveillance with deformation imaging is warranted.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":"e70611"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Reservoir Strain and Heart Failure Rehospitalization Burden in Acute Heart Failure With Atrial Fibrillation.","authors":"Jumpei Yamamoto, Keijiro Nakamura, Hiromasa Hayama, Yoshinari Enomoto, Masaya Yamamoto, Hidehiko Hara, Hisao Hara, Yukio Hiroi","doi":"10.1111/echo.70616","DOIUrl":"10.1111/echo.70616","url":null,"abstract":"<p><strong>Purpose: </strong>To examine associations of left atrial reservoir strain, diameter, and volume index with first rehospitalization and recurrent readmission burden in acute heart failure with atrial fibrillation.</p><p><strong>Methods: </strong>Among 716 enrolled patients, 691 with an available measurement formed the left atrial diameter analysis cohort; left atrial volume index (LAVI) and reservoir strain (LArs) were evaluated in a 320-patient single-center subgroup. Same-day rehospitalization and death were classified as death-first. Fine-Gray and negative-binomial models examined first rehospitalization and recurrent readmission burden.</p><p><strong>Results: </strong>Of 691 patients, 189 had rehospitalization-first, 118 death-first, and 384 were censored. In the 320-patient subgroup, lower LArs was associated with first rehospitalization (adjusted subdistribution hazard ratio [sHR] 0.920 per 1 percentage-point increase, 95% confidence interval [CI] 0.870-0.973) and with a higher recurrent readmission rate (incidence rate ratio 0.877, p < 0.001); the first-event association persisted after additional echocardiographic adjustment including left atrial diameter (sHR 0.928, 95% CI 0.876-0.984). Left atrial diameter was associated with rehospitalization-first (sHR 1.025/mm, 95% CI 1.011-1.039) but not death-first, whereas LAVI was associated with neither, including per standard deviation. With exploratory cutoffs, only combined abnormality was associated with first rehospitalization (sHR 2.12, 95% CI 1.16-3.85). Left atrial indices did not significantly improve discrimination.</p><p><strong>Conclusion: </strong>Lower LArs was associated with first heart failure rehospitalization and recurrent readmission burden, and remained associated after additional echocardiographic adjustment including left atrial diameter. Left atrial diameter was associated with first rehospitalization but LAVI was not; a general left atrial structural mechanism is not established. Incremental predictive value was limited; cohort-derived cutoffs require external validation.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":"e70616"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral Annular Calcification and Its Severity in Relation to Left Atrial Reservoir Strain and a Non-Invasive Left Atrial Stiffness Index","authors":"Muhammed Ali Şahin,&nbsp;Özdemir Kuzucu,&nbsp;Mustafa Ozan Gürsoy","doi":"10.1111/echo.70608","DOIUrl":"https://doi.org/10.1111/echo.70608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Mitral annular calcification (MAC) is associated with atrial fibrillation and diastolic dysfunction, but its relationship with left atrial (LA) mechanics is poorly defined. The ratio of E/e′ to LA reservoir strain (LASr) is a non-invasive surrogate of, not a direct measure of, LA stiffness. We assessed MAC and its severity against LASr and this LA stiffness index (LASI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center cross-sectional study with prospective recruitment, 112 adults in sinus rhythm with ejection fraction ≥50% (58 with MAC, 54 age- and sex-similar controls) underwent two-dimensional speckle-tracking echocardiography. MAC was graded mild to severe; LASI was calculated as E/e′ divided by LASr.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LASr was lower (23.2 ± 7.8% vs. 26.7 ± 7.7%, <i>p</i> = 0.018) and LASI higher (0.57 ± 0.30 vs. 0.34 ± 0.20, <i>p</i> &lt; 0.001) in the MAC group. In models excluding the index components, MAC severity was independently associated with higher LASI (<i>β</i> = 0.41, <i>p</i> &lt; 0.001) and MAC presence with lower LASr (−3.6 points, <i>p</i> = 0.016). After clinical adjustment, each 0.1-unit LASI increase was associated with MAC (odds ratio 1.71, 95% CI[1.34–2.17]). LASI discriminated MAC with an area under the curve of 0.762 (0.674–0.851; cut-off 0.31, sensitivity 79%, specificity 63%), which did not differ from E/e′ (<i>p</i> = 0.52) or LA volume index (<i>p</i> = 0.48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MAC and its severity were associated with impaired LA reservoir function and a higher non-invasive stiffness index. The index did not discriminate MAC better than its simpler components, so these cross-sectional findings are hypothesis-generating.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Transesophageal Echocardiographic Vena Contracta Area for Grading Mitral Regurgitation: Severity Cut-offs From a Prospective Tunisian Cohort","authors":"Yosra Messaoudi,&nbsp;Dedde El Bechir,&nbsp;Abdellaziz Ghadhab,&nbsp;Merzougui Latifa","doi":"10.1111/echo.70609","DOIUrl":"https://doi.org/10.1111/echo.70609","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mitral regurgitation (MR) is among the most common valvular heart diseases, but its echocardiographic quantification remains challenging, particularly in secondary MR and in some organic causes. Three-dimensional vena contracta area (3D VCA) allows direct planimetry of the regurgitant orifice. We aim to compare 3D VCA with two-dimensional (2D) parameters and to derive aetiology-specific severity cut-offs in a Tunisian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective cross-sectional study. Patients with at least moderate MR underwent transthoracic and 2D/3D transesophageal echocardiography with planimetry of the VCA. Spearman correlations between 3D VCA and 2D parameters (vena contracta width, PISA-derived regurgitant orifice area), and diagnostic performance for severe MR (ROC, Youden index), were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-seven patients were included (mean age 61.6 ± 12.5 years; sex ratio 1.1). MR was primary in 66% (rheumatic 34%, degenerative 31%) and secondary in 34%; jets were mostly single, eccentric and holosystolic, and 62.9% had severe MR. 3D VCA correlated strongly with PISA-derived orifice area (rho = 0.78) and with vena contracta width (rho = 0.65), particularly in organic, rheumatic, degenerative and eccentric MR. 3D VCA and 2D orifice area identified severe MR with an area under the curve of 0.93; the optimal 3D VCA cut-off was 0.43 cm² overall, 0.42 cm² (rheumatic), 0.55 cm² (degenerative) and 0.39 cm² (secondary).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>3D VCA reliably quantifies MR, provides aetiology-specific cut-offs and outperforms 2D methods in complex jets. Multicenter validation is needed, particularly in rheumatic-endemic regions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-Phase Ejection Fraction: A Novel Approach to Detecting Early Systolic Dysfunction in Hypertrophic Cardiomyopathy","authors":"Weixu Zhao,&nbsp;Junlang Zhang,&nbsp;Jinglu Yu,&nbsp;Huiyu Tang,&nbsp;Xueliang Chen,&nbsp;Qiwei Li,&nbsp;Jun Wu","doi":"10.1111/echo.70562","DOIUrl":"https://doi.org/10.1111/echo.70562","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The assessment of stable coronary artery disease has been performed using the first-phase ejection fraction (EF1) in previous research. However, the use of EF1 has seldom been employed in the evaluation of early left ventricular systolic dysfunction among patients with hypertrophic cardiomyopathy (HCM).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We aimed to assess early left ventricular systolic dysfunction in patients with HCM by application of first-phase EF1.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cohort included 90 HCM patients who were stratified according to pathophysiological subtype into 50 with nonobstructive (NO-HOCM) and 40 with obstructive (HOCM) disease. An additional 50 age-matched healthy individuals served as controls. Baseline characteristics, conventional echocardiographic parameters, EF1 were measured and serum B-type natriuretic (BNP) peptide was detected. Additionally, the correlations between EF1 and both LVMI and BNP were compared, and receiver operating characteristic (ROC) curve analysis was performed to calculate the area under the curve (AUC) for assessing the value of EF1 in the early detection of left ventricular systolic dysfunction in HCM patients.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Compared to the control group, patients with HOCM showed higher systolic blood pressure and lower heart rate (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Both HOCM and NO-HCM showed enlarged LAD and LVDd, elevated LVMI, LVEF, E/e’ ratios and BNP compared with controls (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, EF1 was decreased in HCM patients than that in controls (38.20 ± 2.02, &lt;i&gt;P &lt;/i&gt;&lt; 0.05), especially in HOCM patients (22.29 ± 3.59 &amp; 25.12 ± 3.19, &lt;i&gt;P&lt;/i&gt; &lt; 0  .05). EF1 was negatively correlated with both LVMI and BNP (all &lt;i&gt;r&lt;/i&gt; &gt; 0.3, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Receiver operating characteristic (ROC) curve analysis demonstrated that EF 1 (AUC = 0.874) exhibited superior diagnostic value for assessing early left ventricular systolic dysfunction in patients with HCM compared with LVEF (AUC = 0.649). The optimal cut-off value for EF1 was &lt; 28.5%, with a sensitivity of 90.6% and a specificity of 81.5%, corresponding to an AUC of 0.874 (95% CI: 0.804–0.946, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Compared with healthy controls, patients with HCM had a lower EF1, and this reduction was significantly more pronounced in those with HOCM. Given its high sensitivity in evaluating left ventricular systolic function in patients with HCM, EF1 represents a promising adjunc","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-Week Changes in Global Longitudinal Strain and Rehabilitation Outcomes After Enhanced External Counterpulsation Following PCI for Myocardial Infarction: An Analysis of a Pre-Existing Matched Cohort","authors":"Juan Su,&nbsp;Li Zhang,&nbsp;Cuihuan Xie","doi":"10.1111/echo.70586","DOIUrl":"https://doi.org/10.1111/echo.70586","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Left ventricular pressure–strain loop (LV-PSL) analysis provides non-invasive myocardial-work indices by integrating strain with contemporaneous brachial systolic blood pressure. Follow-up myocardial-work assessment requires blood pressure measured at the same assessment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To describe baseline myocardial mechanical abnormalities after percutaneous coronary intervention (PCI) for myocardial infarction and to explore associations between a 6-week enhanced external counterpulsation (EECP) program and changes in global longitudinal strain (GLS) and rehabilitation outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This single-center matched observational study was conducted from October 2021 through January 2023. It included 66 patients after PCI for myocardial infarction who completed a 6-week EECP program, 66 patients in a pre-existing matched standard-therapy comparator cohort, and 50 healthy reference participants. Baseline LV-PSL-derived myocardial-work indices were descriptive. Six-week between-group changes in GLS, peak strain dispersion (PSD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), 6-min walk distance (6MWT), Seattle Angina Questionnaire (SAQ) summary score, and weekly angina frequency were analyzed using pair-aware methods with Benjamini–Hochberg false-discovery-rate (FDR) correction. A sensitivity analysis adjusted for baseline outcome value, baseline systolic blood pressure, heart rate, ST-segment-elevation myocardial infarction, ACEI/ARB/ARNI use, and calcium-channel-blocker use with pair-clustered robust standard errors.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Post-PCI patients had less negative baseline GLS and descriptively lower constructive myocardial-work values than healthy reference participants. In the matched exploratory comparison, the between-group difference in GLS change was −1.3 percentage points (95% CI, −2.0 to −0.6; &lt;i&gt;P&lt;/i&gt; &lt; 0.001; FDR &lt;i&gt;q&lt;/i&gt; &lt; 0.001). EECP exposure was also associated with larger improvements in 6MWT and SAQ score, a greater reduction in NT-proBNP, and a greater reduction in weekly angina frequency; PSD change was not different after FDR correction. The adjusted sensitivity analysis gave a GLS difference of −1.3 percentage points (95% CI, −1.9 to −0.7; &lt;i&gt;P&lt;/i&gt; &lt; 0.001; FDR &lt;i&gt;q&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this non-randomized matched cohort, EECP exposure was associated with larger 6-week improvements in GLS and selected rehabilitation outcomes","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Impact of Left and Right Bundle Branch Block on Left Ventricular Systolic Function and Myocardial Mechanics Assessed by Speckle-Tracking Echocardiography and Cardiac Magnetic Resonance Feature Tracking: A Systematic Review and Meta-Analysis”","authors":"Abhinit Kumar,&nbsp;Ranjana Roy,&nbsp;Parappa Sajjan,&nbsp;Alok Bhatt,&nbsp;Jeffrin Reneus Paul","doi":"10.1111/echo.70601","DOIUrl":"https://doi.org/10.1111/echo.70601","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of 3D Transesophageal Vena Contracta Area versus 2D Echocardiographic Assessment of Secondary Mitral Regurgitation","authors":"Rehab Adel Diab,&nbsp;Eman Rashed Zaki,&nbsp;Badria Atef Ebrahim Elhalawany","doi":"10.1111/echo.70602","DOIUrl":"https://doi.org/10.1111/echo.70602","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Secondary mitral regurgitation (MR) is associated with substantial cardiovascular morbidity and mortality, making accurate severity assessment essential for clinical management. Conventional 2D echocardiography has important limitations, particularly in the presence of noncircular regurgitant orifices. Three-dimensional transesophageal echocardiography (3D-TEE) enables direct measurement of Vena Contracta area (VCA) and may provide more accurate quantification of MR severity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim of the work&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To assess the diagnostic value of three-dimensional transesophageal Vena Contracta area versus two-dimensional echocardiographic assessment of secondary mitral regurgitation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study included 52 patients with moderate-to-severe secondary MR, recruited at Alzahraa University Hospital between December 2024 and January 2026. All patients underwent TTE followed by TEE. MR severity was assessed according to current echocardiographic guidelines using an integrative approach that included qualitative, semi-quantitative, and quantitative assessments. Three-dimensional VCA was measured by both TTE and TEE using multiplanar reconstruction. Statistical analysis was performed using Jamovi version 2.3.28 for Windows, with &lt;i&gt;P&lt;/i&gt;-values &lt; 0.05 considered statistically significant.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The mean age of the patients studied was 58.08 ± 9.52 years, with a male-to-female ratio of 43:9. The mean PISA-derived EROA for patients with severe MR was 0.36 ± 0.09 cm&lt;sup&gt;2&lt;/sup&gt;, and the mean regurgitant volume for these patients was 48.6 ± 6.79 mL. VCA measured by 3D TTE (0.69 ± 0.16 cm&lt;sup&gt;2&lt;/sup&gt;) showed a strong positive correlation with 3D TEE VCA (0.67 ± 0.16 cm&lt;sup&gt;2&lt;/sup&gt;) (&lt;i&gt;r&lt;/i&gt; = 0.857, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Bland–Altman analysis demonstrated minimal bias (0.035 cm&lt;sup&gt;2&lt;/sup&gt;) and good agreement between both techniques. ROC analysis showed good diagnostic accuracy for severe MR, with slightly higher accuracy for TEE VCA (AUC = 0.874) compared with TTE VCA (AUC = 0.841).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three-dimensional TEE-derived Vena Contracta area (3D TEE VCA) is a reliable and accurate method for assessing the severity of secondary mitral regurgitation. The strong correlation and good agreement between 3D TEE and 3D TTE VCA measurements, as well as their correlation with PISA-derived EROA, support the value of 3D VCA as a robust quantitative parameter. Moreover, our findings suggest tha","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}