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

{"title":"Myocardial Dysfunction and Risk of Long COVID in Patients Recovered From Mild and Moderate COVID-19","authors":"Binyu Zhou,&nbsp;Yiran Zhang,&nbsp;Shuang Han,&nbsp;Jiqing Zhang,&nbsp;Lin Song,&nbsp;Haiyan Wang","doi":"10.1111/echo.70120","DOIUrl":"https://doi.org/10.1111/echo.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Numerous recovered COVID-19 patients exhibit persistent cardiovascular symptoms. However, the degree of myocardial dysfunction and its associated risk factors remain unclear. This study aims to evaluate myocardial dysfunction in recovered patients and pinpoint predictors of persistent cardiovascular symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the echocardiograms of patients who recovered from mild or moderate COVID-19 and presented with cardiovascular symptoms during the Omicron surge. Myocardial strain was analyzed in 546 patients before and after infection, and in 351 prepandemic healthy controls. Clinical follow-up at 12 months post-infection was used to evaluated symptom persistence, and multivariable logistic regression was used to identify independent predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics showed no significant differences between patients and controls (all <i>p</i> &gt; 0.05). Although the left ventricle global longitudinal strain (LVGLS) remained stable post-infection, significant reductions emerged in regional left ventricle longitudinal strains (LVLS) and all left atrial strains (LAS) (all <i>p</i> &lt; 0.05). Persistent cardiovascular symptoms affected 16.5% (90/546) of patients at 1-year follow-up. Multivariate analysis showed that only LA conduit strain (OR = 0.919, 95% CI: 0.857, 0.985, <i>p</i> = 0.017) and basal inferoseptal LVLS (OR = 0.883, 95% CI: 0.792, 0.986, <i>p</i> = 0.026) correlated with persisting cardiovascular symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrate that subclinical but persistent COVID-19-associated myocardial dysfunction is characterized by regional LVLS impairment and LAS reduction. The identified strain parameters (LAScd and basal inferoseptal LVLS) serve as novel imaging markers for stratifying patients at risk of persistent cardiovascular symptoms. These results advocate for targeted echocardiographic surveillance and early intervention strategies in post-COVID care pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06170307</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530436","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":"Total Anomalous Pulmonary Venous Drainage Caused by Malposition of Septum Primum in Adults","authors":"Shanshan Cheng,&nbsp;Min Hu,&nbsp;Fangfang Feng,&nbsp;Shubao Wang","doi":"10.1111/echo.70118","DOIUrl":"https://doi.org/10.1111/echo.70118","url":null,"abstract":"<p>• MSP has primarily been reported in fetuses or children, with only one case of adult MSP with PAPVD previously reported in 2022.</p><p>The case we report is about an adult with TAPVD which caused by MSP. There are no similar reports so far.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530433","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":"Afterload Mismatch After Mitral Valve Edge-to-Edge Repair: Echocardiographic Evaluation and Clinical Implications","authors":"Sergio Suma,&nbsp;Francesco Mangini","doi":"10.1111/echo.70121","DOIUrl":"https://doi.org/10.1111/echo.70121","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530402","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":"Multimodality Imaging and Immune-Related Adverse Events During Immune Checkpoint Inhibitors Treatment: Where Do We Stand?","authors":"Stephanie Crosio,&nbsp;Giorgio Treglia,&nbsp;Martina Imbimbo,&nbsp;Patrizia Froesch,&nbsp;Lorenzo Grazioli Gauthier,&nbsp;Dimitri Arangalage,&nbsp;Luca Bergamaschi,&nbsp;Sándor A. Györik,&nbsp;Giacomo Maria Viani,&nbsp;Alessandro Caretta,&nbsp;Laura Anna Leo,&nbsp;Giovanni Pedrazzini,&nbsp;Giorgio Moschovitis,&nbsp;Anna Giulia Pavon","doi":"10.1111/echo.70115","DOIUrl":"https://doi.org/10.1111/echo.70115","url":null,"abstract":"<div>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, significantly improving survival across various malignancies. However, these therapies are associated with various types of immune-related adverse events (irAEs), including cardiotoxicity, a spectrum of rare but potentially life-threatening complications impacting significantly morbidity and mortality. Cardiovascular imaging has become key in cardio-oncology, providing essential diagnostic tools for early detection and monitoring. This review synthesizes current evidence and underlines the pivotal role of early and tailored imaging strategies in managing ICI-induced cardiotoxicity. By bridging the knowledge gap, it aims to provide targetable insights to optimize the clinical management in patients undergoing immunotherapy.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530401","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":"Advancements in Computed Tomography Angiography for Pulmonary Embolism Assessment","authors":"Ludovica R. M. Lanzafame,&nbsp;Claudia Gulli,&nbsp;Christian Booz,&nbsp;Thomas J. Vogl,&nbsp;Luca Saba,&nbsp;Riccardo Cau,&nbsp;Patrizia Toia,&nbsp;Giorgio Ascenti,&nbsp;Michele Gaeta,&nbsp;Silvio Mazziotti,&nbsp;Tommaso D'Angelo","doi":"10.1111/echo.70116","DOIUrl":"https://doi.org/10.1111/echo.70116","url":null,"abstract":"<div>\u0000 \u0000 <p>Pulmonary embolism (PE) is a critical condition stemming from venous thromboembolism, with potentially fatal outcomes. Computed tomography pulmonary angiography (CTPA) serves as the gold standard for diagnosing PE, offering unparalleled diagnostic accuracy, accessibility, and speed. Recent innovations, such as spectral CT systems and artificial intelligence (AI)-driven algorithms, have enhanced the diagnostic and prognostic capabilities of CTPA, enabling precise anatomical and functional assessments. This review highlights these technological advancements and their clinical implications.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530432","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 and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review","authors":"Ankit Hanmandlu,&nbsp;Aniruddh Mannari,&nbsp;Aiden Abidov","doi":"10.1111/echo.70107","DOIUrl":"https://doi.org/10.1111/echo.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulmonary embolism (PE) is a common cause of acute RV enlargement (often described as RV strain or RV-S), with significant associated mortality and morbidity. Chest CT pulmonary angiography is a widely available diagnostic modality to rule out PE and assess for RV-S, if positive for PE. Frequently, RV-S is assessed by measuring the right ventricular (RV) to left ventricular (LV) ratio (RV/LV ratio); however, there is no standardized technique for measuring CT RV/LV ratio, and the prognostic value of this marker is not well-defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed and EMBASE databases were searched from inception to December 2023. A total of 35 studies were eligible for data collection based on relevance, completeness, and quality of data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most common clinically effective cutoffs of the RV/LV ratio used were 0.9 and 1.0, and the most common methodology involved measuring RV and LV diameters within the same axial slice on both 2D (axial) and reconstructed 4-Chamber (4-Ch) views. Although 4-Ch and axial views had different RV/LV ratio predictability regarding specific outcomes such as 30-day death, there was no significant overall difference in the prognostic value across the different cutoffs used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrates a lack of definite standardization in measuring CT RV/LV ratio in acute PE. Based on our review, we propose an RV strain defined as CT RV/LV ratio &gt;1.0 measured on a single axial CT slice as an easily measurable and reliable marker of RV dysfunction in acute PE, with associated significant prognostic value in predicting adverse outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530400","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":"Functional Mitral Valve Regurgitation, Pathophysiology, Leaflet ReModeling, and the Role of Imaging","authors":"Francesco Fulvio Faletra,&nbsp;Eluisa La Franca,&nbsp;Massimiliano Mulè,&nbsp;Alessandra Carvelli,&nbsp;Francesca Parisi,&nbsp;Giovanni Di Stefano,&nbsp;Rita Laura Borrello,&nbsp;Vincenzo Nuzzi,&nbsp;Paolo Manca,&nbsp;Manlio Cipriani","doi":"10.1111/echo.70101","DOIUrl":"https://doi.org/10.1111/echo.70101","url":null,"abstract":"<p>Functional mitral regurgitation (FMR) is a complex left ventricle (LV) and left atrium (LA) disorder in which mitral valve regurgitation is just the “tip of the iceberg.” Unlike primary mitral cvalve regurgitation, in which regurgitation occurs due to anatomic abnormalities of the valve itself, the etiology of FMR is multifactorial. Regional and global LV dysfunction, extent and location of fibrotic myocardium (subendocardial/transmural scar), and annulus enlargement are the leading causes of valve regurgitation. A comprehensive understanding of the causes, mechanisms, severity, and clinical consequences of FMVR relies primarily on noninvasive imaging techniques. Echocardiography is the first-line and most commonly used imaging technique. Cardiac magnetic resonance (CMR) has gained growing consensus mainly because it can precisely identify the extent and location of fibrotic myocardium. This review aims to: (a) describe the pathophysiology of the most common phenotypes of FMR, (b) challenge the paradigm that mitral leaflets are structurally normal in FMR, and (c) illustrate the critical role of both echocardiography and CMR in the comprehensive assessment of FMR.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489709","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":"Clinical Outcomes of Intracardiac Echocardiography-Guided Radiofrequency Catheter Ablation for Atrial Fibrillation: A Retrospective Study","authors":"Weiying Long,&nbsp;Qingsong He,&nbsp;Shi Chen,&nbsp;Xue Luo,&nbsp;Wucheng Yang,&nbsp;Jia Zheng,&nbsp;Hua Fu","doi":"10.1111/echo.70096","DOIUrl":"https://doi.org/10.1111/echo.70096","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;Routine radiofrequency catheter ablation relies on x-ray imaging, which may increase the risk of radiation exposure to patients. With the rapid development of intracardiac echocardiography (ICE) technology, it provides a new guidance modality for radiofrequency catheter ablation and shows great potential for application in the treatment of atrial fibrillation (AF).&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 assess the efficacy and safety of intracardiac echocardiography guided radiofrequency catheter ablation for the treatment of AF.&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;A retrospective cohort study was used to collect 184 patients who underwent radiofrequency catheter ablation for the treatment of AF from January 2020 to September 2021 in the cardiovascular medicine department of our hospital. According to whether they used ICE or not, they were divided into the ICE group (30 cases) and the non-ICE group (154 cases). The procedure of the intervention, complications during the intervention and follow-up periods, use of early anticoagulation and antiarrhythmic medications, and the success rate of AF ablation 1 year after the intervention were compared between the two groups.&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;In comparison to the non-ICE group, the septal puncture time (6.27 ± 1.91 min vs. 7.21 ± 2.08 min, &lt;i&gt;p&lt;/i&gt; = 0.022), left atrial modeling time (4.93 ± 1.84 min vs. 5.75 ± 1.96 min, &lt;i&gt;p&lt;/i&gt; = 0.035), and total ablation time (67.73 ± 2.64 min vs. 73.35 ± 1.96 min, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) in the ICE group were significantly reduced. Radiation exposure time (5.09 ± 0.23 min vs. 13.17 ± 0.28 min, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and radiation exposure (33.13 ± 1.99 mGy/cm&lt;sup&gt;2&lt;/sup&gt; vs. 217.6 ± 15.17 mGy/cm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) also were significantly less in the ICE group than in the non-ICE group. The incidence of postintervention nausea and vomiting (3.33% vs. 19.48%, &lt;i&gt;p&lt;/i&gt; = 0.032), and hypotension (3.33% vs. 18.83%, &lt;i&gt;p&lt;/i&gt; = 0.033) was significantly lower in the ICE group than in the non-ICE group. Furthermore, the proportion using amiodarone in the first 3 months during follow-up was significantly lower for the ICE group than for the non-ICE group (40.00% vs. 63.64%, &lt;i&gt;p&lt;/i&gt; = 0.024), and the rate of late recurrence remained unchanged in the ICE group, while there was a trend toward an increase in the rate of late recurrence in the non-ICE group. One year after the operation, the success rates of AF ablation in the ICE group and non-ICE group were 80.00% and 77.92%, and ","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455812","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":"“Better Is the Enemy of Good”: The Deleterious Effects of Supra-Normal Left Ventricular Ejection Fraction","authors":"Maria Dorobanțu,&nbsp;Aura Vîjîiac","doi":"10.1111/echo.70110","DOIUrl":"https://doi.org/10.1111/echo.70110","url":null,"abstract":"&lt;p&gt;Although not recognized as a distinct clinical entity in the current guidelines [&lt;span&gt;1&lt;/span&gt;], a new phenotype of heart failure (HF), characterized by supra-normal left ventricular ejection fraction (LVEF) &gt; 65% (snLVEF), draws the attention of the scientific community in the recent years. In a large paper, Wehner et al. reported a U-shaped relationship between LVEF and all-cause mortality [&lt;span&gt;2&lt;/span&gt;], irrespective of age and other comorbidities, highlighting the fact that patients with snLVEF have an increased risk of death, which might be similar to that of patients with reduced LVEF [&lt;span&gt;2&lt;/span&gt;]. Left atrial (LA) deformation assessed by speckle-tracking echocardiography (STE) is a sensitive marker of diastolic dysfunction [&lt;span&gt;3&lt;/span&gt;] and current consensus recommendations suggest that LA reservoir strain (LARS) should be used as an additional parameter for evaluating LV filling pressures in patients with preserved LVEF [&lt;span&gt;4&lt;/span&gt;]. Moreover, LARS was recently found to be an independent predictor of mortality, stroke, and HF in patients with normal LVEF [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Based on this previous knowledge, in the current issue of &lt;i&gt;Echocardiography&lt;/i&gt;, Liu and colleagues [&lt;span&gt;6&lt;/span&gt;] investigated LA and LV deformation patterns in hypertensive patients with snLVEF. Their study retrospectively enrolled 101 patients with essential arterial hypertension and preserved LVEF ≥50%, who were divided into low-normal LVEF (lnLVEF; 50%–59%), mid-normal LVEF (mnLVEF; 60%–69%), and supra-normal LVEF (≥70%). Their findings showed that hypertensive patients with snLVEF had impaired LA reservoir and conduit functions with preserved pump function, while patients with lnLVEF exhibited impairment of all three LA phasic functions. The authors also found an inverted U-shaped relationship between LARS and LVEF, proving that snLVEF has a deleterious effect on LA remodeling and mechanics, potentially leading to an adverse outcome.&lt;/p&gt;&lt;p&gt;During the past years, researchers have become increasingly aware of the potential detrimental effects of snLVEF. In a population-based cohort of 486 754 individuals, a LVEF≥70% was associated with decreased survival and underdiagnosed HF [&lt;span&gt;7&lt;/span&gt;], while in women already diagnosed with HF, a snLVEF was associated with a higher risk of all-cause death, both in the acute [&lt;span&gt;8&lt;/span&gt;] and chronic setting [&lt;span&gt;9&lt;/span&gt;]. A recent study enrolling patients with transcatheter aortic valve replacement (TAVR) found that patients with LVEF&gt;65% had worse outcomes after TAVR than patients with LVEF between 50% and 65% [&lt;span&gt;10&lt;/span&gt;]. Moreover, HF with snLVEF seems to differ from HF with preserved LVEF (HFpEF) not only in terms of survival, but also of response to treatment. For example, the EMPEROR-Preserved trial proved the beneficial effects of empaglifozin in HFpEF, but these effects were not consistent in the subgroup of patients with snLVEF [&lt;span&gt;11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In an interesting magn","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446689","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 Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value","authors":"Frank L. Dini,&nbsp;Valentina Barletta,&nbsp;Piercarlo Ballo,&nbsp;Giovanni Cioffi,&nbsp;Nicola Riccardo Pugliese,&nbsp;Andrea Rossi,&nbsp;Gani Bajraktari,&nbsp;Stefano Ghio,&nbsp;Michael Y. Henein","doi":"10.1111/echo.70109","DOIUrl":"https://doi.org/10.1111/echo.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The assessment of left ventricular (LV) outflow velocity time integral (LVOT-VTI) has gained favor in the stratification of patients with heart failure (HF). We evaluated the prognostic significance of LVOT-VTI compared with the commonly used indices of LV outflow: cardiac index (CI) and stroke volume index (SVI), their reproducibility and cut-off values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A total of 424 outpatients diagnosed with HF and LV systolic dysfunction (LV ejection fraction &lt; 50%) underwent a Doppler echocardiographic examination, including the assessment of CI, SVI, and LVOT-VTI. The Bland–Altman analysis showed LVOT-VTI the most reproducible outflow index. The study follow-up duration was 3.5 years (interquartile range 1.6–6.5), at the end of which there were 94 cardiovascular deaths (29%). Cox regression univariate analysis showed that LVOT-VTI was the most predictive of the study end-point. The ratio of tricuspid annular displacement-to-pulmonary artery systolic pressure (TAPSE/PASP) (<i>p</i> &lt; 0.0001), LVOT-VTI (<i>p</i> = 0.0011), and end-systolic volume index (<i>p</i> = 0.0036) independently predicted the study end-point. At receiver-operating characteristic (ROC) analysis, LVOT-VTI &lt; 12.0 cm had the best sensitivity and specificity for predicting cardiovascular mortality. Reduced LV EF (<i>p</i> = 0.0011), raised BNP levels (<i>p</i> = 0.0053), and high LV filling pressure (<i>p</i> = 0.044) were associated with low LVOT-VTI in multivariate logistic regression analysis. Patients with low LVOT-VTI and TAPSE/PASP &lt; 0.32 mm/mmHg exhibited the worst prognosis on Kaplan–Meier survival curves (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A LVOT-VTI &lt; 12.0 cm represents the best predictor of the cardiovascular outcome and proved the most reproducible index of LV forward flow in patients with chronic HF and systolic dysfunction. The combination of impaired LVOT-VTI with TAPSE/PASP showed the worst survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446688","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}