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

{"title":"Mitral Annular Calcification and Its Severity in Relation to Left Atrial Reservoir Strain and a Non-Invasive Left Atrial Stiffness Index","authors":"Muhammed Ali Şahin,&nbsp;Özdemir Kuzucu,&nbsp;Mustafa Ozan Gürsoy","doi":"10.1111/echo.70608","DOIUrl":"https://doi.org/10.1111/echo.70608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Mitral annular calcification (MAC) is associated with atrial fibrillation and diastolic dysfunction, but its relationship with left atrial (LA) mechanics is poorly defined. The ratio of E/e′ to LA reservoir strain (LASr) is a non-invasive surrogate of, not a direct measure of, LA stiffness. We assessed MAC and its severity against LASr and this LA stiffness index (LASI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center cross-sectional study with prospective recruitment, 112 adults in sinus rhythm with ejection fraction ≥50% (58 with MAC, 54 age- and sex-similar controls) underwent two-dimensional speckle-tracking echocardiography. MAC was graded mild to severe; LASI was calculated as E/e′ divided by LASr.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LASr was lower (23.2 ± 7.8% vs. 26.7 ± 7.7%, <i>p</i> = 0.018) and LASI higher (0.57 ± 0.30 vs. 0.34 ± 0.20, <i>p</i> &lt; 0.001) in the MAC group. In models excluding the index components, MAC severity was independently associated with higher LASI (<i>β</i> = 0.41, <i>p</i> &lt; 0.001) and MAC presence with lower LASr (−3.6 points, <i>p</i> = 0.016). After clinical adjustment, each 0.1-unit LASI increase was associated with MAC (odds ratio 1.71, 95% CI[1.34–2.17]). LASI discriminated MAC with an area under the curve of 0.762 (0.674–0.851; cut-off 0.31, sensitivity 79%, specificity 63%), which did not differ from E/e′ (<i>p</i> = 0.52) or LA volume index (<i>p</i> = 0.48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MAC and its severity were associated with impaired LA reservoir function and a higher non-invasive stiffness index. The index did not discriminate MAC better than its simpler components, so these cross-sectional findings are hypothesis-generating.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849268","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":"Three-Dimensional Transesophageal Echocardiographic Vena Contracta Area for Grading Mitral Regurgitation: Severity Cut-offs From a Prospective Tunisian Cohort","authors":"Yosra Messaoudi,&nbsp;Dedde El Bechir,&nbsp;Abdellaziz Ghadhab,&nbsp;Merzougui Latifa","doi":"10.1111/echo.70609","DOIUrl":"https://doi.org/10.1111/echo.70609","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mitral regurgitation (MR) is among the most common valvular heart diseases, but its echocardiographic quantification remains challenging, particularly in secondary MR and in some organic causes. Three-dimensional vena contracta area (3D VCA) allows direct planimetry of the regurgitant orifice. We aim to compare 3D VCA with two-dimensional (2D) parameters and to derive aetiology-specific severity cut-offs in a Tunisian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective cross-sectional study. Patients with at least moderate MR underwent transthoracic and 2D/3D transesophageal echocardiography with planimetry of the VCA. Spearman correlations between 3D VCA and 2D parameters (vena contracta width, PISA-derived regurgitant orifice area), and diagnostic performance for severe MR (ROC, Youden index), were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-seven patients were included (mean age 61.6 ± 12.5 years; sex ratio 1.1). MR was primary in 66% (rheumatic 34%, degenerative 31%) and secondary in 34%; jets were mostly single, eccentric and holosystolic, and 62.9% had severe MR. 3D VCA correlated strongly with PISA-derived orifice area (rho = 0.78) and with vena contracta width (rho = 0.65), particularly in organic, rheumatic, degenerative and eccentric MR. 3D VCA and 2D orifice area identified severe MR with an area under the curve of 0.93; the optimal 3D VCA cut-off was 0.43 cm² overall, 0.42 cm² (rheumatic), 0.55 cm² (degenerative) and 0.39 cm² (secondary).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>3D VCA reliably quantifies MR, provides aetiology-specific cut-offs and outperforms 2D methods in complex jets. Multicenter validation is needed, particularly in rheumatic-endemic regions.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849262","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":"First-Phase Ejection Fraction: A Novel Approach to Detecting Early Systolic Dysfunction in Hypertrophic Cardiomyopathy","authors":"Weixu Zhao,&nbsp;Junlang Zhang,&nbsp;Jinglu Yu,&nbsp;Huiyu Tang,&nbsp;Xueliang Chen,&nbsp;Qiwei Li,&nbsp;Jun Wu","doi":"10.1111/echo.70562","DOIUrl":"https://doi.org/10.1111/echo.70562","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;The assessment of stable coronary artery disease has been performed using the first-phase ejection fraction (EF1) in previous research. However, the use of EF1 has seldom been employed in the evaluation of early left ventricular systolic dysfunction among patients with hypertrophic cardiomyopathy (HCM).&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;We aimed to assess early left ventricular systolic dysfunction in patients with HCM by application of first-phase EF1.&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;The cohort included 90 HCM patients who were stratified according to pathophysiological subtype into 50 with nonobstructive (NO-HOCM) and 40 with obstructive (HOCM) disease. An additional 50 age-matched healthy individuals served as controls. Baseline characteristics, conventional echocardiographic parameters, EF1 were measured and serum B-type natriuretic (BNP) peptide was detected. Additionally, the correlations between EF1 and both LVMI and BNP were compared, and receiver operating characteristic (ROC) curve analysis was performed to calculate the area under the curve (AUC) for assessing the value of EF1 in the early detection of left ventricular systolic dysfunction in HCM patients.&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;Compared to the control group, patients with HOCM showed higher systolic blood pressure and lower heart rate (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Both HOCM and NO-HCM showed enlarged LAD and LVDd, elevated LVMI, LVEF, E/e’ ratios and BNP compared with controls (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, EF1 was decreased in HCM patients than that in controls (38.20 ± 2.02, &lt;i&gt;P &lt;/i&gt;&lt; 0.05), especially in HOCM patients (22.29 ± 3.59 &amp; 25.12 ± 3.19, &lt;i&gt;P&lt;/i&gt; &lt; 0  .05). EF1 was negatively correlated with both LVMI and BNP (all &lt;i&gt;r&lt;/i&gt; &gt; 0.3, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Receiver operating characteristic (ROC) curve analysis demonstrated that EF 1 (AUC = 0.874) exhibited superior diagnostic value for assessing early left ventricular systolic dysfunction in patients with HCM compared with LVEF (AUC = 0.649). The optimal cut-off value for EF1 was &lt; 28.5%, with a sensitivity of 90.6% and a specificity of 81.5%, corresponding to an AUC of 0.874 (95% CI: 0.804–0.946, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&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;Compared with healthy controls, patients with HCM had a lower EF1, and this reduction was significantly more pronounced in those with HOCM. Given its high sensitivity in evaluating left ventricular systolic function in patients with HCM, EF1 represents a promising adjunc","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849267","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":"Six-Week Changes in Global Longitudinal Strain and Rehabilitation Outcomes After Enhanced External Counterpulsation Following PCI for Myocardial Infarction: An Analysis of a Pre-Existing Matched Cohort","authors":"Juan Su,&nbsp;Li Zhang,&nbsp;Cuihuan Xie","doi":"10.1111/echo.70586","DOIUrl":"https://doi.org/10.1111/echo.70586","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;Left ventricular pressure–strain loop (LV-PSL) analysis provides non-invasive myocardial-work indices by integrating strain with contemporaneous brachial systolic blood pressure. Follow-up myocardial-work assessment requires blood pressure measured at the same assessment.&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 describe baseline myocardial mechanical abnormalities after percutaneous coronary intervention (PCI) for myocardial infarction and to explore associations between a 6-week enhanced external counterpulsation (EECP) program and changes in global longitudinal strain (GLS) and rehabilitation outcomes.&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;This single-center matched observational study was conducted from October 2021 through January 2023. It included 66 patients after PCI for myocardial infarction who completed a 6-week EECP program, 66 patients in a pre-existing matched standard-therapy comparator cohort, and 50 healthy reference participants. Baseline LV-PSL-derived myocardial-work indices were descriptive. Six-week between-group changes in GLS, peak strain dispersion (PSD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), 6-min walk distance (6MWT), Seattle Angina Questionnaire (SAQ) summary score, and weekly angina frequency were analyzed using pair-aware methods with Benjamini–Hochberg false-discovery-rate (FDR) correction. A sensitivity analysis adjusted for baseline outcome value, baseline systolic blood pressure, heart rate, ST-segment-elevation myocardial infarction, ACEI/ARB/ARNI use, and calcium-channel-blocker use with pair-clustered robust standard errors.&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;Post-PCI patients had less negative baseline GLS and descriptively lower constructive myocardial-work values than healthy reference participants. In the matched exploratory comparison, the between-group difference in GLS change was −1.3 percentage points (95% CI, −2.0 to −0.6; &lt;i&gt;P&lt;/i&gt; &lt; 0.001; FDR &lt;i&gt;q&lt;/i&gt; &lt; 0.001). EECP exposure was also associated with larger improvements in 6MWT and SAQ score, a greater reduction in NT-proBNP, and a greater reduction in weekly angina frequency; PSD change was not different after FDR correction. The adjusted sensitivity analysis gave a GLS difference of −1.3 percentage points (95% CI, −1.9 to −0.7; &lt;i&gt;P&lt;/i&gt; &lt; 0.001; FDR &lt;i&gt;q&lt;/i&gt; &lt; 0.001).&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;In this non-randomized matched cohort, EECP exposure was associated with larger 6-week improvements in GLS and selected rehabilitation outcomes","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811352","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":"Comment on “Impact of Left and Right Bundle Branch Block on Left Ventricular Systolic Function and Myocardial Mechanics Assessed by Speckle-Tracking Echocardiography and Cardiac Magnetic Resonance Feature Tracking: A Systematic Review and Meta-Analysis”","authors":"Abhinit Kumar,&nbsp;Ranjana Roy,&nbsp;Parappa Sajjan,&nbsp;Alok Bhatt,&nbsp;Jeffrin Reneus Paul","doi":"10.1111/echo.70601","DOIUrl":"https://doi.org/10.1111/echo.70601","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811349","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 Value of 3D Transesophageal Vena Contracta Area versus 2D Echocardiographic Assessment of Secondary Mitral Regurgitation","authors":"Rehab Adel Diab,&nbsp;Eman Rashed Zaki,&nbsp;Badria Atef Ebrahim Elhalawany","doi":"10.1111/echo.70602","DOIUrl":"https://doi.org/10.1111/echo.70602","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;Secondary mitral regurgitation (MR) is associated with substantial cardiovascular morbidity and mortality, making accurate severity assessment essential for clinical management. Conventional 2D echocardiography has important limitations, particularly in the presence of noncircular regurgitant orifices. Three-dimensional transesophageal echocardiography (3D-TEE) enables direct measurement of Vena Contracta area (VCA) and may provide more accurate quantification of MR severity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim of the work&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To assess the diagnostic value of three-dimensional transesophageal Vena Contracta area versus two-dimensional echocardiographic assessment of secondary mitral regurgitation.&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;This study included 52 patients with moderate-to-severe secondary MR, recruited at Alzahraa University Hospital between December 2024 and January 2026. All patients underwent TTE followed by TEE. MR severity was assessed according to current echocardiographic guidelines using an integrative approach that included qualitative, semi-quantitative, and quantitative assessments. Three-dimensional VCA was measured by both TTE and TEE using multiplanar reconstruction. Statistical analysis was performed using Jamovi version 2.3.28 for Windows, with &lt;i&gt;P&lt;/i&gt;-values &lt; 0.05 considered statistically significant.&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;The mean age of the patients studied was 58.08 ± 9.52 years, with a male-to-female ratio of 43:9. The mean PISA-derived EROA for patients with severe MR was 0.36 ± 0.09 cm&lt;sup&gt;2&lt;/sup&gt;, and the mean regurgitant volume for these patients was 48.6 ± 6.79 mL. VCA measured by 3D TTE (0.69 ± 0.16 cm&lt;sup&gt;2&lt;/sup&gt;) showed a strong positive correlation with 3D TEE VCA (0.67 ± 0.16 cm&lt;sup&gt;2&lt;/sup&gt;) (&lt;i&gt;r&lt;/i&gt; = 0.857, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Bland–Altman analysis demonstrated minimal bias (0.035 cm&lt;sup&gt;2&lt;/sup&gt;) and good agreement between both techniques. ROC analysis showed good diagnostic accuracy for severe MR, with slightly higher accuracy for TEE VCA (AUC = 0.874) compared with TTE VCA (AUC = 0.841).&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;Three-dimensional TEE-derived Vena Contracta area (3D TEE VCA) is a reliable and accurate method for assessing the severity of secondary mitral regurgitation. The strong correlation and good agreement between 3D TEE and 3D TTE VCA measurements, as well as their correlation with PISA-derived EROA, support the value of 3D VCA as a robust quantitative parameter. Moreover, our findings suggest tha","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811351","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 Rare Vascular Tangle Unraveled: Multimodal Imaging in Giant Coronary Arteriovenous Fistula","authors":"Ping Hu,&nbsp;Jie Wang,&nbsp;Li-yong Ge,&nbsp;Lin Xu,&nbsp;Xiao-Jing Ma","doi":"10.1111/echo.70607","DOIUrl":"https://doi.org/10.1111/echo.70607","url":null,"abstract":"<div>\u0000 \u0000 <p>A 63-year-old woman presented with intermittent palpitations. Transoesophageal echocardiography (TEE) identified a high-velocity shunt from a tortuous left circumflex artery into an enlarged coronary sinus, with a 5-mm fistulous orifice. Coronary CT angiography delineated the full course of a congenital coronary arteriovenous fistula (CAVF), associated circumflex aneurysm, and coronary sinus dilatation. Surgical closure was successfully performed, with intraoperative confirmation of shunt resolution. This case highlights the synergistic utility of multimodal imaging: echocardiography for real-time hemodynamic assessment and CT angiography for precise anatomical mapping—which enables accurate diagnosis, optimal surgical planning, and timely intervention in anatomically complex CAVF before irreversible myocardial damage ensues.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811353","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":"Ejection Fraction in the Fast Lane","authors":"Peter L. M. Kerkhof,&nbsp;Rienzi A. Diaz-Navarro,&nbsp;Neal Handly","doi":"10.1111/echo.70584","DOIUrl":"10.1111/echo.70584","url":null,"abstract":"<p>Ventricular performance is typically evaluated on the basis of primary measurements such as pressure, volume and flow. Representative recordings obtained from a healthy, chronically instrumented conscious dog can be employed to define various metrics, for example, the traditional holosystolic ejection fraction (EF). The metric EF is defined as 1 minus end-systolic volume (ESV) divided by end-diastolic volume (EDV). An alternative proposed 45 years ago refers to the first-third of EF (^⅓EF), which is not (always) identical to first-phase EF1, launched several decades later. All these candidates refer to dimensionless ratios, and are therefore incomplete. Based on the early events during ejection time (ET), Kerkhof-Diaz-Handly (KDH) propose a more powerful metric which has the advantage of carrying physical units. The diastolic phase (TD) is the most variable portion of the cardiac cycle. ECG = electrocardiogram; LVD = left ventricular (equatorial) diameter; Paorta = ascending aorta pressure; Qaorta = ascending aorta flow.\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 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674582","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":"TrueVue Plus Light and Glass Three-Dimensional Echocardiography for Heart Diseases: A Revolution in Cardiovascular Imaging","authors":"Ran Qu,&nbsp;Xueying Tan,&nbsp;Yixin Chen,&nbsp;Sihua Ren,&nbsp;Aijiao Sun,&nbsp;Yangjie Xiao,&nbsp;Wei Qiao,&nbsp;Yanxiao Liang,&nbsp;Yilong Pan,&nbsp;Yunmeng Zhang,&nbsp;Liping Huang,&nbsp;Feifei Sun","doi":"10.1111/echo.70569","DOIUrl":"10.1111/echo.70569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To explore the value and operational points of TrueVue, TrueVue Light, and TrueVue Glass, which are emerging, advanced three-dimensional echocardiographic (3DE) technologies, for the clinical diagnosis of heart diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Echocardiography examinations were performed in 272 patients with suspected structural heart diseases. Two-dimensional (2D) and real-time 3DE methods, including traditional and new 3D imaging techniques were used. The Likert scale was used to compare the novel and traditional techniques. The operational capabilities, advantages, and limitations of the new techniques were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one (7.7%) patients had normal cardiac structure, 98 (36.0%) had congenital heart diseases, 70 (25.7%) had acquired valvular diseases, 43 (15.8%) had cardiomyopathy, and 40 (14.7%) had other cardiac structural abnormalities. TrueVue provided high-resolution, realistic 3D images. TrueVue Light provided a virtual light source to apply light and shade effects that could be set at different locations and depths. TrueVue Glass was used for highlighting the borders of the chambers, thin valves, and vessels. The evaluation scores (Likert scale) of the novel 3DE tools were higher than those of traditional 3DE systems (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For viewing various cardiac lesions, novel 3DE imaging was preferred over conventional displays in all surveyed groups. The use of TrueVue, TrueVue Light, and TrueVue Glass 3DE provides effective reference information, increases the diagnostic accuracy and efficiency, and optimizes the workflow of doctors who diagnose and treat heart diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674655","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":"Combined Left Ventricular and Left Atrial Strain Assessment for Long-Term Risk Stratification in Heart Failure With Reduced Ejection Fraction","authors":"Aleksandra Maksimovic,&nbsp;Sofija Aleksandra Neskovic,&nbsp;Milica Scepanovic,&nbsp;Aleksandra Zivanic,&nbsp;Ivan Stankovic","doi":"10.1111/echo.70587","DOIUrl":"10.1111/echo.70587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Left ventricular (LV) global longitudinal strain (GLS) and left atrial reservoir strain (LASr) are established predictors of adverse outcomes in heart failure with reduced ejection fraction (HFrEF), but the prognostic value of their combined assessment has not been fully elucidated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 341 patients hospitalized with decompensated HFrEF who underwent speckle-tracking echocardiography for assessment of LV GLS and LASr. Receiver operating characteristic (ROC) analysis with Youden index optimization was applied to determine optimal strain cutoff values and develop a combined strain classification model. Cox proportional hazards models were used to identify parameters associated with all-cause mortality. LV GLS was analyzed using absolute values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 59 months, 238 patients (70%) died. In univariable analysis, both LV GLS and LASr were associated with mortality. After multivariable adjustment, both remained independently associated with mortality (GLS: adjusted HR 0.945, 95% CI 0.902–0.991, <i>p</i> = 0.019; LASr: adjusted HR 0.972, 95% CI 0.953–0.992, <i>p</i> = 0.006). ROC analysis identified optimal cutoff values of 7.3% for LV GLS and 9.0% for LASr. Patients with concomitant marked impairment of both strain parameters exhibited the highest mortality risk, whereas those with the least impaired ventricular and atrial strain had the most favorable outcomes. Patients with pronounced impairment of either parameter alone demonstrated intermediate survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients hospitalized with HFrEF, both LV GLS and LASr were independently associated with all-cause mortality. Their combined assessment may identify distinct risk phenotypes and provide enhanced risk stratification beyond either parameter alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680624","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}