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

{"title":"Clinical and Echocardiographic Characteristics of Left Atrial Diverticulum","authors":"Yoshihito Saijo,&nbsp;Hirotsugu Yamada,&nbsp;Natsumi Yamaguchi,&nbsp;Susumu Nishio,&nbsp;Robert Zheng,&nbsp;Tomonori Takahashi,&nbsp;Tomoya Hara,&nbsp;Muneyuki Kadota,&nbsp;Yutaka Kawabata,&nbsp;Rie Ueno,&nbsp;Tomomi Matsuura,&nbsp;Takayuki Ise,&nbsp;Koji Yamaguchi,&nbsp;Shusuke Yagi,&nbsp;Takeshi Soeki,&nbsp;Tetsuzo Wakatsuki,&nbsp;Masataka Sata","doi":"10.1111/echo.70200","DOIUrl":"https://doi.org/10.1111/echo.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Remarkable advancements in cardiac computed tomography (cCT) have provided new insights into previously undescribed anatomical structures, such as the left atrial diverticula (LADs). The aims of the present study were to assess the characteristics of LADs and their relationship with cardiac function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed consecutive patients who underwent preprocedural cCT and transthoracic echocardiography (TTE) for catheter ablation of paroxysmal or persistent atrial fibrillation between January 2020 and 2022. LADs were identified on cCT as smooth contoured protrusions extending from the left atrial wall. LADs were classified as cystiform (body length/orifice width ratio &lt;2) or tubiform (body length/orifice width ratio ≥2), and their volume was measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 201 patients (mean age: 65 ± 12 years, 66% male), 124 LADs were detected in 105 patients, with 19 patients having two LADs each. Of these, 99 (80%) were classified as cystiform, and 25 (20%) as tubiform. No statistically significant differences were observed in the clinical and echocardiographic characteristics between patients with and without LADs. Log-transformed volume of tubiform LADs showed a moderate correlation with age (<i>R</i> = 0.62; <i>p</i> = 0.001), and mild correlations with LA volume index (<i>R</i> = 0.40; <i>p</i> = 0.05), and <i>E</i>/<i>e′</i> (<i>R</i> = 0.44; <i>p</i> = 0.027). However, no such associations were observed for cystiform LADs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LADs were present in approximately half of the patients, with no significant association between LADs prevalence and clinical or echocardiographic characteristics. However, the relationship between LAD volume and cardiac function varied depending on the LAD subtypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944839","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":"Identifying Subtle Fetal Cardiac Alterations in Controlled Gestational Diabetes: A Dream Come True Utilizing the Innovative Fetal Heart Quantification Imaging","authors":"Shaimaa Rakha","doi":"10.1111/echo.70188","DOIUrl":"https://doi.org/10.1111/echo.70188","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938735","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":"Rare Case of Ruptured Sinus of Valsalva Aneurysm","authors":"Wensi Wang,&nbsp;Zhejun Zhang,&nbsp;Xin Guan,&nbsp;Lianqun Wang,&nbsp;Yuhui Zhang","doi":"10.1111/echo.70185","DOIUrl":"https://doi.org/10.1111/echo.70185","url":null,"abstract":"<div>\u0000 \u0000 <p>This manuscript presents a rare case of ruptured sinus of Valsalva aneurysm, which broke into the peri-membranous part of interventricular septum, forming a contained hematoma and protruded into the left ventricular outflow tract with fungal infective endocarditis. Echocardiography and computed tomography played a crucial role in the diagnosis of this complex case.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939066","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":"Relationship Between Human Atrial Natriuretic Peptide and Tricuspid Valve Annular Dilatation in Patients With Atrial Fibrillation","authors":"Kanako Izumi,&nbsp;Hiroto Utsunomiya,&nbsp;Kiyotaka Tohgi,&nbsp;Makoto Takeuchi,&nbsp;Ayano Hamada,&nbsp;Yohei Hyodo,&nbsp;Akane Tsuchiya,&nbsp;Atsuo Mogami,&nbsp;Yusuke Ueda,&nbsp;Kosuke Takahari,&nbsp;Yukiko Nakano","doi":"10.1111/echo.70193","DOIUrl":"https://doi.org/10.1111/echo.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) may cause right-sided heart remodeling such as tricuspid valve annular (TVA) dilatation, leading to atrial functional tricuspid regurgitation with prognostic impact. Not all AF patients develop TVA dilatation; therefore, predicting its occurrence is challenging. This study aimed to investigate human atrial natriuretic peptide (hANP) as a potential diagnostic marker of TVA dilatation in AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 346 patients with lone AF (222 paroxysmal AF [paroxAF], 124 persistent AF [persAF]) who underwent 2-dimensional (2D) transthoracic and 3-dimensional (3D) transesophageal echocardiography (TEE) were retrospectively reviewed. This cohort was considered to have normal tricuspid valve geometry screening by 3D-TEE and having no left-side heart disease, pulmonary hypertension, and right ventricular dysfunction. We evaluated the association of plasma hANP concentration with AF-related right-sided heart remodeling including right atrial (RA) dilatation and TVA dilatation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Plasma hANP levels showed a correlation with RA area index in the paroAF group (<i>r</i> = 0.27, <i>p</i> &lt; 0.001) but not in the persAF group. In contrast, as for association with 3D TVA area, plasma hANP levels demonstrated an inverse correlation with 3D TVA area (<i>r</i> = −0.25, <i>p</i> = 0.005) in the persAF group, especially with TVA diameter in the anterior-posterior direction, but not in the paroAF group. Multivariate analysis revealed that reduced hANP levels were independently associated with TVA dilatation (per 1 increase in Log₁₀hANP, <i>β</i>: −0.17 [95% CI: −306.7 to −7.59]; <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Declining plasma hANP levels may serve as a marker for diagnosing TVA dilatation in persAF patients, highlighting its potential role in assessing AF-related structural changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939065","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 Tract Lesion in a Patient With Rheumatic Valvular Disease: MacCallum Plaque?","authors":"Maria Gabriela Matta,&nbsp;Ahmed Reza,&nbsp;Bradley Hefford,&nbsp;Atifur Rahman","doi":"10.1111/echo.70178","DOIUrl":"https://doi.org/10.1111/echo.70178","url":null,"abstract":"<p>Transesophageal echocardiogram in long axis view showing a mass in the left ventricular outflow tract (LVOT) in diastole (left) and systole (right), with a maximum length of 1.2 cm and erratic motion, likely resulting from mechanical trauma due to aortic regurgitation jet impact in a patient with chronic rheumatic valvulopathy. Ao, ascending aorta; LA, left atrium; LV, left ventricle; LVOT, left ventricle outflow tract.\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 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926163","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":"Exploring the Link Between Left Atrial Strain and Exercise-Induced Pulmonary Hypertension","authors":"Bjørn Strøier Larsen,&nbsp;Tor Biering-Sørensen,&nbsp;Flemming Javier Olsen","doi":"10.1111/echo.70187","DOIUrl":"https://doi.org/10.1111/echo.70187","url":null,"abstract":"&lt;p&gt;Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately half of all HF cases and represents a growing public health burden with substantial morbidity, mortality, and healthcare costs [&lt;span&gt;1, 2&lt;/span&gt;]. With the emergence of available treatment options, such as sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists, there is an increased clinical focus on diagnosing and phenotyping HFpEF [&lt;span&gt;3&lt;/span&gt;]. However, current diagnostic algorithms remain limited in sensitivity and specificity [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this context, left atrial (LA) dysfunction is increasingly recognized as a key contributor to HFpEF pathophysiology and a promising target for improving diagnostic accuracy. Several studies have demonstrated its prognostic value in predicting mortality and HF-related hospitalizations in this population [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Exercise-induced pulmonary hypertension (EIPH) is believed to be an early mechanism contributing to symptoms in HFpEF and may serve as a precursor to overt pulmonary hypertension [&lt;span&gt;6&lt;/span&gt;]. Right heart catheterization (RHC) remains the gold standard for diagnosing and classifying EIPH [&lt;span&gt;7&lt;/span&gt;]. However, its invasive nature with associated procedural risks, albeit low, limits feasibility for widespread clinical application. Stress echocardiography has emerged as a noninvasive alternative for estimating markers associated with abnormal exercise hemodynamics, such as EIPH [&lt;span&gt;8&lt;/span&gt;]. However, consensus on a definitive EIPH definition or a standardized testing protocol with this modality is still lacking [&lt;span&gt;9, 10&lt;/span&gt;]. Furthermore, stress echocardiography requires experienced operators, limiting its availability. As a result, identifying noninvasive markers of EIPH using standard echocardiographic protocols is a desirable goal.&lt;/p&gt;&lt;p&gt;In this issue of &lt;i&gt;the journal&lt;/i&gt;, Kinoshita et al. provide additional insights into the potential value of considering LA dysfunction in patients with HFpEF [&lt;span&gt;11&lt;/span&gt;]. In a retrospective study of 188 patients undergoing stress echocardiography, they explored the relationship between LA reservoir strain and EIPH. EIPH was defined as a peak tricuspid regurgitation gradient of &gt; 50 mmHg and was observed in 34 (18%) of the patients.&lt;/p&gt;&lt;p&gt;The primary finding of the study is that LA reservoir strain at rest was associated with EIPH, with an optimal cut-off value of 21% to discriminate EIPH for a modest area under the curve of 0.69, corresponding to a sensitivity and specificity of 73.5% and 59.1%, respectively. Importantly, the association between LA reservoir strain and EPIH remained significant in multivariable logistic regression analysis.&lt;/p&gt;&lt;p&gt;Collectively, these findings suggest that impaired LA reservoir strain at rest may allude to the presence of elevated pulmonary pressures during exercise. LA reservoir strain is determin","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926101","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":"Methamphetamine-Associated Pulmonary Arterial Hypertension Is Associated With Worse Right Ventricular Function Than Idiopathic Pulmonary Arterial Hypertension: A Matched Study","authors":"Emily O'Neill,&nbsp;Dai-Yin Lu,&nbsp;Satvik Ramakrishna,&nbsp;Dominique Ingram,&nbsp;Benjamin Kogelschatz,&nbsp;John J. Ryan,&nbsp;Jennalyn Mayeux,&nbsp;Christy Ma,&nbsp;Dana Klanderud,&nbsp;Emily Beck,&nbsp;Elizabeth Dranow,&nbsp;Nathan Hatton,&nbsp;Katharine Clapham","doi":"10.1111/echo.70180","DOIUrl":"https://doi.org/10.1111/echo.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Methamphetamine is increasingly recognized as a cause of pulmonary arterial hypertension (PAH). This study examines whether non-invasively measured metrics of right heart function, right atrial (RA) and right ventricular (RV) strain, are more impaired in methamphetamine-associated PAH (MA-PAH) compared with idiopathic PAH (IPAH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis of 51 patients with MA-PAH matched for mean pulmonary artery pressure (mPAP) with 51 patients with IPAH followed at the pulmonary hypertension clinic at the University of Utah was performed. Invasive hemodynamics and echocardiographic measures of right heart function, including RA strain and RV free wall strain, were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the matched IPAH group, MA-PAH patients had lower cardiac index (2.04 ± 0.84 vs. 2.52 ± 1.07 L/min/m², <i>p</i> = 0.016) and higher pulmonary vascular resistance (PVR; 11.8 ± 6.8 vs. 8.9 ± 4.8 Wood units, <i>p</i> = 0.018). The MA-PAH group had larger RA maximal and minimal volume, lower RA reservoir strain (26.4 ± 11.7 vs. 33.4 ± 14.8 %, <i>p</i> = 0.011), more significant RV chamber dilation, and lower fractional area change (FAC; 21.1 ± 11.1 % vs. 34.5 ± 11.8 %, <i>p</i> &lt; 0.001), compared to the IPAH group. RV e’ was lower in MA-PAH (6.5 ± 2.8 cm/s vs. 8.3 ± 4.3 cm/s, <i>p</i> = 0.021), suggesting worse RV diastolic function and RV free wall strain was significantly more reduced compared to patients with I-PAH (17.0 ± 6.5 vs. 22.3 ± 7.2 %, <i>p</i> &lt; 0.001). There were no differences in 5-year survival (<i>p</i> = 0.26), 6MW distance including stratification for males and females (<i>p</i> = 0.249 in females, <i>p</i> = 0.279 in males), and rehospitalization rates within 5 years of diagnosis (<i>p</i> = 0.70).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Despite a similar mPAP, patients with MA-PAH had more RA dilation, RV dilation, lower RV systolic/diastolic function, and worse RA and RV mechanics as assessed by strain compared to patients with I-PAH. Our findings suggest that, in addition to causing remodeling of the pulmonary vasculature, methamphetamine may have a direct cardiotoxic effect on the right heart.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905270","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":"PWV to GLS Ratio in the General Population: Reference Values, Correlates, and Predictive Value of a Noninvasive Ventricular-Arterial Index","authors":"Nicholas Cauwenberghs,&nbsp;Hannah Vanwinkel,&nbsp;Evangelos Ntalianis,&nbsp;Everton J. Santana,&nbsp;František Sabovčik,&nbsp;Werner Budts,&nbsp;Francois Haddad,&nbsp;Tatiana Kuznetsova","doi":"10.1111/echo.70172","DOIUrl":"https://doi.org/10.1111/echo.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Noninvasive imaging markers combining ventricular and arterial properties may help predict cardiac disease. We conducted a general population study to determine reference values, clinical correlates, and the predictive value of the ratio of the carotid-femoral pulse wave velocity (cfPWV) to the left ventricular global longitudinal strain (GLS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We measured cfPWV by applanation tonometry and 4-chamber GLS by echocardiography in 1026 individuals (mean age 50.3 years; 52% women). We derived reference values for cfPWV/GLS from a low-risk subsample. Clinical correlates of cfPWV/GLS were determined by stepwise regression. We calculated multivariable-adjusted hazard ratios (HR) for incident cardiovascular (CV) events (median follow-up: 10.1 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Upper limits of normality for cfPWV/GLS varied with sex and age, ranging from 0.41 m/s% in young women up to 0.64 m/s% in older men. Higher cfPWV/GLS correlated directly with male sex, age, heart rate, pulse pressure, mean arterial pressure, and left ventricular mass (<i>p </i>&lt; 0.05 for all). On a continuous scale, only GLS was a significant predictor of CV events after adjustment (HR per 1% decrease: 1.11; <i>p </i>= 0.0078). A cfPWV/GLS ratio above the median (&gt;0.37 m/s%) did predict future CV events after adjustment (HR vs. below median: 2.02; <i>p </i>= 0.0067). However, abnormal cfPWV/GLS defined by reference limits or by cutoffs from literature did not independently predict CV events (<i>p </i>≥ 0.31 for all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age- and sex-specific reference values for cfPWV/GLS were reported. cfPWV/GLS related to age, sex, and blood pressure. In contrast to GLS, cfPWV/GLS did not emerge as an independent predictor for CV events in the community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909259","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":"Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta","authors":"Melody Farrashi,&nbsp;Shirin Habibi Khorasani,&nbsp;Ahmadreza Tanbakookar,&nbsp;Hamid Reza Pouraliakbar,&nbsp;Bahram Mohebbi,&nbsp;Jamal Moosavi,&nbsp;Mohammadreza Iranian,&nbsp;Seyed Mohammad Forouzannia,&nbsp;Mohammadreza Babaei,&nbsp;Arya Afrooghe,&nbsp;Ata Firouzi,&nbsp;Reza Kiani,&nbsp;Amineh Safavirad,&nbsp;Ehsan Khalilipur,&nbsp;Zahra Khajali,&nbsp;Sedigheh Saedi,&nbsp;Hooman Bakhshandeh,&nbsp;Parham Sadeghipour","doi":"10.1111/echo.70181","DOIUrl":"https://doi.org/10.1111/echo.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited research has explored the transformation of echocardiographic parameters during mid- to long-term follow-up in patients with native coarctation of the aorta (CoA) managed through stenting. This study assesses changes in echocardiographic parameters among patients undergoing stent coarctoplasty, by comparing baseline and 3-year transthoracic echocardiographic (TTE) parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In our earlier work, we detailed the 3-year clinical safety and efficacy outcomes of balloon-expandable versus self-expandable stents for treating native CoA within a randomized clinical trial. The current substudy aims to assess the mid-term effects of stenting by examining all participants with available baseline and 3-year core laboratory-confirmed TTE data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 92 patients enrolled in the randomized trial, 32 individuals (median age: 32 years [IQR: 24.8–37.5]) were included in this substudy. At the 3-year follow-up, significant improvements were observed in myocardial diastolic function, characterized by increased septal E′ and lateral E′ velocities (<i>p</i> = 0.02 and <i>p</i> = 0.03, respectively) and decreased septal and lateral E/E′ ratios (10.84 ± 2.83 to 9.21 ± 3.17, <i>p</i> = 0.02 and 7.39 ± 2.24 to 6.29 ± 1.97, <i>p</i> = 0.02, respectively). At the 3-year follow-up, a significant reduction in left ventricular (LV) mass was observed, decreasing from 160 g (IQR: 130–203) to 142 g (IQR: 121–172) (<i>p</i> = 0.001). Among the 12 patients (37.5%) presenting with baseline LV hypertrophy, nine individuals (75%) experienced normalization, demonstrating a substantial improvement in LV mass. Additionally, the prevalence of diastolic dysfunction significantly decreased from 12 patients (41.3%) to four patients (13.7%) at the 3-year evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In adult patients with <i>de novo</i> native CoA, stent coarctoplasty was found to result in significant and sustained improvements in LV diastolic function and reduced LV mass during the mid-term follow-up. Our findings imply that baseline structural parameters may serve as stronger predictors of long-term therapeutic outcomes than demographic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>Iranian Registry of Clinical Trials: IRCT20181022041406N3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909260","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":"Comparison of Diagnostic Accuracy of CT Derived Fractional Flow Reserve for Predicting Revascularization","authors":"Toshimitsu Tsugu,&nbsp;Kaoru Tanaka,&nbsp;Dries Belsack,&nbsp;Mayuko Tsugu,&nbsp;Nico Buls,&nbsp;Jean-François Argacha,&nbsp;Bernard Cosyns,&nbsp;Yuji Nagatomo,&nbsp;Johan De Mey","doi":"10.1111/echo.70137","DOIUrl":"https://doi.org/10.1111/echo.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>CT-derived fractional-flow-reserve (FFR_CT) is recommended for determining the indication of revascularization. Consensus on optimal fractional-flow-reserve (FFR) measurement methods and lesions is lacking. To investigate the diagnostic accuracy of FFR_CT measurement methods for predicting revascularization and factors affecting FFR_CT measurement methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 340 patients (382 vessels) who underwent CT angiography and showed ≥50% diameter stenosis (DS) on invasive coronary angiography were evaluated. Enrolled vessels were classified into four groups according to lesion length (focal, &lt;40 mm; diffuse, ≥40 mm) and DS (moderate, 50%–69%; severe, 70%–99%). FFR_CT was measured at the distal end of the vessel (vessel-distal FFR_CT), distal to the stenotic lesion (lesion-specific FFR_CT), and trans-lesion FFR_CT (ΔFFR_CT) and compared with DS. Vessel morphology and left ventricular mass were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In focal lesions, the predictive ability for revascularization of ΔFFR_CT (AUC = 0.71) was comparable to that of DS (AUC = 0.76, <i>p</i> = 0.166) and higher than that of lesion-specific FFR_CT (AUC = 0.67, <i>p</i> &lt; 0.001) and vessel-distal FFR_CT (AUC = 0.63, <i>p</i> &lt; 0.001). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFR_CT (<i>β</i>-coefficient = 0.42, <i>p</i> = 0.006). In diffuse lesions, the predictive ability for revascularization of ΔFFR_CT (AUC = 0.73) was comparable to that of DS (AUC = 0.77, <i>p</i> = 0.667), lesion-specific FFR_CT (AUC = 0.72, <i>p</i> = 0.653), and vessel-distal FFR_CT (AUC = 0.69, <i>p</i> = 0.242). Multivariable analysis showed that lesion length was the strongest predictor of ΔFFR_CT (<i>β</i>-coefficient = 0.99, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The predictive performance of ΔFFR_CT for revascularization was similar to DS in focal and diffuse lesions. ΔFFR_CT was influenced by lesion length.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892833","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}