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

{"title":"Echocardiographic Diagnosis of Post-Myocardial Infarction Interventricular Septal Dissection With Mobile Thrombus","authors":"Yating Liu,&nbsp;Jiayu Zhao,&nbsp;Fang Zhang","doi":"10.1111/echo.70301","DOIUrl":"10.1111/echo.70301","url":null,"abstract":"<div>\u0000 \u0000 <p>A 59-year-old male presented with an acute embolic stroke. Subsequent workup revealed an acute anterior ST-elevation MI. Echocardiography demonstrated a large (82 × 32 mm) dissection cavity in the mid-to-apical septum, containing a mobile thrombus, which communicated with the left ventricular cavity through a 2-mm endocardial tear. Despite conservative management, the patient experienced sudden cardiac death (SCD).</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082257","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 Global Longitudinal Strain and Long-Term Transplant-Free Survival in Fontan Patients","authors":"Assami Rösner,&nbsp;Simone Goa Diab,&nbsp;Mark K. Friedberg,&nbsp;George K. Lui","doi":"10.1111/echo.70297","DOIUrl":"10.1111/echo.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Patients with single-ventricle physiology undergoing Fontan operations face high morbidity and mortality risks. While classic-pattern dyssynchrony (CPD) and protein-losing enteropathy (PLE) are known predictors of adverse outcomes, the role of global longitudinal strain (GLS) as an independent predictor of heart failure remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of 135 Fontan-operated patients from 2014 to 2015 evaluated the predictive value of GLS alongside PLE and CPD on mortality and transplantation after 9 years. Echocardiographic data, including GLS, were analyzed using speckle tracking strain analysis in 132 patients. The primary endpoint was transplant-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 132 Fontan patients, 15 had classic-pattern dyssynchrony, 29 had protein-losing enteropathy, 37 had moderately reduced global longitudinal strain (GLS ←8% ≥–16%), and 18 had severely reduced GLS (≥–8%). Cox regression analysis showed moderately reduced GLS increased mortality risk (HR 5.8, 95% CI 1.27–26.5, <i>p</i> = 0.023), with severely reduced GLS showing an HR of 10.3 (95% CI 2.18–48.6, <i>p</i> = 0.003). These results were comparable to CPD (HR 11.5, <i>p</i> = 0.002) and PLE (HR 14.9, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Global longitudinal strain emerged as the best independent factor for predicting long-term transplant-free survival in Fontan patients, highlighting the importance of GLS assessment in routine follow-up to identify high-risk individuals for early intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082191","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":"Fetal Myocardial Performance Index in the Late Third Trimester for the Prediction of Intrapartum Cardiotocographic Abnormalities","authors":"Sikolia Z. Wanyonyi,&nbsp;Ingrid Gichere","doi":"10.1111/echo.70300","DOIUrl":"10.1111/echo.70300","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We sought to determine whether fetal myocardial performance index (MPI) performed in the late third trimester could predict abnormal intrapartum cardiotocographic (CTG) patterns.&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 prospective observational study including women presenting for fetal growth ultrasound from 32 weeks. Three consecutive measurements of the left ventricular MPI were obtained and averaged. The patients’ intrapartum CTG events were later observed.&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;A total of 299 women were analyzed. The fetal MPI across the population were 0.41, 0.50 and 0.63, representing 10th, 50th and 90th centiles, respectively. A one-way analysis of variance (ANOVA) did not show a significant difference in MPI values across intrapartum findings for normal, suspicious and pathological CTGs [&lt;i&gt;F&lt;/i&gt; (3, 298) = 0.417, &lt;i&gt;p&lt;/i&gt; = 0.57], and upon logistic regression, no relationship was observed between MPI and abnormal intrapartum CTG: odds ratio (OR) 2.15; 95% confidence interval (95% CI) (0.036–160.9); &lt;i&gt;p&lt;/i&gt; = 0.718. There was also no difference in mean fetal MPI for those women who had pre-eclampsia [0.36; 95% CI (-0.04 to 0.05); &lt;i&gt;p&lt;/i&gt; = 0.76], gestational diabetes [&lt;i&gt;t&lt;/i&gt; (57.31) = -0.34, &lt;i&gt;p&lt;/i&gt; = 0.73] and fetal growth restriction [0.49; 95% CI (-0.02 to 0.06); &lt;i&gt;p&lt;/i&gt; = 0.56] compared to the low-risk women. Furthermore, MPI had a modest sensitivity (62.5%) and specificity (50.9%) with a positive and negative predictive value of 31.3% and 79.2%, respectively, for detecting abnormal intrapartum CTG. The discriminatory ability of MPI for abnormal CTG was also poor (AUC = 0.53), besides having minimal diagnostic value (positive likelihood ratio of 1.27% and negative predictive value of 0.74%). No association was found between fetal MPI and admission to neonatal intensive care unit: OR 0.53; 95% CI (0.19–1.51).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fetal MPI obtained in the late third trimester is a poor predictor for abnormal intrapartum fetal heart patterns and neonatal outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Summary&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Myocardial performance index is higher in fetuses with fetal growth restriction, obstetric cholestasis, gestational diabetes mellitus and is associated with adverse perinatal outcomes.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Myocardial hypoxia could lead to abnormal intrapartum fetal heart rate patterns on cardiotocogram.&lt;/li&gt;\u0000 \u0000 ","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082308","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":"Effect of Cardioprotection on the Right Ventricular Function in Breast Cancer Patients Receiving Potentially Cardiotoxic Therapy: A SAFE Trial Substudy","authors":"Maria Riccarda Del Bene,&nbsp;Icro Meattini,&nbsp;Giuseppe Pilato,&nbsp;Carlotta Becherini,&nbsp;Francesca Martella,&nbsp;Viola Salvestrini,&nbsp;Livia Marrazzo,&nbsp;Calogero Saieva,&nbsp;Iacopo Olivotto,&nbsp;Giuseppe Barletta,&nbsp;Lorenzo Livi","doi":"10.1111/echo.70291","DOIUrl":"10.1111/echo.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the effects of cardioprotective therapy (CPT) with neurohormonal inhibitors on cancer therapeutics–related cardiac dysfunction (CTRCD) in breast cancer patients, focusing on right ventricular (RV) function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a secondary analysis of SAFE study, a randomized, phase 3, double-blind, placebo-controlled, four-arm trial, in which the effects of short-term CPT (bisoprolol, ramipril, or both) compared to placebo (P-arm) on subclinical CTRCD were evaluated in 222 women without cardiac risk factors who received intensive anthracycline-based chemotherapy (median isoequivalent doxorubicin dose 288 mg/m²). Among them, 35% received trastuzumab, 98% taxanes, 22% underwent neoadjuvant therapy, 78% adjuvant therapy, and 56% had postoperative radiotherapy. CPT started with chemotherapy and continued for 1 year, or until the completion of trastuzumab therapy. All the patients underwent cardiac surveillance at baseline and 3, 6, 12, and 24 months. Left ventricular CTRCD was assessed following the 2022 ESC guidelines. RV function was evaluated according to established recommendations. RV CTRCD was defined as a greater than 10% reduction in RV fractional area change (FAC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 24 months, LV CTRCD was observed in 42.9% of P-arm and 3.1% of the CPT arms (<i>p</i> &lt; 0.001). Compared to the CPT arms, there was a significant reduction in RV FAC (−10.5%), S’-wave velocity (−12.2%), and tricuspid annular plane systolic excursion (−9.6%) in the P-arm. Additionally, the RV diameter increased by 7% in the P-arm. RV CTRCD was found in 49.2% of the P-arm and 22% of the CPT arms (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Short-term neurohormonal cardioprotection was effective in reducing RV CTRCD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082259","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":"Optimizing the Diagnostic Model for Cardiac Amyloidosis: The Role of Segmental Strain, Myocardial Work, and Biomarkers","authors":"Jieyu Ling,&nbsp;Jian Wu","doi":"10.1111/echo.70303","DOIUrl":"10.1111/echo.70303","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071042","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":"Pre-Operative Reduced Atrial Compliance Is Predictive of Post-Operative Atrial Fibrillation in Patients Undergoing Esophagectomy","authors":"Michal Schäfer,&nbsp;Brian Mitzman,&nbsp;Courtney L. Scaife,&nbsp;Jessica Magarinos,&nbsp;Satvik Ramakrishna,&nbsp;Ethan Tumarkin,&nbsp;Bryce Hill,&nbsp;Thomas K. Varghese Jr,&nbsp;Nicolas Contreras","doi":"10.1111/echo.70298","DOIUrl":"10.1111/echo.70298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are no established predictors of postoperative atrial fibrillation (POAF) in patients undergoing esophagectomy. This study aimed to determine whether pre-operative bi-atrial strain might predict POAF in patients undergoing esophageal resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent esophagectomy and had preoperative echocardiography underwent comprehensive myocardial strain analysis measuring left and right atrial (LA and RA) phase-specific strain and left and right global longitudinal strain (LV and RV GLS). Clinical and traditional variables were sampled and considered for multivariable models with the POAF serving as a primary outcome of the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-nine patients constituted the study group and the incidence of POAF was 25.4% (<i>N</i> = 15). Patients who developed POAF were older and had a higher rate of anastomotic leak. LA strain analysis was overall suggestive of reduced LA compliance in the POAF group with decreased LA reservoir strain (33.9 ± 8.9 vs. 22.0 ± 8.8%, <i>p</i> &lt; 0.001) and LA conduit strain (−18.4 ± 9.2 vs. −9.6 ± 5.5%, <i>p</i> &lt; 0.001). RA reservoir strain was also reduced in the POAF group (36.9 ± 8 vs. 29.6 ± 8.1%, <i>p</i> = 0.006) together with reduced RA conduit strain (−20.6 ± 6.9 vs. −15.4 ± 7.6%, <i>p</i> = 0.042). LV GLS was decreased in patients with POAF (−16.2 ± 3.5 vs. −12.3 ± 7.5%, <i>p</i> = 0.036), along with RV GLS (−17.6 ± 3.4 vs. −14.4 ± 3.8%, <i>p</i> = 0.009). Reduced LA reservoir strain remained an independent predictor for POAF when combined with the presence of an anastomotic leak [OR: 0.85 (95% CI: 0.75–0.92), <i>p</i> &lt; 0.001] yielding model with AUC of 0.86 with a sensitivity 60.0% and specificity 90.1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reduced bi-atrial compliance evidenced by standard echocardiographic strain analysis predicts POAF in patients undergoing esophagectomy. Comprehensive echocardiographic evaluation should be considered in surgical candidates before esophageal surgery, given the detected subclinical global myocardial dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034644","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":"The Muscle Mass Paradox: Elevated Lean Mass Indices Impair Systolic Function via Myocardial Remodeling in Obesity","authors":"Hailong Zhang,&nbsp;Jiali Fan,&nbsp;Rui Han,&nbsp;Junyu Zhao,&nbsp;Zengning Li,&nbsp;Haipeng Wang","doi":"10.1111/echo.70283","DOIUrl":"https://doi.org/10.1111/echo.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore the relationships between cardiac parameters and body composition indices, identifying predictors of subclinical cardiac systolic dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using anthropometric and serological parameters, echocardiography, and body composition analysis, this study evaluated metabolic profiles, cardiac remodeling patterns, and body composition characteristics in young adult obese patients, while quantifying the correlations between cardiac parameters and body composition indices. Subclinical left ventricular systolic dysfunction was defined as global longitudinal strain (GLS) &lt; 18%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 91 obese participants categorized as metabolically healthy obesity (MHO) group (<i>n</i> = 25) and metabolically unhealthy obesity (MUO) group (<i>n</i> = 66), with 20 healthy controls as reference. Compared with controls, both MUO and MHO groups showed reduced myocardial longitudinal strain (all <i>p </i>&lt; 0.05), with greater impairment in MUO than MHO. Impaired GLS occurred in 31 obese participants (34.07%), who showed higher fat-free mass index (FFMI), and skeletal muscle mass index (SMI) compared to those with preserved GLS (all <i>p </i>&lt; 0.05). Correlation analysis revealed significant associations between body composition indices and cardiac parameters. Multivariate logistic regression identified SMI (OR 1.81, 95% CI 1.12–2.93, <i>p </i>&lt; 0.001) and FFMI (OR 1.43, 95% CI 1.07–1.91, <i>p </i>&lt; 0.001) as independent predictors of impaired GLS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Impaired GLS commonly manifests in obese individuals. SMI and FFMI were established as independent predictors of this cardiac dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007950","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":"Reduced Peak Myocardial Work Efficiency With Coronary Flow Velocity Reserve Predicts Significant Coronary Artery Stenosis in Chronic Coronary Syndrome","authors":"Yu Xie,&nbsp;Jing Zhang,&nbsp;Jingrong Jiang,&nbsp;Ruohan Zhao,&nbsp;Zhen Wang,&nbsp;Yun Yang,&nbsp;Danni Liu,&nbsp;Min Cheng,&nbsp;Jing Yuan,&nbsp;He Li,&nbsp;Li Zhang,&nbsp;Mingxing Xie,&nbsp;Jing Wang","doi":"10.1111/echo.70284","DOIUrl":"https://doi.org/10.1111/echo.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Identification of significant coronary artery stenosis (CAS) in patients with chronic coronary syndromes (CCS) is crucial for clinical management. Myocardial work (MW) is a new noninvasive method reflecting myocardial metabolism and has been applied in myocardial ischemia. We aimed to explore the value of global MW during vasodilator stress echocardiography in detecting significant CAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with angina or equivalent symptoms underwent coronary angiography and vasodilator stress echocardiography. Significant CAS was defined as ≥70% luminal stenosis in one or more major epicardial vessels or ≥50% in the left main coronary. Global MW was analyzed by speckle-tracking echocardiography with blood pressure. The diagnostic performance of MW parameters in detecting significant CAS was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred forty-six patients were enrolled into the study, and 67 patients had significant CAS. Coronary flow velocity reserve (CFVR), global longitudinal strain (GLS), global MW index (MWI), and global MW efficiency (MWE) were significantly lower in the significant CAS group than those in the non-significant group both at rest and peak stress (<i>p</i> &lt; 0.001 for CFVR, GLS, MWE; <i>p</i> &lt; 0.01 for MWI). Logistic regression analyses showed that CFVR and peak MWE effectively predicted significant CAS. Peak MWE outperformed other parameters with the highest area under the curve (AUC) of 0.820. Furthermore, the model integrating CFVR and peak MWE (AUC = 0.886) was much better than CFVR or peak MWE alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Peak MWE combined with CVFR might be a reliable method of noninvasively screening significant CAS in patients with CCS before invasive angiography.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998606","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":"3D Imaging of Mitral Valve Perforation as a Complication of Austrian Syndrome","authors":"Nitya Panyala,&nbsp;Kyle Rusin,&nbsp;Nathan D. Wheeler","doi":"10.1111/echo.70285","DOIUrl":"https://doi.org/10.1111/echo.70285","url":null,"abstract":"<p>The following are echocardiographic findings in a 68-year-old male with Austrian syndrome.</p><p>The patient presented with sinus drainage, headache, fever, mild productive cough, and conjunctivitis, all of which worsened over 2 weeks. Physical exam revealed a holosystolic murmur in the apex radiating to the axilla, and bilateral rales on auscultation. The work-up revealed multidrug-resistant Streptococcus pneumoniae bacteremia, meningitis, and right eye endophthalmitis.</p><p>Initially, a transthoracic echocardiogram (TTE) was ordered to determine if there was any valvular involvement. TTE findings confirmed mitral valve vegetation and quantified the mitral regurgitation (MR) as severe (Figure 1). Measurements included a peak MR gradient of 71.4 mmHg, an MR volume of 83.9 mL, and an MR effective regurgitant orifice area (EROA) of 0.8 cm². The MR volume and EROA were measured using the proximal isovelocity surface area (PISA) method [<span>1</span>].</p><p>Transesophageal echocardiography (TEE) was performed to obtain a detailed view of the vegetation and to detect any other potential structural abnormalities. A large vegetation was seen on the mitral valve with associated anterior leaflet perforation (Figures 2, 3), resulting in severe regurgitation (Figure 4). These findings represented advanced valvular destruction, a hallmark of aggressive pneumococcal endocarditis.</p><p>The constellation of pneumococcal endocarditis, meningitis, and pneumonia established the diagnosis of Austrian syndrome, a rare but classical triad associated with invasive pneumococcal disease [<span>2</span>].</p><p>The confirmation of a massive mitral valve vegetation with anterior leaflet perforation established the anatomical basis for severe regurgitation, thus requiring surgical intervention. The patient responded favorably to antibiotic therapy with eventual clearance of bacteremia. Following clinical stabilization, cardiothoracic surgery was consulted, and the patient subsequently underwent successful mitral valve replacement.</p><p>This case is notable for its devastating echocardiographic findings related to Austrian syndrome, which revealed a massive vegetation on the mitral valve. The vegetation caused a perforation extending through both the vegetation and the anterior leaflet. This case illustrates the highly destructive nature of pneumococcal endocarditis, which can rapidly erode cardiac tissue and necessitate emergency surgical intervention.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935291","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":"A Paradox Within the Paradox: Beyond Body Composition Indices, Waist Circumference, and Non-Radiological Anteroposterior Thoracic Diameter as Predictors of Subclinical Myocardial Dysfunction in Obesity","authors":"Andrea Sonaglioni,&nbsp;Gian Luigi Nicolosi","doi":"10.1111/echo.70293","DOIUrl":"https://doi.org/10.1111/echo.70293","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935292","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}