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

{"title":"Imaging the Adult With Secundum Atrial Septal Defect: A Practical Echocardiographic Approach From Diagnosis to Device Closure","authors":"Esra Poyraz,&nbsp;Lale Dinc Asarcikli","doi":"10.1111/echo.70640","DOIUrl":"https://doi.org/10.1111/echo.70640","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Secundum atrial septal defect (ASD) is one of the most common congenital heart defects encountered in adults. Echocardiography plays a central role in diagnosis, assessment of haemodynamic significance, anatomical characterization, transcatheter closure planning, and follow-up. However, the frequently non-circular geometry of secundum ASD can make accurate anatomical assessment challenging, particularly with single-plane measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This narrative review provides a practical echocardiographic approach to adult secundum ASD, emphasizing the complementary roles of transthoracic echocardiography (TTE), multiplanar two-dimensional transesophageal echocardiography (TEE), color Doppler, and three-dimensional (3D) TEE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Content</h3>\u0000 \u0000 <p>TTE provides initial diagnosis and assessment of physiological consequences, including right-sided chamber remodeling, ventricular function, tricuspid regurgitation, and pulmonary pressure. Multiplanar 2D TEE enables systematic assessment of ASD size, morphology, and surrounding septal rims, while measurements obtained in different planes may reveal substantial differences and highlight the limitations of single-plane sizing. 3D TEE provides an en-face spatial representation of the interatrial septum and complements 2D measurements by defining defect geometry, rim relationships, and suitability for transcatheter closure. Haemodynamic assessment should integrate right ventricular volume overload, shunt magnitude, pulmonary vascular status, and left ventricular disease rather than defect diameter alone. Cardiovascular magnetic resonance or cardiac computed tomography may provide complementary information when echocardiography is insufficient to define pulmonary venous connections, anatomy, or haemodynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A systematic multimodality echocardiographic approach integrates anatomical and physiological information throughout the management of adult secundum ASD. Combining TTE, multiplanar 2D TEE, 3D TEE, and targeted advanced imaging can facilitate individualized assessment and informed transcatheter closure planning.</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":"149068603","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":"Arterial-Ventricular Coupling Strain Index as an Independent Predictor of 10-Year ASCVD Risk in Diabetic-Hypertensive Patients","authors":"Anni Chen,&nbsp;Jianxiong Chen,&nbsp;Xinyi Li,&nbsp;Lan Yang,&nbsp;Xinqi Wang,&nbsp;Guiyang Xi,&nbsp;Lin Jin,&nbsp;Zhaojun Li","doi":"10.1111/echo.70641","DOIUrl":"https://doi.org/10.1111/echo.70641","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>The combination of diabetes mellitus and hypertension significantly increases the risk of cardiovascular diseases (CVD). This study aimed to evaluate the association between ventricular-arterial coupling and the 10-year atherosclerotic cardiovascular disease risk (10Y-ASCVDR) in this patient population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational study included 340 participants, all of whom underwent echocardiography, arterial stiffness, and metabolic index assessments. Arterial-ventricular coupling strain index (AVCSI) was evaluated using the arterial velocity pulse index (AVI) to left ventricular global longitudinal strain (LVGLS) ratio. The Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) model was used to predict the 10Y-ASCVDR. Receiver operating characteristic (ROC) curves and logistic regression analysis were employed to assess the ability of the AVCSI to predict 10Y-ASCVDR &gt;10%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariable logistic regression analysis revealed that the AVCSI was an independent predictor of a high 10Y-ASCVDR (β = −0.009, OR = 0.991, 95% CI: 0.984–0.999, <i>p</i> = 0.019). ROC curves analysis demonstrated a high sensitivity (80.56%) of the AVCSI in diagnosing 10Y-ASCVDR &gt;10%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The arterial-ventricular coupling strain index is significantly associated with 10Y-ASCVDR in patients with diabetes and hypertension and may offer additional value for early risk stratification, supporting its potential role in guiding preventive strategies.</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":"149068604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance and Clinical Impact of Point-of-Care Echocardiography for Early Detection of Neonatal Cardiac Lesions: A Systematic Review","authors":"Komal Mushtaq,&nbsp;Muhammad Talha Javeed","doi":"10.1111/echo.70617","DOIUrl":"10.1111/echo.70617","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Congenital heart disease (CHD) remains a leading cause of neonatal morbidity and mortality worldwide, with a significant proportion of cases remaining undetected before birth. While pediatric cardiologist-performed echocardiography represents the diagnostic gold standard, access to specialist services is limited across many neonatal care settings globally. Neonatologist-performed point-of-care echocardiography has emerged as a bedside diagnostic tool; however, the evidence supporting its diagnostic performance and clinical impact requires systematic evaluation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To systematically review the diagnostic performance and clinical impact of point-of-care echocardiography performed by neonatologists or trained non-cardiologist clinicians for the early detection of cardiac lesions in neonates across diverse clinical settings.&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 systematic search of PubMed and Google Scholar was conducted in April 2026, supplemented by reference list screening of all included studies (198 additional records screened), forward citation searches (32 additional records), and a supplementary Embase search conducted in August 2026 in response to peer review. Studies evaluating neonatologist-performed echocardiography in neonates aged 0–28 days, reporting diagnostic performance metrics or clinical impact outcomes with a cardiologist comparator or confirmed diagnosis as reference standard, were included. Methodological quality was assessed using the QUADAS-2 tool. Due to substantial clinical and methodological heterogeneity, findings were synthesized narratively in accordance with PRISMA 2020.&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;Thirteen primary studies (2008–2026, including two ahead-of-print articles) from eleven countries encompassing over 31 800 neonates were included and synthesized across three domains: diagnostic performance and agreement, CHD detection capability, and clinical impact. Concordance between neonatologist and cardiologist echocardiography ranged from 91.15% to 97.9% (kappa 0.68–0.862). One population-based screening study reported sensitivity of 92% and specificity of 99.6%. No cases of missed major or critical CHD were reported in the included studies, although evidence remains limited and predominantly retrospective. Neonatologist-performed echocardiography was associated with management changes in 48%–66% of consultations involving structural or mixed cardiac assessment, and in up to 79% of consultations addressing hemodynamic indications alone (patent ductus arteriosus, pulmonary hypertension, sys","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018646","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":"Development of a Preoperative Transthoracic Echocardiography-Based Nomogram for Predicting 1-Year Cardiovascular Events in End-Stage Renal Disease Kidney Transplant Recipients","authors":"Meishu Pan,&nbsp;Lifang Xu,&nbsp;Yongzhi Cai,&nbsp;Yue Li,&nbsp;Wenze Deng,&nbsp;Ailing Ou,&nbsp;Shuilian Gan,&nbsp;Yingchuan Zhou,&nbsp;Ji Wu","doi":"10.1111/echo.70633","DOIUrl":"10.1111/echo.70633","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kidney transplantation (KT) is optimal therapy for end-stage renal disease (ESRD), yet cardiovascular events (CVEs) are the top cause of morbidity and mortality in transplant recipients. We aimed to build a preoperative transthoracic echocardiography (TTE)-based predictive model combined with clinical and laboratory indicators to stratify post-transplant cardiovascular risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center cohort enrolled 547 ESRD patients receiving KT from 2021 to 2022. Preoperative TTE, clinical and lab data were collected, with 1-year post-transplant CVEs as the primary endpoint. LASSO and multivariate logistic regression screened independent risk factors; ROC, calibration curves and decision curve analysis (DCA) validated model performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall 17.55% (96/547) patients developed 1-year CVEs. Interventricular septal thickness at end-diastole (IVSTd), pulmonary hypertension (PH), aortic valve calcification (AVC) and diabetes history were independent risk factors. The training set AUC reached 0.776 (sensitivity 61.8%, specificity 79.4%, 95%CI 0.711–0.841), and the testing set AUC was 0.749 (95%CI 0.618–0.880). Calibration curves showed favorable consistency, and DCA proved stable clinical net benefit within the 7%–68% threshold range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One-year post-transplant CVE incidence remains high. IVSTd, PH, AVC and diabetes are independent predictors. This TTE-integrated model has reliable discrimination and clinical value for non-invasive cardiovascular risk stratification in KT candidates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972163","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":"Suboptimal Echocardiographic Image Quality Predicts in-Hospital Mortality Across the Adult Age Spectrum, Independent of Admission Type: A Large-Scale NLP Study","authors":"Murat Pehlivan,&nbsp;Yusuf Ziya Şener,&nbsp;Aybüke Uyar,&nbsp;Mert Eşme,&nbsp;Cafer Balcı,&nbsp;Burcu Balam Doğu,&nbsp;Meltem Gülhan Halil,&nbsp;Mustafa Cankurtaran","doi":"10.1111/echo.70613","DOIUrl":"10.1111/echo.70613","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Suboptimal echocardiographic image quality is common and usually treated as a reason for study exclusion, yet discarded studies come disproportionately from older patients. We examined whether it independently predicts in-hospital mortality across the adult age spectrum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 32,813 reports from 19,731 patients (ECHO-NOTE2NUM/MIMIC-III, 2001–2012). A validated natural language processing (NLP) classifier (<i>κ</i> = 0.996) identified suboptimal studies. Multivariable logistic regression, GEE, and IPTW assessed mortality across five age groups (18–49, 50–64, 65–74, 75–84, ≥85 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 9,150 studies (27.9%) were suboptimal, with similar rates across age groups but differing causes (tachycardia and body habitus in younger versus poor acoustic windows in older patients). Suboptimal imaging independently predicted mortality (IPTW OR 1.47, 95% CI 1.41–1.54). Age modified this association (interaction <i>p</i> = 0.04): the effect was consistently elevated across 18–74 and attenuated to 1.20 (1.06–1.35) in patients aged ≥85. Comorbidity adjustment only partly attenuated the age gradient (Charlson-adjusted interaction <i>p</i> = 0.12), while documented goals-of-care limitations (Do Not Resuscitate / Do Not Intubate; DNR/DNI) rose from 7.9% (18–49) to 32.0% (≥85), peaking in the same stratum in which the mortality association disappeared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Suboptimal image quality independently predicts in-hospital mortality across a broad 18–74 vulnerability window, with attenuation in patients aged ≥85 that is only partly explained by comorbidity and parallels a steep rise in goals-of-care limitations. Image quality is best read as an age-dependent prognostic signal whose actionability declines as care shifts toward comfort in the oldest old, supporting active escalation in adults aged 18–74 and goals-concordant interpretation thereafter.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957205","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":"Distinguishing Cardiac Sarcomas From Lymphomas: Comparative Insights From Clinical and Echocardiographic Characteristics","authors":"Jingzhi Huang,&nbsp;Hongwen Fei,&nbsp;Shuo Chen","doi":"10.1111/echo.70588","DOIUrl":"10.1111/echo.70588","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiac sarcomas and lymphomas are rare malignant tumors with distinct treatment strategies and prognoses. Accurate preoperative differentiation remains clinically challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included consecutive patients diagnosed with primary cardiac sarcoma or lymphoma between January 2010 and December 2024. All diagnoses were pathologically confirmed. Clinical profiles, echocardiographic features, imaging findings, and outcomes were systematically compared. Univariate and multivariate logistic regression analyses were performed to identify independent discriminatory factors, and receiver operating characteristic curves were used to evaluate diagnostic performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-four patients were enrolled (22 sarcomas, 22 lymphomas). Multivariate analysis identified younger age (OR: 1.08, 95% CI: 1.02–1.15; <i>p</i> = 0.009) and isoechoic lesions (OR: 0.09, 95% CI: 0.01–0.91; <i>p</i> = 0.041) as independent predictors of sarcoma, with the combined model yielding an AUC of 0.85 (95%CI: 0.71–0.94). Lymphomas more frequently exhibited mixed echogenicity (45.5% vs. 13.6%, <i>p</i> = 0.016) and multi-chamber involvement (50.0% vs. 22.7%, <i>p</i> = 0.006). No significant survival difference was observed between groups (log-rank <i>p</i> = 0.758).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Age and echogenicity pattern are key independent discriminators: hypoechoic masses in younger patients favor sarcoma, whereas mixed‑echoic masses in older patients suggest lymphoma. Histopathological confirmation remains essential, and clinicians should be aware of potential misdiagnosis by advanced imaging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957239","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":"Cardiac Schwannoma Presenting as a Pericardial Cyst: A Diagnostic Pitfall","authors":"Xinyu Li,&nbsp;Xiaojing Ma,&nbsp;Yanling Xue,&nbsp;Juan Xia","doi":"10.1111/echo.70627","DOIUrl":"10.1111/echo.70627","url":null,"abstract":"<p>\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":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957207","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":"Time-Dependent Changes in Pulmonary Artery Pressure and Biventricular Function After Adenotonsillar Surgery: A Tissue Doppler Echocardiography Study","authors":"Hülya Özer,&nbsp;Mehmet Emre Arı,&nbsp;Pelin Altınbezer,&nbsp;Gökhan Toptaş,&nbsp;Sibel Alıcura,&nbsp;Güleser Saylam,&nbsp;Utku Arman Örün","doi":"10.1111/echo.70622","DOIUrl":"10.1111/echo.70622","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Upper airway obstruction caused by adenotonsillar hypertrophy may affect the heart in children through chronic negative intrathoracic pressure and increased pulmonary vascular load. This study evaluated changes over time in pulmonary artery pressure and right and left ventricular systolic and diastolic function after adenotonsillar surgery using conventional echocardiography and tissue Doppler imaging (TDI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study included non-obese children aged 5–11 years with clinically and endoscopically confirmed adenotonsillar hypertrophy who underwent adenoidectomy, tonsillectomy, or adenotonsillectomy. Echocardiography was performed before surgery and at 1 and six months after surgery by the same operator. We assessed systolic pulmonary artery pressure (sPAP), conventional echocardiographic measures, tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE), tissue Doppler systolic and diastolic velocities, myocardial performance index (MPI), and ejection time (ET) for both ventricles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SPAP decreased significantly over time, with significant differences between all three time points after Bonferroni adjustment. TAPSE and MAPSE were within age-adjusted normal ranges before surgery but both changed significantly over time. TAPSE increased progressively, while MAPSE was higher at both postoperative visits than at baseline. Right ventricular TDI showed significant time effects for lateral e′ velocity and the tricuspid e′/a′ ratio; lateral s′ did not change significantly. In the mitral annulus, significant time effects were seen for lateral e′, septal e′, and septal a′. After Bonferroni adjustment, only lateral e′ was higher at six months than at baseline, while septal a′ differed only between 1 and six months. MPI and ET did not change significantly in either ventricle, and conventional echocardiographic measures remained normal throughout follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adenotonsillar surgery was associated with an early fall in pulmonary artery pressure and different patterns of change in the two ventricles. Right ventricular changes were more prominent, including an early and progressive increase in TAPSE, while left ventricular diastolic changes were later and more limited. Because conventional echocardiographic measures remained normal, the clinical importance of the modest TDI changes is uncertain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921688","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 Enhancement of Mitral Annular e' Following Transcatheter Aortic Valve Implantation: The Role of Early Diastolic Filling","authors":"Takahide Ito,&nbsp;Kanako Akamatsu,&nbsp;Shimpei Fujioka,&nbsp;Kensuke Kinoshita,&nbsp;Yohei Yamauchi,&nbsp;Daisuke Shishikura,&nbsp;Yumiko Kanzaki,&nbsp;Hideki Ozawa,&nbsp;Masahiro Daimon,&nbsp;Takahiro Katsumata,&nbsp;Hideaki Morita","doi":"10.1111/echo.70619","DOIUrl":"10.1111/echo.70619","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Early improvements in left ventricular (LV) diastolic function have been documented following transcatheter aortic valve implantation (TAVI), but it remains unclear whether the increase in early diastolic mitral annular velocity (e′) reflects intrinsic improvement in LV relaxation or altered hemodynamic conditions. This study investigated early changes in e' after TAVI, with a particular focus on the hemodynamic determinants of the increase in e′.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted in 129 consecutive patients with severe aortic stenosis who underwent successful TAVI and echocardiographic evaluation before and within one week after the procedure. Clinical and echocardiographic parameters were compared before and after TAVI, and factors associated with changes in e′ were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TAVI significantly increased septal, lateral, and mean e′, transmitral early diastolic (E) velocity, and LV ejection fraction (LVEF) while reducing the transvalvular pressure gradient. In multivariate linear regression analysis, with changes in LVEF, E velocity, mean transvalvular pressure gradient, stroke volume, baseline mean e′, and atrial fibrillation entered as covariates, baseline mean e′ (<i>β</i> = −0.590, <i>p</i> &lt; 0.001), atrial fibrillation (<i>β</i> = 0.523, <i>p</i> = 0.006), and changes in E velocity (<i>β</i> = 0.019, <i>p</i> = 0.018) were independently associated with changes in mean e′.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>e' increased rapidly after TAVI. Changes in E velocity were independently associated with changes in mean e′, even after adjustment for changes in stroke volume, suggesting that early changes in e′ reflect not only intrinsic improvement in LV relaxation but also load-related mechanisms during early diastolic filling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931868","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":"Beyond E/e′: A Physiology-Based Framework for Emerging Echocardiographic Biomarkers in the Noninvasive Assessment of Left Ventricular Filling Pressure","authors":"Ehsan Shahverdi,&nbsp;Mahkameh Rasouli,&nbsp;Lars Roman Herda","doi":"10.1111/echo.70618","DOIUrl":"10.1111/echo.70618","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Accurate noninvasive estimation of left ventricular (LV) filling pressure is essential for diagnosing and managing heart failure and other cardiovascular diseases. Although the E/e′ ratio remains the cornerstone of contemporary echocardiographic assessment, its diagnostic performance is influenced by loading conditions, myocardial disease, cardiac rhythm, and technical limitations. This review presents a physiology-based framework for emerging echocardiographic biomarkers, examining how each parameter reflects distinct pathophysiological processes—including myocardial relaxation, myocardial performance, atrial remodeling, and structural remodeling—and how these processes contribute to the estimation of LV filling pressure.&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 structured narrative review of the contemporary literature was performed, emphasizing studies evaluating both conventional and emerging echocardiographic parameters against invasive hemodynamic reference standards. Biomarkers were classified according to the physiological processes they primarily represent rather than being reviewed as isolated imaging parameters. Particular attention was given to their mechanistic rationale, diagnostic performance, clinical applicability, technical limitations, and potential integration into multiparametric assessment strategies.&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;Emerging echocardiographic biomarkers provide complementary physiological information beyond conventional Doppler indices. Left atrial reservoir strain and left atrial stiffness primarily reflect chronic pressure elevation and atrial remodeling, whereas diastolic strain rate and left ventricular untwisting characterize impaired myocardial relaxation. Global longitudinal strain and myocardial work predominantly assess myocardial performance, while three-dimensional echocardiography improves structural characterization. Artificial intelligence functions as an integrative analytical approach capable of combining multidimensional imaging and clinical data rather than representing an independent physiological biomarker. Current evidence indicates that no single parameter adequately captures the complex determinants of LV filling pressure. Instead, each biomarker contributes distinct physiological information with varying diagnostic value depending on the underlying disease phenotype and clinical context.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Assessment of LV filling pressure should move beyond the search for a single superior biomarker toward physiology-guided integration of complementary echocardiographic paramet","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921666","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}