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

{"title":"Pulmonary Valve Amyloid Deposition Mimicking Infective Endocarditis in Val30Met Hereditary Transthyretin Amyloidosis","authors":"Emre YALÇIN,&nbsp;Memduh DURSUN,&nbsp;Doğu VURALLI BAKKALOĞLU,&nbsp;Cafer ZORKUN,&nbsp;Berrin UMMAN,&nbsp;Derya BAYKIZ","doi":"10.1111/echo.70651","DOIUrl":"10.1111/echo.70651","url":null,"abstract":"<div>\u0000 \u0000 <p>A 53-year-old man with Val30Met hereditary transthyretin amyloidosis (hATTR) developed a highly mobile pulmonary valve mass with severe pulmonary regurgitation. Concomitant methicillin-sensitive <i>Staphylococcus aureus</i> (MSSA) bacteremia raised suspicion for infective endocarditis. Echocardiography and cardiac magnetic resonance imaging characterized the lesion but could not establish its etiology. Surgical excision and pulmonary valve replacement were performed, and histopathological examination demonstrated Congo red–positive amyloid deposition. This case highligts that atypical cardiac manifestations beyond myocardial infiltration can occur in patients with hATTR. We present a case of isolated pulmonary valvular amyloid infiltration without overt myocardial involvement in Val30Met-associated hATTR.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185617","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":"Beyond Atrial Fibrillation: Clinical and Echocardiographic Predictors of Ischaemic Stroke and Systemic Thromboembolism in Rheumatic Heart Disease: A Systematic Review and Meta-Analysis","authors":"Naveen Baby,&nbsp;Nishanth Gowda,&nbsp;H. V. Neha","doi":"10.1111/echo.70649","DOIUrl":"10.1111/echo.70649","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is the best-established thromboembolic risk factor in rheumatic heart disease (RHD), but stroke and thromboembolism also occur without documented AF. We systematically synthesised associations between non-AF clinical/echocardiographic predictors and thromboembolism in RHD, comparing AF-adjusted with unadjusted estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched, supplemented by Google Scholar and citation screening. Eligible studies evaluated RHD patients with ≥1 non-AF predictor of stroke or thromboembolism. Two reviewers performed selection, extraction, and QUIPS risk-of-bias assessment; certainty was graded using GRADE. Unadjusted, adjusted, and AF-adjusted estimates were extracted separately, and random-effects meta-analysis was performed when feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen studies (∼8,206 patients) met eligibility criteria. SEC, LA size/volume, LA/appendage thrombus, LA appendage flow, LA mechanical function, mitral valve severity, age, and previous thromboembolism were most frequently examined. Four studies provided comparable crude ORs for SEC (pooled OR 8.27, 95% CI 3.21–21.29; <i>I²</i> = 66%), substantially attenuated after AF adjustment (as low as OR 1.7, 95% CI 1.1–3.0). Older age and previous stroke remained associated with thromboembolism in AF-inclusive models, and LA mechanical/reservoir function showed consistent inverse associations, including in sinus rhythm. Certainty was low for SEC, age, and LA function; moderate for previous stroke/thromboembolism; very low for anticoagulation non-use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In RHD, thromboembolic risk extends beyond documented AF. SEC showed the strongest unadjusted association but was substantially attenuated after AF adjustment, likely partly reflecting subclinical AF; it is TEE-dependent and inconsistently graded. Older age, previous thromboembolism, and impaired LA mechanical/reservoir function showed more persistent associations after AF-inclusive adjustment; prospective validation is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185360","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":"A Clinician-Led Feasibility Study for Echocardiographic View Classification Using Standard Workstation Hardware and Routine Clinical Archives","authors":"Jinjie Xie,&nbsp;Yaxin Wang,&nbsp;Wei Liu","doi":"10.1111/echo.70591","DOIUrl":"10.1111/echo.70591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate whether a frontline echocardiographer, without engineering support or dedicated research hardware, can independently develop a validated five-class echocardiographic view classifier using artificial intelligence–assisted coding, standard departmental workstation hardware, and routine clinical archives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A clinician used artificial intelligence–assisted coding (Kimi 2.6, Moonshot AI) to develop a pipeline on a standard Tomtec echocardiographic analysis workstation (Intel Core i7, NVIDIA RTX 4060 8 GB VRAM, 32 GB RAM) running Ubuntu 22.04 LTS via Windows Subsystem for Linux 2. From 1387 transthoracic echocardiograms, 9796 B-mode end-diastolic frames were extracted. A batch annotation strategy was employed: 466 seed images were annotated to train an overfitted EfficientNet-B0 screener, which pre-classified 5029 high-confidence standard-view frames. These were batch-reviewed in approximately 24 min, yielding 5028 verified frames from 1242 patients, partitioned into training (<i>n</i> = 3545), validation (<i>n</i> = 731), and internal test (<i>n</i> = 752) sets. A five-class ResNet-18 classifier was trained and evaluated on the primary dataset and evaluated on an external validation dataset (74 patients, 263 frames) without retraining.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total expert annotation burden was 32 min. The classifier achieved 98.27% accuracy (95% CI: 97.06%–99.08%) on the internal test set with a macro F1 of 0.9784. On external validation, overall accuracy was 71.48% (95% CI: 65.61%–76.86%) with a macro F1 of 0.7100. Parasternal short-axis and apical two-chamber views generalized robustly (100% and 94.23%, respectively), whereas apical four-chamber, apical three-chamber, and parasternal long-axis views showed lower accuracy due to device-specific image processing differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinical artificial intelligence development in echocardiography is substantially more accessible than conventionally assumed. A single clinician using existing hardware and artificial intelligence–assisted coding can produce a validated view classifier with minimal annotation burden, providing a practical roadmap for in-house customization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168073","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 Left Atrial Remodeling With Pharmacological Rhythm Versus Rate Control in Paroxysmal and Persistent Atrial Fibrillation","authors":"Shao-Fu Chien,&nbsp;Chih-Hui Chin,&nbsp;Chao-Chien Chang,&nbsp;Shih-Yu Huang,&nbsp;Hung-Yi Chiou","doi":"10.1111/echo.70646","DOIUrl":"10.1111/echo.70646","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Evidence regarding left atrial (LA) remodeling with pharmacological rhythm control remains limited, particularly in patients with atrial fibrillation (AF) outside heart-failure-specific populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort included 156 adults with paroxysmal or persistent AF receiving mutually exclusive pharmacological rate-control (<i>n</i> = 92) or rhythm-control (<i>n</i> = 64) therapy who underwent two transthoracic echocardiograms. LA remodeling was assessed using serial echocardiography, and clinical outcomes were evaluated after the second examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 74 patients with paired left atrial volume index (LAVI) measurements, LAVI increased from 39.9 to 50.3 mL/m² with rate control (<i>p</i> &lt; 0.001) but remained unchanged with rhythm control (44.9 to 43.4 mL/m²; <i>p</i> = 0.465). After adjustment for baseline LAVI and clinical covariates, rhythm control was associated with a 9.38 mL/m² lower follow-up LAVI (95% CI, -15.53 to -3.24; <i>p</i> = 0.003). The association with lower follow-up LAVI was also observed among patients without heart failure and remained similar in sensitivity analyses. During post-landmark follow-up, rhythm control was associated with a lower hazard of all-cause mortality or stroke hospitalization (adjusted HR, 0.46; 95% CI, 0.24–0.88; <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pharmacological rhythm control was associated with more favorable longitudinal LA remodeling than rate control, including among patients without heart failure, and was also associated with a lower hazard of subsequent all-cause mortality or stroke hospitalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169026","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":"Development and Validation of a Predictive Model for Subclinical Myocardial Dysfunction in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy: Integrating 2D Speckle Tracking Echocardiography and Conventional Echocardiographic Parameters","authors":"Sujing Wang,&nbsp;Bo Wang,&nbsp;Qian Liu,&nbsp;Jie Jiang,&nbsp;Meng Chen,&nbsp;Fang Wu,&nbsp;Jieli Bao","doi":"10.1111/echo.70637","DOIUrl":"10.1111/echo.70637","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anthracycline cardiotoxicity is often silent at the subclinical stage. Left ventricular ejection fraction (LVEF) detects injury late, and global longitudinal strain (GLS) is sensitive but usually used alone. This study aimed to develop and internally validate a baseline model combining speckle-tracking GLS, conventional echocardiography, and clinical factors to identify women at high risk of subclinical myocardial dysfunction before doxorubicin (DOX) chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a single-center prospective study, 200 breast cancer patients scheduled for DOX-based chemotherapy underwent baseline and 1-month assessment. The primary outcome was subclinical myocardial dysfunction, defined as &gt; 15% relative GLS reduction with preserved LVEF. <b><i>P</i> &lt; 0.10 variables</b> in univariable analysis entered multivariable logistic regression for nomogram construction. Discrimination, calibration, and decision curve analysis used 1000-bootstrap validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Subclinical myocardial dysfunction occurred in 60 of 200 patients (30.0%). Independent predictors were baseline GLS, LDL-C, trastuzumab use, planned cumulative dose, LAVI, and hypertension. The model reached an AUC of 0.803, higher than baseline GLS, a clinical-only model, and baseline LVEF. The bootstrap-corrected C-index was 0.777.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A baseline nomogram combining GLS, conventional echocardiography, and clinical factors may help identify patients at high risk of early subclinical myocardial dysfunction before chemotherapy, outperforming single parameters and supporting risk-stratified monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117917","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":"Right Ventricular Pacing Burden–Dependent Biventricular Remodeling in Patients With Preserved Left Ventricular Ejection Fraction: A Prospective Longitudinal Study","authors":"Onoufrios Malikides,&nbsp;Maria Marketou,&nbsp;Andria Papazachariou,&nbsp;Vironas Malikides,&nbsp;Gregory Chlouverakis,&nbsp;Eleftherios Kallergis,&nbsp;Alexandros Patrianakos,&nbsp;Emmanuel Simantirakis","doi":"10.1111/echo.70647","DOIUrl":"10.1111/echo.70647","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess right ventricular (RV) systolic trajectories across right ventricular pacing (RVP) burdens and their relationship with left ventricular (LV) remodeling in patients with preserved baseline LV ejection fraction (LVEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 200 patients undergoing dual-chamber pacemaker implantation with an apical RV lead. Clinical, electrocardiographic, device, and echocardiographic assessments were performed at baseline, three months, and 12 months. Patients were grouped by RVP burden: 0%–3% (<i>n</i> = 43), 70%–79% (<i>n</i> = 51), or ≥80% (<i>n</i> = 106). RV global longitudinal strain (RVGLS), RV fractional area change (RVFAC), and tricuspid annular plane systolic excursion (TAPSE) were evaluated using adjusted linear mixed-effects models. Continuous RVP associations and concurrent RV–LV changes were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 200 patients (median age, 79 years), adjusted mixed-effects models demonstrated significantly different longitudinal trajectories across RVP groups for RVGLS (Holm-adjusted <i>p</i> = 0.0096) and TAPSE (Holm-adjusted <i>p</i> = 0.050), but not for RVFAC (Holm-adjusted <i>p</i> = 0.252). RVGLS and TAPSE deteriorated with high RVP while remaining comparatively stable with minimal pacing. Within the 70%–100% range, each 10% higher RVP burden was associated with an additional TAPSE reduction of 0.305 at 3-months (95%CI, 0.084, 0.527; <i>p</i> = 0.007) and 0.401 mm at 12-months (95%CI, 0.179, 0.622 mm; <i>p</i> &lt; 0.001). The overall continuous time-by-RVP interaction was significant for TAPSE (Holm-adjusted <i>p</i> = 0.0035), but not for RVGLS or RVFAC. Worsening LVGLS was associated with deterioration in all RV indices at both assessments (FDR-adjusted <i>p</i> ≤ 0.0017), while increasing LV end-systolic volume was associated with all RV indices at 12-months (all FDR-adjusted <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Substantial RVP was associated with statistically detectable changes in RV indices. Within the high-pacing range, greater RVP burden was associated with a greater longitudinal decline in TAPSE. Concurrent RV-LV changes were also present, although their clinical significance requires further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117942","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":"Agreement Between Echocardiography and Ultrasonic Cardiac Output Monitoring (USCOM) for Hemodynamic Assessment in Pediatric Patients: A Bland–Altman Analysis","authors":"Saviga Sethasathien,&nbsp;Orana Arsasuwan,&nbsp;Theerapon Jariyasakoolroj,&nbsp;Suchaya Silvilairat","doi":"10.1111/echo.70645","DOIUrl":"10.1111/echo.70645","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiography is widely used for non-invasive measurements of stroke volume and cardiac output, while Ultrasonic Cardiac Output Monitor (USCOM) offers an alternative Doppler-based approach. Whether these two modalities can be used interchangeably in clinical practice remains unclear. This study aims to evaluate the correlation and agreement between echocardiography and USCOM for hemodynamic assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 44 pediatric patients underwent hemodynamic assessment using echocardiography and sequential USCOM measurement during the same evaluation. Spearman's rank correlation was used to assess the relationship between methods. Agreement was evaluated using Bland-Altman analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Strong correlations were found for stroke volume (SV; <i>r</i> = 0.97), cardiac output (CO; <i>r</i> = 0.95), cardiac index (CI; <i>r</i> = 0.91), stroke volume index (SVI; <i>r</i> = 0.90), and aortic valve (AV) diameter (<i>r</i> = 0.91; <i>p</i> &lt; 0.001), with a moderate correlation for left ventricular outflow tract (LVOT) velocity (<i>r</i> = 0.64, <i>p</i> &lt; 0.001). Bland-Altman analysis revealed echocardiography produced lower values of all parameters compared to USCOM. Significant proportional bias was identified for SV, SVI, CO, and CI (all <i>p</i> ≤ 0.006), indicating that two methods increased disagreement with higher measured values. AV diameter and LVOT velocity showed no significant proportional bias and narrower limits of agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although echocardiography and USCOM correlate strongly for hemodynamic parameters, clinically meaningful systematic bias and proportional error limit their interchangeability for volumetric flow measurements. These devices should not be used interchangeably for quantitative hemodynamic monitoring, particularly in high-output states.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117969","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":"Body Roundness Index Trajectories and Incident Left Ventricular Hypertrophy: Results of a Community-Based Study in Korea","authors":"Jae-Hyeong Park,&nbsp;Nan Hee Kim,&nbsp;Soon-Ki Ahn,&nbsp;Seong Hwan Kim","doi":"10.1111/echo.70644","DOIUrl":"10.1111/echo.70644","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular hypertrophy (LVH) constitutes Stage B heart failure and marks elevated risk for atrial fibrillation, stroke, and death. Unlike body mass index, body roundness index (BRI), derived from waist circumference and height, more accurately reflects visceral adiposity. Because existing BRI–LVH evidence is usually cross-sectional, we investigated whether the BRI trajectory can predict incident LVH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of a total of 2,578 subjects who underwent echocardiographic examinations, we studied 1,764 participants who were free of LVH on echocardiography at baseline (2007–2008, wave 4). BRI trajectory was determined from BRI values measured at four biennial examinations (2001–2008). The outcome was incident LVH on echocardiography during the follow-up (2009–2016, wave 5–8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 53.2±6.3 years, and 828 (46.9%) were women. Latent class mixed models identified 3 sex-specific BRI trajectory classes: stable-low (Class 1), stable-moderate (Class 2), and variable-high BRI (Class 3). Among men, 225 (24.0%), 615 (65.7%), and 96 (10.3%) were classified into these classes, respectively; among women, 319 (38.5%), 356 (43.0%), and 153 (18.5%). Incident LVH, defined as LVH on echocardiography at any of the 4 follow-up examinations conducted during 2009–2016 (wave 5–8), developed in 249 of 936 men (26.6%) and 196 of 828 women (23.7%), and incidence increased across trajectory classes in both sexes (in men, 5.8%, 30.6%, and 50.0%; in women, 7.5%, 32.3%, and 37.3%; both <i>P</i> &lt; 0.001). In the fully adjusted model, compared with Class 1, OR of incident LVH were increased for Class 2 (men; 4.75 [95% CI, 2.33–9.66]; women, 4.53 [2.67–7.68]; both <i>P</i> &lt; 0.001) and for Class 3 (men, 9.28 [3.91–22.02]; women, 4.60 [2.50–8.48]; both <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a community-based Korean cohort, sex-specific BRI trajectories characterized by stable-moderate (Class 2) or variable-high (Class 3) BRI trajectory groups were associated with a substantially increased risk of incident LVH in both men and women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117956","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":"Not Only the Left Ventricle: The Impact of Potentially Cardiotoxic Oncological Treatment on the Left Atrium and Right Ventricle","authors":"Maria Żak,&nbsp;Alexander Suchodolski,&nbsp;Tomasz Niklewski,&nbsp;Mariola Szulik","doi":"10.1111/echo.70642","DOIUrl":"10.1111/echo.70642","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) remain recommended for cardiotoxicity surveillance during cancer therapy, yet it changes late and overlooks injury to the other cardiac chambers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We systematically reviewed echocardiographic and cardiac magnetic resonance (CMR) studies that assessed left atrial (LA), right atrial (RA), and right ventricular (RV) function in patients exposed to potentially cardiotoxic oncological treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for English-language studies published between January 2020 and March 2026, following the PRISMA recommendations. Across tumor types—lymphoma, acute lymphoblastic leukemia, breast, gastrointestinal, and melanoma—and across anthracycline-, trastuzumab-, fluoropyrimidine-, and immune checkpoint inhibitor–based regimens, strain imaging detected subclinical dysfunction that conventional measures missed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LA reservoir strain declined early and frequently preceded any fall in LVEF, outperforming volumetric LA indices for the detection and prediction of cancer therapy–related cardiac dysfunction (CTRCD). RV deformation parameters, particularly free-wall longitudinal strain and three-dimensional RV ejection fraction, identified RV involvement that was sometimes independent of LV cardiotoxicity and was associated with adverse cardiac events. Data on the RA remain sparse but point in the same direction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multichamber strain assessment adds sensitivity to LVEF and GLS-based monitoring; standardization of acquisition, reference values, and reporting is needed before it can enter routine cardio-oncology surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117996","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":"Clinical Value of Real-Time Three-Dimensional Echocardiography for Evaluating Right Ventricular Structure and Function in Patients With Pulmonary Hypertension Across Different Echocardiographic Pulmonary Artery Systolic Pressure Strata","authors":"Junlan Liu,&nbsp;Yihua Wang","doi":"10.1111/echo.70621","DOIUrl":"https://doi.org/10.1111/echo.70621","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating right ventricular (RV) structure and function in patients with pulmonary hypertension (PH) across different echocardiographic pulmonary artery systolic pressure (PASP) strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 150 patients with PH and 84 healthy controls were included. Patients with PH were stratified into mild, moderate and severe echocardiographic PASP strata. Conventional two-dimensional (2D) echocardiographic parameters and RT-3DE–derived RV parameters were compared among groups. Correlations between echocardiographic parameters and pulmonary pressure burden were analyzed. Cross-validated receiver operating characteristic analyses were performed to evaluate the diagnostic performance of 2D parameters, RT-3DE parameters and combined 2D plus RT-3DE models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PH etiologies included Group 1 pulmonary arterial hypertension (31.3%), Group 2 PH due to left heart disease (51.3%), Group 3 PH due to lung disease and/or hypoxia (11.3%), Group 4 PH associated with pulmonary artery obstruction (1.4%), and Group 5 PH with unclear and/or multifactorial mechanisms (4.7%). RV-TD, RV/LV ratio, RAEA, and RV-FW increased across echocardiographic PASP strata, whereas S′, TAPSE, RVFAC, and RVEF decreased. RT-3DE-derived RV volume and functional parameters differed significantly among groups; within the PH cohort, RVEDV, RVESV, RVSV, and RV cardiac output increased across PASP strata, while RVEF progressively decreased. The combined 2D plus RT-3DE model showed high cross-validated discrimination for moderate-to-severe PH and severe PH, with AUCs of 0.956 and 0.998, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined 2D echocardiography and RT-3DE provide complementary noninvasive information for evaluating RV remodeling and systolic dysfunction in patients with PH across different echocardiographic PASP strata.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068602","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}