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

{"title":"Women With Moderate or Severe Aortic Stenosis by Aortic Valve Area Are Disproportionately Classified With Normal-Flow Low-Gradient Aortic Stenosis and Assigned Lower Severity Grades Than Men","authors":"Christopher Sidwell,&nbsp;Anna Curtis,&nbsp;Theodore Kolias,&nbsp;Andrew Harris,&nbsp;Megan Joseph,&nbsp;Troy LaBounty","doi":"10.1111/echo.70270","DOIUrl":"https://doi.org/10.1111/echo.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients with aortic stenosis (AS) may have discordant severity grades between AS by aortic valve area (AS_AVA) and AS using hemodynamic-based guidelines (AS_GL). Individuals with normal left ventricular function and normal-flow low-gradient (NF-LG) AS that is moderate or severe by AVA are downgraded in severity by current guidelines. We evaluated the prevalence and risk of NF-LG AS in patients with moderate or severe AS_AVA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared the prevalence and mortality of NF-LG AS and low-flow low-gradient (LF-LG) AS compared to normal-flow high-gradient (NF-HG) AS in patients with moderate and severe AS_AVA and normal left ventricular function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5360 patients, 2974 had moderate AS_AVA and 2386 had severe AS_AVA (mean age 73.3 ± 12.8 years; 49.3% female; 1637 deaths over median of 4.2 years). In moderate AS_AVA, women were more frequently classified as NF-LG AS, with AS severity downgraded to mild using guidelines (52.0% women vs. 29.1% men, <i>p</i> &lt; 0.001). In severe AS_AVA, women were also more likely to have NF-LG AS and be classified as mild or moderate AS using guidelines (23.9% women vs. 14.4% men, <i>p</i> &lt; 0.001). Patients with NF-LG moderate or severe AS_AVA had comparable mortality to NF-HG AS (<i>p</i> &gt; 0.05 for each).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Women with moderate or severe AS_AVA have markedly higher rates of NF-LG AS than men and are more likely to be assigned a lower AS severity grade based on current guidelines, despite mortality similar to NF-HG AS. Discordance in AS severity between AS_AVA and AS_GL is common in both genders, although more common in women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869952","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":"Stress Echocardiography Revisited: Toward Improving Patient Selection and Clinical Decision-Making","authors":"Silviu Stanciu,&nbsp;Mariana Floria,&nbsp;Diana-Elena Iov,&nbsp;Daniela Maria Tanase","doi":"10.1111/echo.70186","DOIUrl":"https://doi.org/10.1111/echo.70186","url":null,"abstract":"&lt;p&gt;Nowadays stress echocardiography is globally adopted in clinical practice. The European Society of Cardiology and the American College of Cardiology/American Heart Association recommend SE as the first-line option for investigation of suspected ischemic heart disease (IHD) [&lt;span&gt;1, 2&lt;/span&gt;]. Since the first use of SE in identifying myocardial ischemia and/or myocardial viability, this ultrasound technique has evolved greatly. For example, triple imaging SE means the assessment of the regional wall motion (kinetics), coronary flow reserve, and left ventricular elastance. In addition, two-dimensional and three-dimensional speckle tracking echocardiography are utilized to measure regional changes in longitudinal strain and area strain through their polar projection [&lt;span&gt;3&lt;/span&gt;]. These ultrasound approaches allow a more detailed evaluation of the locations and severity of myocardial damage. Analyzing strain can uncover subclinical cardiac dysfunction or remodeling of cardiomyocytes. As the myocardium undergoes structural and functional remodeling, cardiac strain diminishes, making it a valuable marker for assessing disease progression. Nowadays, beside IHD, currently indications of SE are&lt;sup&gt;3&lt;/sup&gt;: (i) in heart failure for prediction of contractile reserve and the response to medical therapy in cardiac resynchronization therapy, for B lines stress detection, for diastolic heart failure assessment; (ii) in dilated and hypertrophic cardiomyopathy for genetic stress echo; (iii) in valvular heart diseases for transvalvular or surgical aortic valve replacement; (iv) in congenital heart diseases for right ventricular contractile reserve; (v) for pulmonary hypertension, and (vi) in high altitude and extreme physiology (SE outdoor). Therefore, SE is evolving very much, having now a diagnostic, therapeutic decision-making, and prognostic role in many heart diseases.&lt;/p&gt;&lt;p&gt;Dobutamine is a synthetic catecholamine that enhances myocardial contractility and is often used in assessing cardiac function in patients with IHD. Various doses of dobutamine can have differing effects on myocardial viability; lower doses may improve contractility without significantly increasing oxygen demand, while higher doses may lead to arrhythmias and increased myocardial oxygen consumption. In patients with IHD, the use of β-blockers can counteract some of the adverse effects of increased heart rate and myocardial oxygen demand induced by dobutamine. While dobutamine SE can help identify viable myocardium, the presence of β-blockers may modify the functional response, enhancing the protective effects on cardiac workload and potentially improving outcomes in patients with heart failure due to IHD. The recently published study conducted by Li et al. [&lt;span&gt;4&lt;/span&gt;] investigated the prognostic value of varying doses of dobutamine SE in evaluating myocardial viability in patients with IHD. Three dosing protocols of dobutamine—low, medium, and high—were assessed. The researc","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869120","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":"Spectral Imaging Techniques in Heart Disease Assessment Using Photon-Counting Detector Computed Tomography","authors":"Sámuel Beke,&nbsp;Emese Zsarnóczay,&nbsp;Lili Száraz,&nbsp;Borbála Vattay,&nbsp;Dmitrij Kravchenko,&nbsp;Milan Vecsey-Nagy,&nbsp;Giuseppe Tremamunno,&nbsp;Tilman Emrich,&nbsp;Akos Varga-Szemes,&nbsp;Bálint Szilveszter,&nbsp;Pál Maurovich-Horvat","doi":"10.1111/echo.70177","DOIUrl":"https://doi.org/10.1111/echo.70177","url":null,"abstract":"<p>The photon-counting detector (PCD) system was developed to overcome the limitations of traditional energy-integrating detectors (EIDs) in computed tomography. This technique results in a higher contrast-to-noise ratio (CNR), better spatial resolution, and additionally provides detector-based spectral information. Spectral imaging is based on the acquisition and detection of different photon energy spectra. By using spectral information, image quality (IQ) can be improved, and materials can be distinguished; furthermore, their quantity and concentration can be determined. Spectral data-based parameters and reconstructions can be utilized in calcification measurement, luminal stenosis assessment, and myocardium characterization. The aim of this review is to summarize the spectral imaging applications of PCD computed tomography in the assessment of heart diseases.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861917","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":"Echocardiographic Left Atrial Stiffness Index Predicts Myocardial Iron Overload in Pediatric β-Thalassemia","authors":"Yiqun Guan,&nbsp;Yan Deng,&nbsp;Xiao Li,&nbsp;Shaolin Luo,&nbsp;Guizi Liang,&nbsp;Jie Hu,&nbsp;Yongshou Pan","doi":"10.1111/echo.70262","DOIUrl":"https://doi.org/10.1111/echo.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Myocardial iron overload (MIO) is the leading cause of mortality among individuals with thalassemia major. This study aimed to evaluate the predictive value of the left atrial stiffness index (LASI) for MIO among β-thalassemia pediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 105 children with thalassemia and 30 healthy controls were included in the study. The patients were categorized into three groups on the basis of LASI tertiles. MIO was assessed via cardiac magnetic resonance (CMR) T2* imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LASI differed significantly between patients and controls (<i>p</i> &lt; 0.001). The LASI and E/e′ ratio were negatively correlated with the CMR T2* value (LASI: <i>r</i> = −0.76, <i>p</i> &lt; 0.001; E/e′: <i>r</i> = −0.48, <i>p</i> &lt; 0.001), whereas left atrial reservoir strain (LASr), global longitudinal strain (GLS), and left atrial strain conduit strain (LAScd) were positively correlated with the CMR T2* value (LASr: <i>r</i> = 0.64, <i>p</i> = 0.002; GLS: <i>r</i> = 0.70, <i>p</i> &lt; 0.001; LAScd: <i>r</i> = 0.57, <i>p</i> = 0.009). Restricted cubic spline (RCS) analysis revealed nonlinear associations between the LASI, GLS, and CMR T2* values (nonlinearity <i>p</i> &lt; 0.001). In pediatric thalassemia patients, the LASI, GLS, and LASr independently predicted MIO. The LASI demonstrated the highest diagnostic accuracy (AUC = 0.90; optimal cutoff: 22.68%), outperforming GLS (AUC = 0.76; cutoff: 18.70%) and LASr (AUC = 0.80; cutoff: 37.05%) (DeLong test: <i>p</i> = 0.048 vs. GLS; <i>p</i> = 0.022 vs. LASr).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The LASI is strongly correlated with the CMR T2* value and is a promising tool for predicting MIO in pediatric patients with thalassemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Ejection Fraction: Refining Risk Assessment in Takotsubo Syndrome","authors":"Christina Karamarkou","doi":"10.1111/echo.70268","DOIUrl":"https://doi.org/10.1111/echo.70268","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricular Outflow Tract Velocity Time Interval: An Invaluable Yet Forgotten Echocardiographic Variable","authors":"Khalid Sawalha,&nbsp;Srikanth Vallurupalli,&nbsp;Angel López-Candales","doi":"10.1111/echo.70239","DOIUrl":"https://doi.org/10.1111/echo.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiographic examination of the right ventricular outflow tract (RVOT) has been invaluable in examining pulmonary artery (PA) flows and RV hemodynamics in response to increasing afterload. Currently, the TAPSE/PASP ratio is the preferred noninvasive variable for this assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our main aim was to determine the specific relationship that might exist between RVOT VTI Doppler measurements and TAPSE/PASP ratios across a wide range of different left ventricular (LV) ejection fractions and PASP values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study is the first to provide cutoff values for RVOT VTI according to the prevailing PA-RV hemodynamics. With TAPSE values &gt;2 cm, normal RVOT VTI values should be &gt;13 cm. However, when PASP or PVR are used in the metric analysis, RVOT VTI values &gt;15 cm are, if PASP values &lt;35 mmHg or PVR is &lt;1.6 WU. Most interestingly, we found no correlation between RVOT VTI and the TAPSE/PASP ratio. Instead, the RVOT VTI/PVR ratio was very useful and appears as a potentially echocardiographic alternative to assess RV-PA coupling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Even when both TAPSE and RVOT VTI, as well as PASP and PVR, convey somewhat similar information, significant anatomical and functional differences exist between these variables. These differences might explain why the RVOT VTI/PVR ratio might be more useful than TAPSE/PASP, particularly given the limitations of using TAPSE in certain clinical scenarios and the more reliable hemodynamic data provided by PVR. Regardless, additional studies are now needed to provide prospective comparisons between both ratios.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832654","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 a Special Type of Coronary Artery-Coronary Sinus Fistula","authors":"Jing-Fang Cao,&nbsp;Zhao-Jun Zhang,&nbsp;Hong-Xia Jing,&nbsp;Ran Chen","doi":"10.1111/echo.70267","DOIUrl":"https://doi.org/10.1111/echo.70267","url":null,"abstract":"<div>\u0000 \u0000 <p>Coronary artery fistula (CAF), a rare congenital cardiovascular anomaly with low incidence, is prone to diagnostic oversight. This case report details the diagnosis and management of a CAF patient initially identified by ultrasound and confirmed by digital subtraction angiography (DSA). It elucidates CAF pathogenesis and the diagnostic utility of ultrasound, aiming to inform clinical practice.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832850","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":"Applications of Speckle Tracking Echocardiography in Stress Echocardiography: A Systematic Review on Feasibility, Diagnostic, and Clinical Utility","authors":"Johannes Kersten,&nbsp;Achim Jerg,&nbsp;Johannes Kirsten,&nbsp;Hasema Persch,&nbsp;Sarah Krieg,&nbsp;Yuefei Liu,&nbsp;Jon Magne Letnes,&nbsp;Jana Schellenberg","doi":"10.1111/echo.70251","DOIUrl":"https://doi.org/10.1111/echo.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This review evaluates the applications of speckle-tracking echocardiography (STE) in stress echocardiography, focusing on feasibility, physiological adaptations, and its diagnostic and prognostic utility in cardiovascular conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed identified studies published up to December 28, 2024, using terms related to STE, stress echocardiography, and myocardial strain. Grey literature was excluded. Eligible studies assessed myocardial strain under stress conditions and reported on feasibility, diagnostic accuracy, or prognostic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-four studies were included, covering healthy individuals, athletes, at-risk populations, and patients with cardiovascular conditions. Feasibility studies demonstrated high interobserver reliability, with strain parameters measurable in &gt; 80% of cases (intraclass correlation coefficient [ICC] 0.80 to 0.92). In healthy individuals and athletes, STE revealed myocardial adaptations and exercise-induced changes. In at-risk populations, such as those with diabetes or after cardiotoxic therapies, STE identified subclinical myocardial dysfunction, facilitating early intervention. For coronary artery disease (CAD) and heart failure (HF), stress-induced changes in global and segmental strain improved diagnostic accuracy and risk stratification, with thresholds such as a &gt; 15% reduction in global longitudinal strain under stress aiding therapeutic decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>STE enhances the diagnostic and prognostic utility of stress echocardiography by providing reproducible strain parameters and facilitating early detection of dysfunction in high-risk populations. Future research should focus on standardizing strain analysis and integrating artificial intelligence (AI) to optimize clinical applications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782455","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":"Characterization and Prognostic Value of Longitudinal Strain in the Different Patterns of Takotsubo Syndrome","authors":"Jordi Sans-Roselló,&nbsp;Estefanía Fernández-Peregrina,&nbsp;Pablo Carrión Montaner,&nbsp;Mario Sutil-Vega,&nbsp;David Viladés-Medel,&nbsp;Pablo M. Rubio,&nbsp;Aleksanders E. Kardenass,&nbsp;Victor Garcia-Hernando,&nbsp;David Belmar-Cliville,&nbsp;Gabriel Torres-Ruiz,&nbsp;Antonio Martínez-Rubio,&nbsp;Héctor M. García-García","doi":"10.1111/echo.70256","DOIUrl":"https://doi.org/10.1111/echo.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Global longitudinal strain (GLS) has shown greater sensitivity than left ventricle (LV) ejection fraction to assess myocardial dysfunction in takotsubo syndrome (TTS). The aim of this study is to evaluate the GLS and segmental longitudinal strain (LS) in the different contractility patterns of TTS and to assess their prognostic value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this double-center retrospective study, consecutive TTS patients were included. Patients were distributed according to LV wall motion abnormalities, and GLS and LS were assessed. The development of MACE at 1-year follow-up included all-cause death, heart failure event, acute myocardial infarction, stroke, and hospitalization for symptomatic arrhythmias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred sixty-three patients were included. Median GLS value was −10.5% (IQR −13.5/−7.4). The classical TTS pattern presented the worst GLS values (−9.7% IQR −12.9/−7.1; <i>p</i> = 0.005). Apical and mid-ventricular LS were the most impaired among LV regions (−8.9% IQR −14.8/−6.1 and −9.1% IQR −13.0/−6.8; <i>p</i> &lt; 0.001, respectively), whereas the left anterior descending territory LS was the most affected (−9.5% IQR −14.0/−7.0; <i>p</i> = 0.002). The incidence of MACE at 1-year follow-up was 24.2%. After a multivariable Cox regression analysis, poorer GLS values (HR: 2.62 [95% CI: 1.14–6.02]; <i>p</i> = 0.023), age &gt; 75 years (HR: 3.78 [95% CI: 1.60–8.91]; <i>p</i> = 0.002), and secondary TTS forms (HR: 2.46 [95% CI: 1.11–5.47]; <i>p</i> = 0.027) were independent predictors of MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Macroscopic alterations present in TTS patients do not correspond to the real involvement of the LV. Apical, mid-ventricular, and LAD territory LS values were the most impaired. Worse GLS values at admission, age &gt; 75 years, and secondary TTS forms were independent predictors of MACE at 1-year follow-up in these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773516","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":"Hemolysis After Mitral Annuloplasty Ring With Residual Mild Mitral Regurgitation","authors":"Xuejie Li,&nbsp;Lin Ma","doi":"10.1111/echo.70260","DOIUrl":"https://doi.org/10.1111/echo.70260","url":null,"abstract":"<p>Hemolysis is a rare complication of prosthetic-ring annuloplasty surgery. We report a patient admitted to our institution for hematuria and renal insufficiency. He had undergone mitral annuloplasty for severe mitral regurgitation and tricuspid annuloplasty 3 months ago. Admission laboratory values included hemoglobin 5.4 g/dL, hematocrit 16%, creatinine 1.85 mg/dL, and a schistocyte count of 5.5% (normal value below 1%). As part of the patient's work up, his mitral valve function was assessed using transesophageal echocardiography (TEE) which revealed the presence of mild mitral regurgitation with an eccentric regurgitant jet impinging on the annulus. Assuming the cause of hemolysis was an eccentric mitral regurgitation jet directly hitting the annulus after a thorough workup ruled out other potential etiologies, the patient was scheduled to undergo surgical mitral bioprosthetic valve replacement. Complete resolution of hemolysis postoperatively helped confirm that the patient's hemolysis had been caused by the eccentric mitral regurgitant jet, which was impinging on the mitral annuloplasty ring. It was a rare case of hemolysis after mitral annuloplasty ring with residual mild mitral regurgitation.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767278","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}