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

{"title":"Echocardiographic Phenomapping in HFpEF: From Imaging Biomarkers to Precision Cardiovascular Medicine","authors":"Ehsan Shahverdi, Maren Schulz, Carsten Schneider, Mathias Lange","doi":"10.1111/echo.70582","DOIUrl":"10.1111/echo.70582","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent and clinically heterogeneous syndrome characterized by substantial variability in pathophysiology, disease progression, therapeutic response, and clinical outcomes. Although conventional echocardiography remains central to diagnosis, traditional imaging parameters incompletely capture the biological complexity of HFpEF. Growing recognition of distinct disease phenotypes has stimulated interest in echocardiographic phenomapping as a strategy to improve patient characterization and support future precision medicine approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To critically review the contemporary role of echocardiography in HFpEF phenomapping, evaluate the strengths and limitations of emerging imaging biomarkers, and propose a conceptual echocardiographic framework for phenotype-oriented classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive narrative review was conducted using PubMed/MEDLINE, Scopus, and Web of Science. Contemporary evidence addressing myocardial mechanics, left atrial and right ventricular function, stress echocardiography, artificial intelligence, machine learning, and multimodal phenotyping was narratively reviewed, critically appraised, and synthesized, with emphasis on clinical applicability, methodological limitations, and future research directions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Contemporary echocardiography enables multidimensional assessment of myocardial structure, ventricular mechanics, atrial function, right ventricular performance, pulmonary vascular interactions, and exercise physiology, providing information beyond conventional diagnostic parameters. Advanced imaging biomarkers, including global longitudinal strain, myocardial work indices, left atrial strain, right ventricular strain, and right ventricular–pulmonary arterial coupling, demonstrate incremental diagnostic and prognostic value in selected patient populations, although their routine clinical implementation remains limited by incomplete standardization, inter-vendor variability, and the need for external validation. Exercise echocardiography further uncovers latent hemodynamic abnormalities and impaired cardiovascular reserve. Artificial intelligence and machine learning have identified candidate HFpEF phenogroups in research settings and may facilitate integration of multidimensional imaging data, although prospective validation and demonstration of clinical utility remain necessary before widespread adoption. Based on the current evidence, we propose a conceptual echo","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":"148674597","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":"Is Insulin Pump Therapy More Effective Than Multiple Daily Insulin Injections in Preventing Subclinical Cardiac Dysfunction in Children With Type 1 Diabetes Mellitus? A Myocardial Strain Study by Three-Dimensional Speckle-Tracking Echocardiography","authors":"Ayşe Güler Eroğlu,&nbsp;Berfin Altaş Özgür,&nbsp;Nida Gülderen Kalay Şentürk,&nbsp;Ali Karakaş,&nbsp;Samed Cihad Çelik,&nbsp;Büşra Kara,&nbsp;Hande Turan,&nbsp;Elvan Bayramoğlu,&nbsp;Olcay Evliyaoğlu","doi":"10.1111/echo.70563","DOIUrl":"10.1111/echo.70563","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Subclinical myocardial dysfunction may occur early in children and adolescents with type 1 diabetes mellitus (T1DM), despite preserved conventional cardiac function. However, the effect of insulin delivery modality on myocardial mechanics remains unclear. This study aimed to compare conventional echocardiographic and three-dimensional speckle-tracking echocardiographic (3D-STE) findings between pediatric patients receiving insulin pump therapy (IPT) and those receiving multiple daily insulin injections therapy (MDIIT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 56 children and adolescents with T1DM receiving either IPT (<i>n</i> = 27) or MDIIT (<i>n</i> = 29) were enrolled. All participants underwent conventional echocardiography, tissue-Doppler imaging, three-dimensional echocardiography, and 3D-STE. Global and regional strain parameters derived from 3D-STE were analyzed and compared between treatment groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The two groups were comparable with respect to age, sex, anthropometric characteristics, and glycated hemoglobin levels (all <i>p</i> &gt; 0.05). Diabetes duration and treatment duration were significantly longer in the MDIIT group (<i>p</i> = 0.022 and <i>p</i> &lt; 0.001, respectively). No significant differences were observed in left ventricular ejection fraction, indexed ventricular volumes, or global strain parameters (longitudinal, circumferential, and radial strain) (all <i>p</i> &gt; 0.05). Several regional strain parameters differed between groups, with more favorable anteroseptal circumferential and radial strain values observed in patients receiving IPT (all <i>p</i> &lt; 0.05). The E′/A′ ratio was higher in the IPT group (<i>p</i> = 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children and adolescents with T1DM receiving IPT and MDIIT demonstrated comparable conventional echocardiographic and global 3D-STE findings. However, differences in several regional strain indices suggest the presence of subtle myocardial abnormalities in patients receiving MDIIT despite preserved global ventricular function. Further prospective studies are warranted to clarify the clinical significance of these findings.</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":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671158","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":"Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.","authors":"Shervin Zoghi, Yaseen M Hakim, Shuai Chen, Maud M Morshedi, Roger E Goldman","doi":"10.1111/echo.70595","DOIUrl":"https://doi.org/10.1111/echo.70595","url":null,"abstract":"<p><strong>Background: </strong>Current risk stratification algorithms for intermediate-risk pulmonary embolism (PE) inadequately identify patients who may benefit from escalated care interventions (ECIs) beyond anticoagulation and do not incorporate temporal assessments of right ventricular (RV) function.</p><p><strong>Objectives: </strong>To evaluate whether changes in tricuspid annular plane systolic excursion (TAPSE) on repeat transthoracic echocardiography (TTE) before ECIs are associated with clinical outcomes in acute intermediate-risk PE.</p><p><strong>Methods: </strong>Acute intermediate-risk PE patients at a single quaternary care center were retrospectively identified. Inclusion required two or more TTE studies with TAPSE measurements before discharge or ECI initiation. Patients were stratified into worsening (ΔTAPSE < 0 mm) and stable/improving cohorts. The primary outcome was 30-day mortality. Secondary outcomes included 90-day mortality, intubation, ICU admission, vasopressor requirement, and ECIs.</p><p><strong>Results: </strong>Eighty-eight patients met inclusion criteria (38 worsening, 50 stable/improving). Worsening TAPSE was associated with a significantly increased risk of 30-day mortality (RR 5.26; p = 0.003), 90-day mortality (RR 3.01; p = 0.004), and intubation (RR 1.86; p = 0.010). In univariate logistic regression, each 1 mm increase in ΔTAPSE was associated with lower odds of 30-day mortality (OR 0.86; p = 0.005). Among 53 patients with initial TAPSE ≥16 mm, those with subsequent decline had significantly higher 30-day mortality (33.3% vs. 8.7%; p = 0.048).</p><p><strong>Conclusion: </strong>Worsening RV function on repeat echocardiography was associated with short-term mortality in acute intermediate-risk PE, even with initially preserved cardiac function. Serial assessment of RV function may refine risk stratification, and the impact on patient triage and escalation decisions warrants prospective evaluation.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70595"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762519","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":"Systolic Anterior Motion and Dynamic Mitral Regurgitation Following SAVR: A Case of Hemodynamic Optimization Over Intervention.","authors":"Teresa Farella, Andrea Faggiano, Elisa Gherbesi, Giulia Conti, Arianna Berra, Maria Chiara Palloni, Massimiliano Ruscica, Stefano Carugo","doi":"10.1111/echo.70597","DOIUrl":"10.1111/echo.70597","url":null,"abstract":"<p><p>Mitral regurgitation (MR) frequently coexists with severe aortic stenosis and may persist or worsen after surgical aortic valve replacement (SAVR) despite afterload reduction. Following SAVR, abrupt ventricular unloading can unmask hyperdynamic ventricular function, promote systolic anterior motion and left ventricular outflow tract (LVOT) obstruction, resulting in dynamic MR and hemodynamic instability. A thorough preoperative assessment of ventricular geometry and mitral valve anatomy is crucial to identify patients at increased risk of post-SAVR LVOT obstruction. We describe a case of severe dynamic MR and LVOT obstruction following SAVR, successfully managed through comprehensive echocardiographic evaluation and tailored hemodynamic optimization, ultimately avoiding unnecessary percutaneous mitral intervention.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70597"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702488","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":"Three-dimensional Speckle Tracking Imaging to Assess Subclinical Myocardial Mechanical Alterations in Patients With Type 2 Diabetes Mellitus Combined With Subclinical Hypothyroidism.","authors":"Zijing Zhai, Yuanyuan Bai","doi":"10.1111/echo.70594","DOIUrl":"10.1111/echo.70594","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate subclinical myocardial mechanical alterations by utilizing three-dimensional speckle tracking imaging (3D-STI) in patients with type 2 diabetes mellitus (T2DM) combined with subclinical hypothyroidism (SCH), and evaluate its intergroup discriminatory capacity.</p><p><strong>Methods: </strong>A total of 147 participants were enrolled and divided into four groups: prediabetes group (n = 37), isolated T2DM group (n = 35), T2DM combined with SCH group (n = 40), and healthy control group (n = 35). Conventional echocardiographic indices, three-dimensional myocardial strain parameters, and ventriculo-arterial coupling indicators were compared among groups. Receiver operating characteristic (ROC) curves were plotted to evaluate the ability of myocardial strain parameters to identify individuals presenting early subclinical left ventricular myocardial mechanical abnormalities within the study cohort. Partial correlation analysis was performed to explore the independent correlation between thyroid-stimulating hormone (TSH) and left ventricular functional parameters after adjusting for confounding variables. Multiple linear regression analysis was applied to assess the independent effect of TSH on myocardial comprehensive index (MCI) after adjusting for confounding factors.</p><p><strong>Results: </strong>Glycated hemoglobin (HbA1c) was elevated in the prediabetes, T2DM, and T2DM + SCH groups, while TSH was significantly higher in the T2DM + SCH group. Global longitudinal strain (GLS), left ventricular twist angle (LVtw), torsion (Tor), and myocardial comprehensive index (MCI) decreased progressively across the four groups. Effective arterial elastance (Ea) and ventriculo-arterial coupling index (VAC) were increased in the T2DM and T2DM+SCH groups. ROC analysis demonstrated that MCI yielded the highest AUC (0.967) and sensitivity (97.30%) for prediabetes, and the optimal AUC (0.937), sensitivity (90.00%) and specificity (85.71%) for T2DM+SCH. Partial correlation analysis was performed after adjustment for age, sex, BMI, systolic blood pressure, diastolic blood pressure, triglycerides and HbA1c. The results revealed a significant negative correlation between TSH and MCI (r = -0.616, p < 0.01). Multivariate linear regression analysis was conducted with MCI as the dependent variable. After adjusting for age, sex, BMI, blood pressure, lipid and glucose metabolic parameters, TSH was independently negatively associated with MCI. When TG-Ab and TPO-Ab were added for exploratory analysis, elevated TSH remained independently associated with decreased MCI, while thyroid autoantibodies showed no independent effect. Partial correlation analysis indicated a moderate negative correlation between TSH and MCI (r = -0.407, p < 0.01).</p><p><strong>Conclusion: </strong>3D-STI enables the identification of early subclinical myocardial mechanical alterations in patients with T2DM combined with SCH.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70594"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727834","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":"Pulmonary Pressure by Echocardiography: Looking Beyond the Number.","authors":"Francisco Gual-Capllonch, Pere Pericàs","doi":"10.1111/echo.70605","DOIUrl":"https://doi.org/10.1111/echo.70605","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70605"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801156","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":"Prognostic Value of Prolapse Width for Mid-Term Degenerative Mitral Regurgitation Stability After Transcatheter Edge-to-Edge Repair.","authors":"Xinping Lin, Boren Tan, Cheng Li, Jie Liang, Huixiang Yan, Qifeng Zhu, Xianbao Liu","doi":"10.1111/echo.70596","DOIUrl":"10.1111/echo.70596","url":null,"abstract":"<p><strong>Background: </strong>Long-term durability of degenerative mitral regurgitation (DMR) reduction after transcatheter edge-to-edge repair (TEER) remains limited, and reliable anatomical predictors are still lacking.</p><p><strong>Methods: </strong>This study prospectively enrolled patients with symptomatic DMR undergoing TEER across 27 centers in China. All pre-procedural clinical and echocardiographic parameters were collected and analyzed. The primary outcome was MR ≤ 1+ at 3-year follow-up. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify predictors and optimal cutoff values.</p><p><strong>Results: </strong>A total of 78 patients with available 3-year echocardiographic assessments were included in the imaging-based analysis (mean age, 74.4 ± 5.1 years; 67.9% with NYHA class III/IV symptoms; mean STS score for mitral valve replacement, 6.8 ± 2.7%). At 3-year follow-up, 49 patients (62.8%) maintained MR ≤1+. TEER was associated with significant reverse cardiac remodeling, including reductions in left ventricular end-diastolic volume (125.4 ± 40.6 to 99.8 ± 19.7 mL) and pulmonary artery systolic pressure (43.0 ± 11.6 to 34.3 ± 11.4 mmHg) (both p < 0.001), while LVEF remained stable. Mitral valve (MV) prolapse/flail width independently predicted MR durability (OR: 0.789; 95% CI: 0.655-0.951; p = 0.013). ROC analysis identified a cutoff value of 16 mm (AUC: 0.714; p = 0.002), with patients having prolapse/flail width ≥16 mm demonstrating lower rates of MR ≤1+ at 3 years.</p><p><strong>Conclusions: </strong>Pre-procedural prolapse/flail width is an independent predictor of 3-year MR durability after TEER in patients with DMR. Larger prolapse/flail width is associated with reduced mid-term MR stability, suggesting its potential value for risk stratification and procedural planning.</p><p><strong>Trial registration: </strong>This study has been registered at ClinicalTrials.gov with a number of NCT04734756.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70596"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708378","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":"Development of a Diagnostic Model Based on Serum ST2 and Left Atrial Strain for Left Ventricular Systolic Dysfunction in Patients With Chronic Coronary Syndrome.","authors":"Xiaoxin Jiang, Rui Ma, Xiaoli Zhang, Genshan Ma","doi":"10.1111/echo.70583","DOIUrl":"10.1111/echo.70583","url":null,"abstract":"<p><strong>Aims: </strong>The study investigated the predictive value of serum soluble ST2 (sST2) and left atrial strain parameters for left ventricular systolic dysfunction (LVSD), and the correlation analysis with corresponding indicators in patients with chronic coronary syndrome (CCS).</p><p><strong>Methods: </strong>A total of 135 patients with CCS who presented to the Cardiology Department Zhongda hospital and underwent echocardiographic examinations from January 2025 to December 2025 were ultimately included. Based on two-dimensional speckle tracking echocardiography, left ventricular global longitudinal strain and left atrial strain were measured within 72 h of CCS diagnosis, and the patients were categorized into two groups: LV GLS > -17%, LVSD group; and LV GLS≤-17%, non- LVSD group. Baseline data were collected from all patients and compared between the two groups. The correlation between sST2 and LA parameters in CCS patients was evaluated using Spearman correlation.  Based on the results of the multivariate logistic regression analysis, a predictive model for LVSD in CCS patients was established.</p><p><strong>Results: </strong>In the LVSD group, sST2 levels, early diastolic mitral inflow velocity (E)/ early diastolic mitral annular velocity (e') ratio, left atrial volume index (LAVI), and left atrial stiffness index (LASI) were increased. In the CCS patients, sST2, E/e', LAVI, and LASI demonstrated good correlation. sST2 and LASI were independent predictors for diagnosing LVSD in patients with CCS. ROC curve analysis showed that ST2 and LASI had diagnostic value for left ventricular systolic dysfunction in patients with CCS.</p><p><strong>Conclusion: </strong>This study found that in patients with CCS complicated by LVSD, sST2 levels were elevated, left atrial strain parameters were impaired, and a certain correlation was observed between the two. Furthermore, we investigated whether sST2 and LASI are independent predictors for diagnosing LVSD in CCS patients. By combining these two indicators, a diagnostic model can be constructed.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70583"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727613","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":"Agreement Between Standard and Right Ventricular-Focused Apical Four-Chamber Views for Right Ventricular Longitudinal Functional Indices: A Within-Participant Agreement Study.","authors":"Fei-Yi Sun, Ti Zhao, Jia-Qi Shen, Xiao-Fang Pan","doi":"10.1111/echo.70585","DOIUrl":"10.1111/echo.70585","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether right ventricular (RV) longitudinal functional indices measured from standard and RV-focused apical four-chamber (A4C) views are interchangeable at the individual level.</p><p><strong>Methods: </strong>We conducted a secondary cross-sectional agreement analysis of anonymized echocardiographic data acquired in Dalian, China, from January 2021-January 2022. The primary analysis included 115 of 120 screened adults after prespecified eligibility and audit-stage exclusions; sensitivity analyses retained all 120. Paired measurements comprised tricuspid annular plane systolic excursion (TAPSE), lateral tricuspid annular S', e', and a' velocities, and tissue motion annular displacement (TMAD)-derived indices. Observer reproducibility was evaluated in 30 cases.</p><p><strong>Results: </strong>TAPSE was similar between standard and RV-focused views (22.4 ± 3.6 vs 22.4 ± 3.2 mm; mean difference, -0.09 mm; p = 0.805), and other group-level differences were small. Individual agreement was limited: intraclass correlation coefficients (ICCs) were 0.40 for TAPSE, 0.45-0.65 for tissue Doppler velocities, and 0.39-0.68 for TMAD indices. Sensitivity-analysis ICCs remained poor to moderate (0.21-0.65). Intraobserver and interobserver ICCs in the 30-case subset were 0.97-1.00 and 0.94-0.99, respectively.</p><p><strong>Conclusion: </strong>Standard and RV-focused A4C views produced similar group means but only poor-to-moderate individual agreement. The acquisition view should be kept consistent and documented in serial reports and research datasets.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70585"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702343","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":"Pretreatment Coronary Ultrasound Radiomics Combined With the Prognostic Nutritional Index for Predicting IVIG Resistance in Children With Kawasaki Disease.","authors":"Caiyi Xiao, Chaorong Chen, Yuanyuan Huang, Xianbin Wei, Bin Li, Jing Wu, Huiying Huang, Dunhui Su, Bulin Zhang, Ji Wu","doi":"10.1111/echo.70559","DOIUrl":"10.1111/echo.70559","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD) is associated with an increased risk of coronary artery injury and subsequent adverse cardiovascular outcomes. Early identification of patients at risk remains difficult in clinical practice. Conventional coronary ultrasound is largely based on geometric parameters, such as luminal diameter and Z scores, and may not fully capture local heterogeneity within coronary images. In this study, we investigated whether pretreatment coronary artery ultrasound radiomics could improve early identification of IVIG resistance in children with KD. We further developed a multimodal prediction model incorporating radiomics, the prognostic nutritional index (PNI), and clinical characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 352 children diagnosed with KD and treated at The First Affiliated Hospital of Guangxi Medical University between January 2020 and January 2026 were retrospectively included. All patients received standardized treatment after diagnosis. Demographic characteristics, pretreatment laboratory results, conventional coronary ultrasound parameters, and two-dimensional static ultrasound images of the left coronary artery (LCA), left anterior descending artery (LAD), and right coronary artery (RCA) were collected. The pretreatment two-dimensional static coronary ultrasound images were imported into 3D Slicer for region-of-interest segmentation. A clinical prediction model was constructed using multivariable logistic regression. PNI was defined a priori as the primary nutritional-immunologic indicator. In addition, the potential incremental predictive value of other nutritional-inflammatory indices, including the C-reactive protein-to-albumin ratio (CAR), neutrophil-to-albumin ratio (NAR), neutrophil percentage-to-albumin ratio (NPAR), and C-reactive protein-albumin-lymphocyte (CALLY) index, was further evaluated. Radiomics features were selected through repeated segmentation, intraclass correlation coefficient (ICC)-based stability filtering, correlation filtering, and least absolute shrinkage and selection operator (LASSO) regression. The Clinic, Clinic + PNI, Radiomics, and Clinic + PNI + Radiomics models were assessed using receiver operating characteristic curves, DeLong tests, calibration curves, decision curve analysis, and Shapley Additive Explanations (SHAP) interpretation. The Kobayashi, Egami, and Sano scores were evaluated in the same training and validation cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 352 children, 57 (16.2%) were classified as IVIG resistant. Multivariable analysis showed that higher pretreatment maximum coronary artery Z score (Z&lt;sub&gt;max&lt;/sub&gt;), longer fever duration, and higher neutrophil count were associated with an increased risk of IVIG resistance. In the validation cohort, the Clinic + PNI model showed favorable discriminatory ability, with an AUC of 0.855 (95% CI, 0.767-0.911), a sen","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70559"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714506","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}