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

{"title":"Sex Differences in Echocardiographic Measures of Right Ventricular Function and RV-PA Coupling.","authors":"Jamilah S AlRahimi, Amjad SaemAldahar, Alhanouf Alotaibi, Nawal Kutob, Jameel Hakeem, Faisal A Turkestani","doi":"10.1111/echo.70485","DOIUrl":"https://doi.org/10.1111/echo.70485","url":null,"abstract":"<p><strong>Background: </strong>Right-ventricular-pulmonary arterial (RV-PA) coupling reflects the relationship between RV contractility and pulmonary vascular load and is a key determinant of cardiopulmonary performance. The tricuspid annular plane systolic excursion-to-pulmonary artery systolic pressure ratio (TAPSE/sPAP) provides a noninvasive estimate of RV-PA coupling. However, sex-related differences in its relationship with pulmonary pressure remain unclear.</p><p><strong>Objective: </strong>To evaluate sex-related differences in pulmonary pressure, diastolic load, RV systolic function, and RV-PA coupling.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of echocardiographic data from 243 adults. Pulmonary pressure was assessed using systolic (sPAP), mean (mPAP), and diastolic (dPAP) measurements. RV function was evaluated using TAPSE and RV S' velocity, and diastolic load using the E/e' ratio and estimated PCWP. RV-PA coupling was estimated using TAPSE/sPAP and RV S'/sPAP ratios. Categorical variables (n = 193) were analyzed using Fisher's exact test, and continuous variables using correlation and regression analyses.</p><p><strong>Results: </strong>Females exhibited a higher prevalence of abnormal sPAP (p = 0.038) and E/e' (p < 0.001), whereas males had a higher prevalence of abnormal mPAP (p < 0.001) and PCWP (p = 0.0016). Abnormal RV S' was more frequent in females (p = 0.0178). TAPSE and RV S' were inversely correlated with pulmonary pressure (ρ ≈ -0.45 to -0.55, p < 0.001). Regression analysis demonstrated a significant sex × pulmonary pressure interaction.</p><p><strong>Conclusions: </strong>Sex-related differences were observed in pulmonary pressure indices and RV systolic parameters; however, no significant difference was found in the primary RV-PA coupling index. These findings are associative and hypothesis-generating.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70485"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787891","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":"Echocardiographic Evaluation of Coronary Microvascular Dysfunction and Biventricular Mechanics in Behçet's Disease: The Additive Value of Coronary Sinus Flow Index.","authors":"Muhammed Emre Güleşir, Mehmet Coşgun, Murat Taşçı","doi":"10.1111/echo.70484","DOIUrl":"https://doi.org/10.1111/echo.70484","url":null,"abstract":"<p><strong>Purpose: </strong>Behçet's disease (BD) is a systemic vasculitis that can present with cardiac involvement. The aim of this study is to evaluate subclinical cardiac involvement in BD patients using left ventricular global longitudinal strain (GLS), right ventricular strain (RVGLS), and coronary sinus flow (CSF) measurements, and to investigate the relationship between echocardiographic findings and disease activity (BDCAF) and cumulative damage (BODI) scores.</p><p><strong>Methods: </strong>This cross-sectional study included 48 BD patients and 35 healthy controls. All participants underwent transthoracic echocardiography (TTE); biventricular strain was measured to evaluate function, and coronary sinus parameters were measured to evaluate coronary flow. In the BD group, disease activity was evaluated using the BDCAF, and cumulative organ damage was evaluated using the BODI score.</p><p><strong>Results: </strong>Compared to the control group, GLS (absolute; 18.51 ± 2.02 vs. 19.53 ± 1.71, p = 0.018), right ventricular free wall strain (RVFWS; absolute) (25.35 ± 3.32 vs. 26.87 ± 3.01, p = 0.047), and CSF index (2.62 ± 0.99 vs. 3.58 ± 1.17 mL/min/g, p < 0.001) were found to be significantly lower in the BD group. The CSF index showed a positive correlation with both GLS (r = 0.31, p = 0.004) and RVFWS (r = 0.26, p = 0.021). In multivariable linear regression analysis, the CSF index and gender were identified as independent predictors of GLS. While the BODI score, indicating cumulative organ damage, showed a significant negative correlation with biventricular strain parameters (GLS long axis; GLS-L, RVGLS, RVFWS) (p < 0.05); no significant relationship was observed between the BDCAF score, which reflects acute disease activity, and echocardiographic parameters. Furthermore, the combined model using GLS and the CSF index exhibited a higher diagnostic performance in distinguishing BD patients compared to their individual use (AUC: 0.759, 80.9% sensitivity, 65.7% specificity).</p><p><strong>Conclusion: </strong>In BD patients, the decrease in CSF, reflecting coronary microangiopathy, is independently associated with the deterioration in myocardial deformation. Our findings suggest that subclinical cardiac involvement may be linked to the chronic disease burden accumulated over the years, rather than transient acute inflammatory flares. The integrated assessment of CSF and GLS with TTE provides a valuable and non-invasive strategy for the early detection of high-risk patients.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70484"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788085","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":"Atrial Function and Volumetry in Cancer Therapy-Related Cardiotoxicity: Prognostic Insights and Emerging Imaging Markers.","authors":"Michele Migliari, Anna Laura Vacca, Luca Fazzini, Nicola Campana, Martino Deidda, Christian Cadeddu Dessalvi","doi":"10.1111/echo.70423","DOIUrl":"https://doi.org/10.1111/echo.70423","url":null,"abstract":"<p><p>Cancer therapy-related cardiac dysfunction (CTRCD) represents a major cause of morbidity among cancer survivors, even in the absence of overt left ventricular (LV) systolic impairment. Current cardio-oncology surveillance strategies predominantly focus on LV ejection fraction and global longitudinal strain, potentially overlooking early alterations in diastolic function and atrial remodeling. The atria, particularly the left atrium, play a pivotal role in modulating ventricular filling pressures and serve as sensitive integrators of cumulative hemodynamic stress. Increasing evidence supports the prognostic value of left atrial volume index and left atrial strain for the early detection of subclinical cardiotoxicity, refinement of diastolic function assessment, and prediction of heart failure and atrial arrhythmias. Moreover, emerging data suggest that right atrial size and mechanics may provide additional insights into right heart involvement during immunotherapy and thoracic radiotherapy, although evidence remains limited. This narrative review summarizes current evidence on atrial volumetric and functional assessment in cardio-oncology, with a particular focus on strain imaging, diastolic function, and novel indices such as left atrial stiffness and mechanical dispersion. We highlight methodological challenges, gaps in standardization, and future directions, including artificial intelligence-assisted imaging and multimodal risk stratification. Integrating atrial imaging into routine cardio-oncology practice may improve early detection of CTRCD, enhance prognostic stratification, and support personalized surveillance strategies in cancer patients exposed to cardiotoxic therapies.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70423"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822896","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":"Combined Atrioventricular Coupling Index in Transfusion-Dependent Thalassemia: Insights From a Cross-Sectional Analysis.","authors":"Antonella Meloni, Luca Saba, Vincenzo Positano, Laura Pistoia, Emanuela De Marco, Paola Maria Grazia Sanna, Filomena Longo, Daniele Di Bernardo, Piera Giovangrossi, Calogera Gerardi, Andrea Barison, Riccardo Cau","doi":"10.1111/echo.70482","DOIUrl":"https://doi.org/10.1111/echo.70482","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this cross-sectional study was to investigate the association between the combined atrioventricular coupling index (CACI) and demographic characteristics, clinical variables, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure, pulmonary hypertension, and arrhythmias) in patients with transfusion-dependent tlhalassemia (TDT).</p><p><strong>Methods: </strong>We evaluated 292 consecutive patients with TDT (151 females; mean age 36.72 ± 11.76 years) enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. In addition, 32 age- and sex-matched healthy controls (12 females; mean age 40.78 ± 14.35 years) were included. The CACI was calculated as the sum of the left atrioventricular coupling index (LACI) and the right atrioventricular coupling index (RACI).</p><p><strong>Results: </strong>Compared with healthy controls, patients with TDT exhibited significantly higher CACI values (50.83% ± 20.34% vs. 34.62% ± 12.59%; p < 0.0001). Moreover, CACI demonstrated superior discriminatory performance compared with LACI in distinguishing TDT patients from controls (p = 0.001). Aging was significantly and positively associated with CACI, and higher CACI values were observed in patients with prior splenectomy, diabetes, and the presence of late gadolinium enhancement (LGE). In stepwise regression analysis, LGE emerged as an independent predictor of CACI (F = 15.40; p < 0.0001). Finally, TDT patients with cardiac complications showed significantly higher CACI values than those without cardiac complications.</p><p><strong>Conclusion: </strong>CACI values were higher in patients with TDT, enabling discrimination of TDT patients. Higher CACI values were significantly associated with the presence of LGE. Furthermore, patients with cardiac complications exhibited impaired CACI.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70482"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788102","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":"Coronary Sinus Flow and Myocardial Strain Impairment in Behçet's Disease: Microvascular Dysfunction or Mechanical Constraint Related to Thoracic Geometry?","authors":"Andrea Sonaglioni, Gian Luigi Nicolosi","doi":"10.1111/echo.70490","DOIUrl":"https://doi.org/10.1111/echo.70490","url":null,"abstract":"<p><p>The integration of coronary sinus flow (CSF) and myocardial deformation imaging represents an emerging non-invasive approach for detecting subclinical cardiac involvement in systemic diseases. In their recent study, Güleşir et al. provide evidence of reduced CSF and impaired biventricular strain in patients with Behçet's disease (BD), suggesting a potential link between coronary microvascular dysfunction and myocardial mechanical alterations. While this interpretation is biologically plausible in the context of systemic vasculitis, alternative mechanisms may contribute to the observed findings. In particular, extrinsic mechanical factors related to thoracic shape that affect cardiac geometry and venous drainage may simultaneously influence both CSF and myocardial strain parameters. Insights from conditions such as pectus excavatum, where chest wall deformity induces apparent reductions in myocardial strain despite preserved intrinsic function, highlight the potential role of mechanical constraint as a confounding factor. This commentary discusses the interplay between coronary flow, myocardial deformation, and cardiac mechanics, emphasizing the need for a more nuanced interpretation of echocardiographic findings. A comprehensive approach integrating structural, hemodynamic, and microvascular determinants may be essential to accurately characterize subclinical cardiac involvement in BD and other systemic conditions.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70490"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822962","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":"Divergent Left Ventricular Remodeling by Sex in Adults With Overweight and Obesity: An Echocardiographic Geometry Analysis.","authors":"Muneera AlTaweel","doi":"10.1111/echo.70476","DOIUrl":"https://doi.org/10.1111/echo.70476","url":null,"abstract":"<p><strong>Background: </strong>Sex-specific differences in left ventricular (LV) geometry are poorly characterized across the obesity severity spectrum in real-world echocardiographic cohorts, and standard LVMI cut-offs derived from male or mixed-sex populations may systematically underclassify LVH in women.</p><p><strong>Methods: </strong>Routine transthoracic echocardiography was performed in 205 adults with overweight or obesity (BMI ≥ 25 kg/m²). LV geometry was classified into four mutually exclusive patterns: normal geometry, concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) using sex-specific LVMI thresholds (>95 g/m² females; >115 g/m² males) and a relative wall thickness (RWT) cut-off of 0.42. Binary logistic regression evaluated sex as an independent predictor of LV geometry outcomes, adjusting for age and obesity class.</p><p><strong>Results: </strong>Despite higher BMI in females (35.1 vs. 29.7 kg/m²; p < 0.001), mean LVMI was paradoxically lower (87.0 vs. 93.0 g/m²; p = 0.042), yet female sex independently predicted LVH by LVMI (OR 2.11, 95% CI 1.01-4.41; p = 0.047), a finding visible only with sex-specific thresholds. Overall concentric burden was similar (CR + CH: 47.6% vs. 46.9%), but pattern distribution differed: females more often showed CH (17.7% vs. 11.1%) and EH (15.3% vs. 7.4%), while males more frequently had normal geometry (42.0%) or CR (35.8%). The divergence was greatest in the overweight subgroup: CH was nearly threefold higher in females (34.8% vs. 12.8%), and RWT was significantly greater (0.470 vs. 0.385; p = 0.020).</p><p><strong>Conclusions: </strong>Female sex independently predicts LVH by LVMI despite lower mean LVMI, a paradox visible only when sex-specific echocardiographic thresholds are applied. Females and males carry similar overall concentric burdens but follow divergent geometric remodeling paths, a difference detectable at the overweight threshold. These findings underscore the necessity of sex-specific LVMI reference values in echocardiographic practice.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70476"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845578","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":"Structural and Functional Remodeling and Long-Term Outcomes in Women With Hypertrophic Cardiomyopathy.","authors":"Hala Mahfouz Badran, Abdelmaguid Ma Abu Hagar, Naglaa Faheem, Magdi H Yacoub, Suzy Salah Lasheen","doi":"10.1111/echo.70468","DOIUrl":"https://doi.org/10.1111/echo.70468","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in hypertrophic cardiomyopathy (HCM) are increasingly recognized, yet women remain underrepresented in most cohorts. This study aimed to characterize sex-specific differences in clinical features, myocardial mechanics, and long-term outcomes, with a focus on distinctive characteristics in women with HCM.</p><p><strong>Methods: </strong>We studied 501 patients with HCM who underwent comprehensive clinical and echocardiographic evaluation between August 2010 and July 2017; 181 (36%) were women. Survival and event-free outcomes were assessed during a median follow-up of 6.23 years (range: 2.8-9.25 years) using Kaplan-Meier analysis and the log-rank test.</p><p><strong>Results: </strong>At baseline, women were more likely to have familial HCM and were less symptomatic (NYHA class, p < 0.01) but had higher heart rate (p < 0.001), smaller LV end-diastolic and end-systolic diameters, and lower LV mass index (LVMI) than men. Women demonstrated higher E/E' ratio (p < 0.03), increased pulmonary artery systolic pressure (p < 0.03), reduced global longitudinal strain (GLS) (-10.6 ± 4.7 vs. -12.0 ± 5.1, p < 0.003), and lower early diastolic strain rate (SRe, P < 0.0001). Hospitalizations for heart failure, arrhythmias, or stroke were more frequent in women (34.4% vs. 24.4%, p < 0.03). Kaplan-Meier analysis showed a nonsignificant trend toward poorer survival in women. Cox regression analysis identified age as an independent predictor of hospitalization, while LV end-diastolic diameter, S' velocity, independently predicted mortality.</p><p><strong>Conclusions: </strong>Women with HCM exhibit distinct structural and mechanical features, including smaller ventricular size, lower LV mass, higher filling pressures, and impaired myocardial deformation. These differences are associated with increased morbidity and support the need for sex-specific diagnostic thresholds and individualized management strategies.</p><p><strong>Key findings: </strong>In this cohort of 501 patients with HCM, women exhibited smaller ventricles, higher filling pressures, and more impaired myocardial deformation despite fewer symptoms. These sex-specific structural and functional differences were associated with increased hospitalizations and highlight the need for tailored diagnostic thresholds and management strategies in women.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70468"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787951","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":"Educational Framework for Pediatric Echocardiography Laboratory Training in Neonatal Hemodynamics.","authors":"Audrey Hébert, Adrianne R Bischoff, Amanda Darnall, Bernadette Richards, Wyman Lai, Philip T Levy, Patrick J McNamara","doi":"10.1111/echo.70465","DOIUrl":"https://doi.org/10.1111/echo.70465","url":null,"abstract":"<p><p>Neonatal hemodynamics is an evolving field of newborn medicine focused on providing comprehensive physiological-based approaches for the assessment and management of cardio-pulmonary disorders in the critically ill neonate and infant. Training in neonatal hemodynamics requires a structured approach to echocardiography to ensure expertise in assessing cardiovascular function in critically ill neonates. This educational framework outlines a systematic approach to echocardiography laboratory training for Neonatal Hemodynamics trainees with a focus on competency in image acquisition, interpretation, and integration of findings into neonatal physiology. Training emphasizes hands-on learning, direct supervision, and progressive assessments, with primary exposure to critically ill neonates and select cases in older pediatric patients to broaden diagnostic skills. By incorporating a structured echocardiography laboratory rotation and interdisciplinary collaboration, this framework aims to support the development of expertise in neonatal cardiovascular assessment.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70465"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788127","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":"Evaluation of Left Atrial Function by 2D Speckle-Tracking Echocardiography in Patients With Vasovagal Syncope.","authors":"Doaa Ghallab Barbry, Asmaa Ahmed Ali, Badria Atef Ebrahim Elhalawany","doi":"10.1111/echo.70466","DOIUrl":"https://doi.org/10.1111/echo.70466","url":null,"abstract":"<p><strong>Background: </strong>Vasovagal syncope (VVS) is the most common cause of syncope and is traditionally attributed to autonomic dysregulation and reduced preload. Recent evidence suggests that left atrial (LA) size and function may influence susceptibility to syncope. Two-dimensional speckle-tracking echocardiography (2D-STE) allows detailed assessment of LA mechanics. This study aimed to evaluate LA structure and function in patients with VVS using conventional echocardiography and 2D-STE.</p><p><strong>Methods: </strong>This study included 100 participants recruited from Al-Zahraa University Hospital between January and December 2025: 50 patients with head-up tilt test (HUTT)-confirmed VVS and 50 healthy controls. All subjects underwent clinical assessment, electrocardiography, conventional transthoracic echocardiography, tissue Doppler imaging, and 2D speckle-tracking echocardiography (2D-STE). Left atrial dimensions, volumes, and functional indices were measured. LA strain parameters including reservoir (S-R), conduit (S-CD), and contractile strain (S-CT) were derived from apical views. Data were analyzed using SPSS version 27, with p < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Compared with controls, VVS patients exhibited significantly smaller LA dimensions and volumes. LA volume was markedly reduced in the VVS group (30.30 ± 8.77 vs. 43.60 ± 10.54 mL, p < 0.001), as was the LA volume index (17.30 ± 4.27 vs. 24.79 ± 5.31 mL/m², p < 0.001). Speckle-tracking analysis demonstrated significant impairment of LA reservoir strain (35.9 ± 8.26 vs. 43.36 ± 8.90, p < 0.001) and LA contractile strain (-10.48 ± 3.82 vs. -14.6 ± 4.5, p < 0.001) in VVS patients. No significant difference was observed in LA conduit strain.</p><p><strong>Conclusion: </strong>Patients with vasovagal syncope (VVS) may have smaller left atrial size and impaired atrial mechanical function, particularly in reservoir and contractile phases. Left atrial strain assessment by 2D speckle-tracking echocardiography (2D-STE) may provide incremental value in identifying atrial involvement in VVS and offers a potential noninvasive marker for syncope susceptibility.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70466"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787554","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":"Longitudinal Assessment of Fetal Ventricular Geometry and Function in Hypertensive Pregnancies.","authors":"Ayman F Sabry, Patrick D Evers, Erin J Madriago","doi":"10.1111/echo.70478","DOIUrl":"https://doi.org/10.1111/echo.70478","url":null,"abstract":"<p><strong>Background: </strong>Maternal hypertension has a complex and not fully understood impact on the fetal heart.</p><p><strong>Objective: </strong>The study investigated the impact of various forms of maternal hypertension on fetal heart function and ventricular remodeling and follows up postnatal outcomes.</p><p><strong>Methods: </strong>The research involved 45 pregnant women with hypertension and 15 with normal pregnancies. Fetal echocardiograms were conducted between 24 and 34 weeks of pregnancy using various methods to evaluate cardiac function. The study measured ventricular transverse and longitudinal diameters, along with the sphericity index. Follow-up postnatal echocardiograms were also conducted.</p><p><strong>Results: </strong>The study included 15 cases each of gestational hypertension, chronic hypertension, and preeclampsia, with 15 control subjects. The E/A ratio of the tricuspid valve was significantly lower in fetuses in all groups compared to the control group. The E wave was significantly reduced in the chronic hypertension and preeclampsia groups (p < 0.001) compared to the control group. The Tei Doppler index for the left and right ventricles was significantly higher in both chronic hypertension and preeclampsia groups, affecting both fetuses and neonates. However, there was no statistically significant difference in gestational hypertension for either fetuses or neonates. In fetuses, the left ventricle had a decreased transverse dimension in both the chronic hypertension and preeclampsia groups (p < 0.001 and 0.002). In neonates, the transverse diameter decreased significantly in all groups (p < 0.037, 0.005, and 0.012 respectively). The right ventricle showed a significant increase in transverse diameter in the chronic hypertension and preeclampsia groups in fetuses and only in the chronic group in neonates. The E' wave was also significantly different in both the preeclampsia and chronic hypertension groups. The E/ E' of the left ventricle in preeclampsia was statistically significant in both fetuses and neonates.</p><p><strong>Conclusion: </strong>Hypertensive pregnancies can affect fetal cardiac function and structure, which may persist into the early days of life.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 5","pages":"e70478"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787842","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}