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

{"title":"Machine-Reported Electrocardiographic Right Axis Deviation or Right Ventricular Hypertrophy and Echocardiographic Pulmonary Hypertension Phenotypes and Right-Heart Abnormalities","authors":"Yoshihiro Fuchigami","doi":"10.1111/echo.70539","DOIUrl":"10.1111/echo.70539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Machine-reported electrocardiographic findings suggesting right-heart strain are routinely generated during electrocardiogram (ECG) acquisition, but their relationship to echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities remains incompletely defined. This study evaluated whether machine-reported right axis deviation (RAD) or right ventricular hypertrophy (RVH) is associated with echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities in hospitalized patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study used linked MIMIC-IV-ECG and MIMIC-IV-ECHO data. Echocardiograms were linked to the closest ECG obtained from 7 days before echocardiography through the time of echocardiography. The primary exposure was machine-reported RAD or RVH. The primary outcome was Echo-PH specific, a composite echo-derived phenotype including tricuspid regurgitation velocity greater than 3.4 m/s, moderate or severe pulmonary hypertension text, or right ventricular pressure overload. Logistic regression adjusted for demographics, comorbidities, and ICU status, with patient-level cluster-robust standard errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 68 905 ECG–echocardiography pairs from 42 078 patients; 2815 pairs were RAD/RVH-positive. For Echo-PH specific, RAD/RVH had sensitivity 7.5%, specificity 96.7%, positive predictive value 35.5%, and negative predictive value 81.4%. RAD/RVH remained associated with Echo-PH specific after full adjustment using cluster-robust standard errors (odds ratio, 2.04; 95% confidence interval, 1.84–2.26). The adjusted probability of Echo-PH specific was 18.8% without RAD/RVH and 30.0% with RAD/RVH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Machine-reported ECG RAD/RVH was highly specific but insensitive for echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities. These routine ECG findings may serve as supportive clues to echocardiographic right-heart disease but should not be used to exclude it.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431490","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":"Association of Echocardiographic Ventricular–Arterial Coupling With Elevated 10-Year ASCVD Risk in Hypertensive Patients","authors":"Shiyi Zhang,&nbsp;Jianxiong Chen,&nbsp;Lan Yang,&nbsp;Lingheng Wu,&nbsp;Guiyang Xi,&nbsp;Xinyi Li,&nbsp;Anni Chen,&nbsp;Xinqi Wang,&nbsp;Qinghua Niu,&nbsp;Lin Jin,&nbsp;Zhaojun Li","doi":"10.1111/echo.70547","DOIUrl":"10.1111/echo.70547","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between the arterial velocity pulse index-to-left ventricular global longitudinal strain ratio (AVI/LVGLS) and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk assessed using the China-PAR model in patients with hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 190 patients with hypertension and 203 controls were included. Ventricular-arterial coupling (VAC) was assessed using the AVI/LVGLS ratio, with absolute LVGLS values used to ensure consistent directional interpretation. High estimated ASCVD risk was defined as ≥10%. Least absolute shrinkage and selection operator (LASSO) regression was used to identify potential predictors of elevated ASCVD risk. Multivariable logistic regression analyses were subsequently performed to evaluate the independent association between AVI/LVGLS and ASCVD risk using both continuous and categorical (lowest fifth percentile) approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AVI/LVGLS was significantly higher in patients with hypertension than in controls (<i>p</i> &lt; 0.05). LASSO regression identified AVI/LVGLS as an important predictor of high estimated ASCVD risk. Receiver operating characteristic analysis demonstrated that AVI/LVGLS had superior discriminatory performance compared with VVI, AVI, and LVGLS alone. In multivariable logistic regression analysis, AVI/LVGLS below the fifth percentile was independently associated with high estimated ASCVD risk after adjustment for conventional cardiovascular risk factors (OR = 6.106, 95% CI: 1.352–27.565, <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VAC, assessed by AVI/LVGLS ratio, was independently associated with increased estimated ASCVD risk in patients with hypertension. AVI/LVGLS may reflect integrated myocardial and vascular alterations and could serve as a complementary marker for cardiovascular risk stratification in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425921","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":"2D-Echocardiographic Estimation of Right Ventricular Volumes Using a Previously Validated Geometric Model Is Associated With Outcomes After Transcatheter Tricuspid Interventions","authors":"Mhd Nawar Alachkar,&nbsp;Tanja Kücken,&nbsp;Johannes Schlegl,&nbsp;Marwin Bannehr,&nbsp;Michael Lichtenauer,&nbsp;Vera Paar,&nbsp;Michael Neuß,&nbsp;Anja Haase-Fielitz,&nbsp;Christoph Edlinger,&nbsp;Christian Butter","doi":"10.1111/echo.70557","DOIUrl":"10.1111/echo.70557","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine whether a simplified, previously proposed two-dimensional (2D) approach to RV volume assessment can provide adjunctive prognostic information in patients undergoing Transcatheter Tricuspid Valve Interventions (TTVI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>In this prospective single-center study, 113 patients undergoing TTVI were included (T-TEER; <i>n</i> = 91, heterotopic caval valve implantation; <i>n</i> = 17, and orthotopic transcatheter tricuspid valve replacement; <i>n</i> = 5). RV end-diastolic and end-systolic volumes were calculated using a previously described 2D-based geometric model. The primary endpoint was a composite of all-cause mortality or rehospitalization for acute decompensated heart failure at 1 year. The primary endpoint occurred in 47 patients (41.6%). In univariable Cox regression analysis, both RVEDVi (HR 1.05 per 10 mL/m², 95% CI 1.01–1.10, <i>p</i> = 0.03) and RVESVi (HR 1.13 per 10 mL/m², 95% CI 1.01–1.25, <i>p</i> = 0.03) were associated with adverse outcome. Receiver operating characteristic analysis identified cut-off values of 90 mL/m² for RVEDVi and 35 mL/m² for RVESVi. Patients above these thresholds (diastolic, systolic, or both) showed significantly reduced event-free survival (log-rank <i>p</i> &lt; 0.01). In a multivariable Cox regression analysis, RV dilatation showed a trend toward worse outcomes (HR 2.09, 95% CI 0.91–4.80, <i>p</i> = 0.08), whereas the TriScore remained independently associated with outcome (HR 1.30, 95% CI 1.10–1.53, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RV volumes derived from a simple 2D echocardiographic model are associated with clinical outcomes and may provide additional information for the assessment of patients undergoing TTVI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425991","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":"Early Left Ventricular Mechanical Dyssynchrony Predicts Left Atrial Dysfunction Following Right Ventricular Pacing","authors":"Ismail Mohamed Ibrahim,&nbsp;Shehab Ezzat Ahmed Talaat,&nbsp;Tarek Ahmed Naguib,&nbsp;Hisham Samir Roshdy","doi":"10.1111/echo.70555","DOIUrl":"10.1111/echo.70555","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left atrial reservoir strain (LASr) is an established marker of left atrial (LA) mechanical dysfunction and may identify early remodeling preceding HFpEF in patients undergoing conventional right ventricular (RV) pacing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify early determinants of impaired LASr at 12 month follow-up after conventional right ventricular pacing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-two patients undergoing conventional right ventricular pacing were prospectively enrolled. TTE was performed at baseline, 3 months, and 12 months. Left ventricular (LV) mechanical dispersion (LVMD), global longitudinal strain (LVGLS), diastolic function indices, and LA strain parameters were assessed. Patients were stratified according to 12-month LASr, with values &lt;25% defining impaired LA mechanics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen patients (36.5%) developed impaired LA mechanics. Baseline clinical and echocardiographic parameters were comparable between groups. At 3 months, patients who subsequently developed impaired LA mechanics exhibited significantly greater LVMD (56 ± 11 vs. 42 ± 9 ms, <i>p</i> &lt; 0.001), reduced LVGLS (−17.2 ± 2.1% vs. −18.4 ± 1.9%, <i>p</i> = 0.03), and higher E/e′ ratio (12.3 ± 2.5 vs. 10.9 ± 2.2, <i>p</i> = 0.04), while LASr remained similar between groups. On multivariable analysis, 3-month LVMD independently predicted impaired LASr at 12 months (OR 2.04, 95% CI 1.18–3.52, <i>p</i> = 0.01). ROC analysis demonstrated that LVMD had the highest discriminatory performance (AUC 0.84, 95% CI 0.75–0.93).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early LVMD develops before overt atrial dysfunction following conventional right ventricular pacing. LVMD is an independent predictor of subsequent impairment in LA mechanics and may identify patients at risk for adverse atrial remodeling before the onset of clinically apparent heart failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425983","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":"Moving the Goalposts in Hypertensive Risk Assessment: The AVI/LVGLS Ratio as a Sensitive Detector of Maladaptive Ventricular–Arterial Coupling","authors":"Giancarlo Trimarchi,&nbsp;Fausto Pizzino,&nbsp;Massimiliano Mariani","doi":"10.1111/echo.70558","DOIUrl":"10.1111/echo.70558","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This commentary discusses the AVI/LVGLS ratio as an emerging, fully non-invasive marker of ventricular–arterial coupling (VAC) for refining cardiovascular risk assessment in hypertension beyond conventional indices such as left ventricular ejection fraction and Ea/Ees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We critically appraised the study by Zhang et al., which evaluated the association between the arterial velocity-pulse index to left ventricular global longitudinal strain ratio and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk in hypertensive patients. The commentary integrates these findings with prior evidence on arterial stiffness, myocardial deformation, and VAC assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Zhang et al. showed that AVI/LVGLS differed significantly between hypertensive patients and normotensive controls and was independently associated with elevated estimated 10-year ASCVD risk. An AVI/LVGLS ratio below the fifth percentile predicted high ASCVD risk after multivariable adjustment, while the composite index demonstrated better discrimination than AVI, LVGLS, or conventional ventricular–vascular index alone. These findings support the incremental value of combining vascular load and myocardial deformation into a single echocardiography-compatible parameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AVI/LVGLS may provide a practical bridge between vascular and myocardial phenotyping in hypertension, offering a sensitive marker of maladaptive VAC and subclinical cardiovascular risk. Prospective, multicenter validation is required before implementation in routine risk stratification or therapeutic monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426024","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":"Right Atrial Contribution in CTEPH: Active Compensation or Relative Preservation?","authors":"Alexandra Mihai,&nbsp;Francesca Ileana Adamo,&nbsp;Giorgia Serino","doi":"10.1111/echo.70553","DOIUrl":"10.1111/echo.70553","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413560","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":"Serial Strain-Based Echocardiographic Characterization of Early Left Heart Functional Changes During Short-Term Mavacamten Treatment in Obstructive Hypertrophic Cardiomyopathy","authors":"Liu Yang,&nbsp;Zaihan Zhu,&nbsp;Xingke Qiao,&nbsp;Yuzhu Zhang,&nbsp;Anxiang Sha,&nbsp;Chunlu Jing,&nbsp;Dan Suo,&nbsp;Dandan Sun","doi":"10.1111/echo.70549","DOIUrl":"10.1111/echo.70549","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To characterize early left heart functional changes during short-term mavacamten use in a real-world obstructive hypertrophic cardiomyopathy (oHCM) cohort using serial strain-based echocardiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational cohort study included 37 patients with oHCM: 22 receiving mavacamten and 15 in the comparison group. Serial echocardiographic, clinical and laboratory data were collected at baseline and at 4, 12, and 30 weeks. GLS was assessed as the main imaging variable using two-dimensional speckle-tracking echocardiography, with GCS, GRS, and LA strain parameters evaluated as exploratory strain indices. LVOT peak gradients were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At week 30, compared with the comparison group, the mavacamten group had a greater reduction in the Valsalva-provoked LVOT gradient (between-group LSM difference, −51.18 mmHg; <i>p</i> &lt; 0.001). The mavacamten group showed a more pronounced longitudinal change in GLS (−3.47%; <i>p</i> &lt; 0.001). Left atrial reservoir strain (LASr) increased to a greater extent in the mavacamten group (5.82%; <i>p</i> &lt; 0.001). Exploratory analyses suggested between-group differences in left atrial conduit strain (LAScd) and left atrial contractile strain (LASct) mainly at week 30. No significant between-group differences were observed in GCS or GRS at any follow-up time point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this oHCM cohort, short-term mavacamten use was accompanied by larger reductions in LVOT gradients and greater changes in GLS than those observed in the comparison group. Exploratory analyses suggested corresponding changes in LA strain indices. Serial strain-based echocardiographic assessment may provide complementary information on short-term changes in left heart function during follow-up. These observations require confirmation in larger studies with longer follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406716","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 Case of Anomalous Systemic Venous Connections to Left Sided Atrium in Left Isomerism”","authors":"Veena Bharathi Kota,&nbsp;Lamk Kadiyani,&nbsp;Sivasubramanian Ramakrishnan,&nbsp;Damandeep Singh,&nbsp;Sanjeev Kumar","doi":"10.1111/echo.70550","DOIUrl":"10.1111/echo.70550","url":null,"abstract":"<div>\u0000 \u0000 <p>A 7-month-old infant with Tetralogy of Fallot physiology showed disproportionate left heart dilatation. Multisite saline contrast echocardiography demonstrated immediate left sided atrial opacification, suggesting anomalous systemic venous return. Cardiac CT confirmed total anomalous systemic venous connection to the left sided atrium with left isomerism. Early recognition enables timely surgical correction and improved outcomes.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399837","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":"Association of Valvular Disease Progression Using Echocardiographic Findings in a Large U.S. Cohort","authors":"Abes A. Bautista Neughebauer,&nbsp;Amin Yehya,&nbsp;Raymond L. Benza,&nbsp;Deepak Talreja","doi":"10.1111/echo.70546","DOIUrl":"10.1111/echo.70546","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of valvular disease in the US is approximately 2.5%. Given that over 5 million Americans are affected, it is crucial to find those at higher risk of progression. The goal of this paper is to uncover which patients are more likely to have valvular disease progression using demographic factors, EKG and echocardiogram (ECHO) findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper utilized the EchoNext Database, which pairs 100,000 electrocardiograms and echocardiograms based on specific structural heart disease labels. Univariate and multivariate logistic regression were used to find risk factors for progression for aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), tricuspid regurgitation (TR) and pulmonary insufficiency (PI). Progression was defined as worsened valvular disease on follow up ECHOs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 100,000 encounters of EKGs/ECHOs included in the study, and 36,286 individual patients. Independent risk factors of AS progression were age and QRS duration. Age, QRS duration, AS, AR, MR and pericardial effusion were independent risk factors for AR progression. MR progression was independently associated with PR, QRS and QTc durations, MR and left ventricular ejection fraction. QRS duration, MR, TR and right ventricular function were independent factors for TR progression. Lastly, for PI progression, male sex and AS were found to be independent risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of demographic, electrocardiographic and echocardiographic findings can help better assess the progression of valvular disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392245","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 Appendage Mechanical Dysfunction in De Novo Organized Left Atrial Tachyarrhythmia: A Multicenter Pre-Ablation Study","authors":"Maciej Wójcik,&nbsp;Paweł Błaszkiewicz,&nbsp;Bartłomiej Bińkowski,&nbsp;Marek Kiliszek,&nbsp;Piotr Denysiuk,&nbsp;Tomasz Kucejko","doi":"10.1111/echo.70545","DOIUrl":"10.1111/echo.70545","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Whether de novo organized left atrial tachyarrhythmia (LAT) shows preserved left atrial appendage (LAA) mechanics has not been adequately characterized. We compared LAA peak emptying velocity across atrial fibrillation (AF) phenotypes and de novo LAT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multicenter retrospective cohort of 634 consecutive first-ablation candidates undergoing pre-ablation transesophageal echocardiography (TEE) at five centers: paroxysmal AF (PAF, <i>n</i> = 146), persistent AF (PeAF, <i>n</i> = 310), long-standing persistent AF (LsPeAF, <i>n</i> = 86), and LAT (<i>n</i> = 92). Markedly reduced LAA function was peak emptying velocity &lt;25 cm/s. Multivariable regression adjusted for rhythm during TEE, CHA₂DS₂-VASc, body mass index (BMI), left ventricular ejection fraction (LVEF), and left atrial (LA) diameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean LAA velocity was 55.7 ± 19.4 (PAF), 44.3 ± 18.5 (PeAF), 31.0 ± 12.5 (LsPeAF), and 36.6 ± 13.5 cm/s (LAT); <i>p</i> &lt; 0.001. LAT lay closer to LsPeAF than to PAF and did not differ from LsPeAF (Tukey <i>p</i> = 0.140). Prevalence of velocity &lt;25 cm/s: 2.7%, 11.9%, 32.6% and 18.5% (<i>p</i> &lt; 0.001). After adjustment, larger LA diameter (<i>β</i> = −0.53/mm, <i>p</i> &lt; 0.001) and higher CHA₂DS₂-VASc (<i>β</i> = −1.93/point, <i>p</i> &lt; 0.001) were independently associated with lower velocity. Compared with LAT, PAF had lower odds of velocity &lt;25 cm/s (OR 0.19, 95% CI 0.06–0.62).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>De novo organized LAT exhibits LAA mechanical dysfunction comparable to long-standing persistent AF rather than to PAF. Organized rhythm does not imply preserved appendage function. LAA peak emptying velocity may serve as a functional remodeling marker for pre-ablation phenotyping.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392316","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}