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

{"title":"Large Subcutaneous Mass Adjacent to the Left Ventricular Apex","authors":"Tomomi Miyamoto,&nbsp;Michiyo Yamano,&nbsp;Kazuki Maeda,&nbsp;Mayumi Takeoka,&nbsp;Sakiko Honda,&nbsp;Tatsuya Kawasaki","doi":"10.1111/echo.70149","DOIUrl":"https://doi.org/10.1111/echo.70149","url":null,"abstract":"<p>Two-dimensional speckle tracking helped determine whether the tumor adjacent to the left ventricular apex had infiltrated the pericardium. The peak strain value remains unaffected, although the peak timing in the area adjacent to the tumor is delayed. Consequently, the tumor was determined not to have infiltrated the pericardium.\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":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749462","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":"How to Decide Right Heart Function After Left Ventricular Assist Device?","authors":"Jia-Ling Lin,&nbsp;Chih-Hsin Hsu","doi":"10.1111/echo.70152","DOIUrl":"https://doi.org/10.1111/echo.70152","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761884","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":"Echocardiography and the Unmet Clinical Needs in Chronic Heart Failure","authors":"Massimo Iacoviello","doi":"10.1111/echo.70141","DOIUrl":"https://doi.org/10.1111/echo.70141","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749568","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":"Congenital Atresia of the Left Main Coronary Artery: Multiple Imaging Diagnosis of a Rare Coronary Anomaly","authors":"Mei Wu,&nbsp;Juan Xia,&nbsp;Yafeng He,&nbsp;Xiaojing Ma","doi":"10.1111/echo.70142","DOIUrl":"https://doi.org/10.1111/echo.70142","url":null,"abstract":"<div>\u0000 \u0000 <p>Left main coronary artery atresia (LMCAA) is a rare congenital coronary anomaly and sometimes presents with non-specific clinical symptoms that make the diagnosis challenging. We are presenting an interesting case that required multimodality imaging to establish the diagnosis.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735502","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 Study of Post-Chemotherapy Cardiotoxicity in Breast Cancer Patients Based on Ultrasound Radiomics","authors":"Caiyun Xia,&nbsp;Shutian Wu,&nbsp;Yuxin Zhong,&nbsp;Jiangtao Wang,&nbsp;Alin Yao,&nbsp;Biaohu Liu","doi":"10.1111/echo.70136","DOIUrl":"https://doi.org/10.1111/echo.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study is to develop and validate a combined model based on ultrasound radiomics to detect cardiotoxicity after chemotherapy in patients with breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this paper, we included 208 patients with breast cancer diagnosed pathologically and after chemotherapy, of whom had high-quality echocardiographic images; among them, 105 cases experienced cardiotoxicity, while 103 cases did not, which were divided into a training set and a validation set using a wholly randomized method according to a ratio of 7:3. Then, the left ventricular myocardium in the parasternal long-axis view of echocardiography was manually traced, the myocardial features of each image were extracted and filtered, and then a radiomics model was established; lastly, we plotted the receiver operating characteristic (ROC) curve; calculated the area under the curve (AUC); and assessed the diagnostic performance of the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The AUC of the combined model in the training set was 0.88 (95%CI,0.828–0.936), which was higher than the clinical model at 0.73 (95%CI,0.646–0.807) and the radiomics model at 0.84 (95%CI,0.774–0.903). In the validation set, the AUC of the combined model was 0.87 (95%CI,0.783–0.959), which was higher than the clinical model at 0.75 (95%CI,0.631–0.877) and the radiomics model at 0.81 (95%CI,0.698–0.917). The combined model of the training group and the validation group had statistical significance compared to both the clinical model and the radiomics model (<i>Z</i> = −4.066, <i>p</i> &lt; 0.001; <i>Z</i> = −1.977, <i>p</i> = 0.048); (<i>Z</i> = −1.986, <i>p</i> = 0.047; <i>Z</i> = −2.142, <i>p</i> = 0.032). Meanwhile, the results of Hosmer–Lemeshow goodness-of-fit test were favorable (the training group: <i>X</i>² = 6.776, <i>p</i> = 0.561; the validation group: <i>X</i>² = 11.949, <i>p</i> = 0.154).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combined model based on radiomics is an effective tool for the early diagnosis of cardiac toxicity in breast cancer patients after chemotherapy. It helps to detect cardiotoxicity of breast cancer patients during chemotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735501","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":"Impaired Aortic Biomechanical Properties in Patients With Severe Obstructive Sleep Apnea Syndrome","authors":"Li Yu,&nbsp;Zurong Yang,&nbsp;Zhang Ming,&nbsp;Qichang Zhou,&nbsp;Shi Zeng","doi":"10.1111/echo.70135","DOIUrl":"https://doi.org/10.1111/echo.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Evaluating the biomechanical properties of the aorta is crucial for assessing cardiovascular risk and preventing disease progression. The aim of this study was to evaluate the biomechanical properties of the ascending aorta (AA) in severe obstructive sleep apnea syndrome (OSAS) patients with or without hypertension (HT) via velocity vector imaging (VVI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 68 patients with severe OSAS were selected, 35 of whom were included in the simple OSAS group and 33 of whom were included in the OSAS + HT group, and 40 volunteers without these two disorders who were taken as the control group. AA biomechanical properties, that is, AA longitudinal strain (ALS), AA circumferential strain (ACS), and fractional area change (FAC), were evaluated via VVI. Pulsed Doppler early transmitral peak flow velocity (E), early diastolic mitral annular velocity (e’), left ventricular (LV) global longitudinal strain (GLS), and the AA dimension (AD) were also measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ALS (mean ± SD; 32.8% ± 11.9% and 19.7% ± 7.6% vs. 40.6% ± 15.6%, <i>p</i> = 0.006), ACS (mean ± SD; 11.8% ± 3.5% and 8.6% ± 2.7% vs. 16.5% ± 5.8%, <i>p</i> = 0.02), and FAC (mean ± SD; 21.0% ± 5.3% and 12.4% ± 3.8% vs. 32.8% ± 9.7%, <i>p</i> = 0.004) were significantly lower in the patient groups (OSAS and OSAS + HT, respectively) than in the control group. LV systolic and diastolic functions were also impaired in the patient groups. Compared with volunteers without OSAS and HT, these patients had a greater AD and E/e’ ratio and a lower GLS (<i>p</i> &lt; 0.01). The aortic biomechanical properties were strongly correlated with the LV function and sleep parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AA biomechanical properties are impaired in patients with severe OSAS, especially those with HT. Impairments in these aortic biomechanical properties are associated with diminished LV function and abnormal sleep parameters. This discovery may help clinicians identify and manage potential cardiovascular risks in OSAS patients. Further large-scale longitudinal studies are needed to confirm the potential predictive value of aortic events (e.g., aortic aneurysm or dissection) in patients with OSAS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726873","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":"Meta-Analysis of the Association Between Left-Ventricular Late Gadolinium Enhancement on Cardiac MRI and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy","authors":"Jiantao Song,&nbsp;Peng Chen,&nbsp;Xiangyue Pan,&nbsp;Bo Chen,&nbsp;Jianhui Zang,&nbsp;Junjie Zhang","doi":"10.1111/echo.70144","DOIUrl":"https://doi.org/10.1111/echo.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is a common complication in individuals with hypertrophic cardiomyopathy (HCM), associated closely with myocardial fibrosis. Late gadolinium enhancement (LGE) detected by cardiac magnetic resonance (CMR) imaging is a marker of myocardial fibrosis and may indicate an increased risk of AF. This meta-analysis was performed to investigate the relationship between left ventricular (LV)-LGE and the occurrence of AF in patients with HCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of the PubMed, Embase, and Web of Science databases was conducted to identify observational studies in which the prevalence or incidence of AF in patients with HCM with and without LV-LGE was compared. Random-effects models were employed to calculate pooled odds ratios (ORs) and mean differences (MDs), accounting for potential heterogeneity across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen reports of 15 observational studies performed with 4 947 patients with HCM were included. The pooled results revealed that CMR-detected LV-LGE was associated with a significantly greater risk of AF (OR, 1.97; 95% confidence interval [CI] 1.41–2.75; <i>p</i> &lt; 0.001, <i>I</i>² = 60%). Subgroup analyses yielded consistent results across study designs, patient ages, sex distributions, analytical models, and study quality scores. Based on data from six studies in which it was reported, the extent of LV-LGE was greater in patients with AF than in those without AF (MD, 2.83%; 95% CI, 0.69–4.97; <i>p</i> = 0.01, <i>I</i>² = 66%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CMR-detected LV-LGE is associated with a heightened AF risk in patients with HCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>CRD42024621359</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726871","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":"Impact of Various Doses of Dobutamine on Myocardial Viability and the Effects of β-Blockers in Patients With Ischemic Cardiomyopathy: An Assessment Using Stress Echocardiography","authors":"Li Li,&nbsp;Zhiming Jiang,&nbsp;Liangyi Li,&nbsp;Na Yi,&nbsp;Linlin Chen,&nbsp;Linzi Li","doi":"10.1111/echo.70134","DOIUrl":"https://doi.org/10.1111/echo.70134","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;This study aimed to investigate the predictive value of dobutamine stress echocardiography (DSE) at varying doses for myocardial viability, with a particular emphasis on the impact of &lt;i&gt;β&lt;/i&gt;-adrenergic blockers on myocardial viability in patients with ischemic cardiomyopathy (ICM).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 189 patients with ICM underwent DSE. Based on the dosage of dobutamine, patients were randomly divided into three groups: low-dose group (LD, 10 µg/kg/min, &lt;i&gt;n&lt;/i&gt; = 63), medium-dose group (CD, 20 µg/kg/min, &lt;i&gt;n&lt;/i&gt; = 63), and high-dose group (HD, 30 µg/kg/min, &lt;i&gt;n&lt;/i&gt; = 63). All patients received &lt;i&gt;β&lt;/i&gt;-blockers 1 min after the DSE examination. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), radial strain (RS), and radial strain rate (RSr) during left ventricular systole (LVS) were analyzed, along with secondary effects and myocardial viability in the LD-β, CD-β, and HD-β groups.&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;During the postoperative dobutamine injection, HR, SBP, and DBP in the LD, CD, and HD groups were significantly higher compared to pre-injection levels (&lt;i&gt;p &lt;/i&gt;&lt; 0.05), with DBP in the HD group being notably higher than in the LD and CD groups (&lt;i&gt;p &lt;/i&gt;&lt; 0.05). After intravenous injection of metoprolol, all indicators significantly decreased in the LD and CD groups (&lt;i&gt;p &lt;/i&gt;&lt; 0.05). The rates of RS and RSr in the CD and HD groups were significantly lower than those in the LD group (&lt;i&gt;p &lt;/i&gt;&lt; 0.05). The proportion of normal wall motion viability (VWM) post-injection was significantly higher than pre-injection levels (&lt;i&gt;p &lt;/i&gt;&lt; 0.05), with the CD group surpassing the LD group (&lt;i&gt;p &lt;/i&gt;&lt; 0.05). The use of &lt;i&gt;β&lt;/i&gt;-adrenergic blockers demonstrated that the sensitivity, specificity, and accuracy of myocardial viability in the LD, CD, and HD groups were all superior to those of the control group (&lt;i&gt;p &lt;/i&gt;&lt; 0.05), with the CD group exhibiting the highest diagnostic performance (&lt;i&gt;p &lt;/i&gt;&lt; 0.05). The incidence of arrhythmias in the HD group was 20.3%, compared to 7.9% in the LD group (χ&lt;sup&gt;2&lt;/sup&gt; = 6.78, &lt;i&gt;p&lt;/i&gt; = 0.034). Additionally, the occurrence of cardiovascular events in the HD group was 17.2%, significantly higher than the 6.3% observed in the LD group (χ&lt;sup&gt;2&lt;/sup&gt; = 6.21, &lt;i&gt;p&lt;/i&gt; = 0.045).&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;Moderate-dose DSE exhibited the optimal diagnostic performance in assessing myocardial viability in patients with ICM. Furthermore, the use of &lt;i&gt;β&lt;/i&gt;-blockers effectively enhances the sensitivity and ","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726872","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":"Evaluation of Segmental Myocardial Work and Exercise Tolerance in Hypertension Patients With Left Ventricular Remodeling Through Stress Echocardiography","authors":"Qingfeng Zhang,&nbsp;Yi Wang,&nbsp;Hongmei Zhang,&nbsp;Geqi Ding,&nbsp;Lixue Yin","doi":"10.1111/echo.70093","DOIUrl":"10.1111/echo.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to elucidate the characteristics of segment myocardial work (MW) and reserve function through exercise stress echocardiography (ESE) and to explore the associations between MW parameters and exercise capacity in patients with left ventricular remodeling due to hypertension (LVRH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 105 patients with LVRH (LVMI ≥ 115 g/m² for males and LVMI ≥ 95 g/m²for females) underwent ESE examination following established guidelines. Additionally, 59 healthy subjects served as a control group. Speckle tracking software was employed for analysis, calculating MW parameters by integrating longitudinal strain with the noninvasive left ventricular pressure curve. Global and segmental myocardial work indices, reserve function, and exercise capacity were evaluated and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The global work index (GWI), global constructive work (GCW), and global wasted work (GWW) were significantly elevated both at rest and peak in the LVRH group, whereas global work efficiency (GWE) was reduced. GWI shows an increasing trend from the basal to the apex, The apex segment GWI of the LVRH group exhibited the highest peak value (2754.5 ± 231.0 mmHg), while there was no significant difference in peak GWI at the basal level between the two groups. The GWI-rest and ΔGWI showed significant correlation with exercise metabolic equivalent (MET) (<i>r</i> = −0.502, <i>p</i> &lt; 0.001) and diastolic function E/e′-peak (<i>r</i> = 0.612, <i>p</i> &lt;0.001). Multivariable linear regression demonstrated that GWI-rest, ΔGWI provided powerful incremental value in independent associations with exercise capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MW parameters reflect the contractile force under hemodynamic overload, offering a more compelling perspective for evaluating cardiac function, including segments value. GWI-rest and ΔGWI is significantly correlated with exercise endurance in LVRH patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674929","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":"Impaired Left Atrial Reservoir Strain Causes Exercise-Induced Pulmonary Hypertension in Patients With Preserved Left Ventricular Ejection Fraction","authors":"Masaki Kinoshita,&nbsp;Tatsuro Tasaka,&nbsp;Kaori Fujimoto,&nbsp;Makoto Saito,&nbsp;Sumiko Sato,&nbsp;Kazuhisa Nishimura,&nbsp;Katsuji Inoue,&nbsp;Shuntaro Ikeda,&nbsp;Takumi Sumimoto,&nbsp;Osamu Yamaguchi","doi":"10.1111/echo.70139","DOIUrl":"10.1111/echo.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Exercise-induced pulmonary hypertension (EIPH), assessed using exercise stress echocardiography (ESE), is important in diagnosing early stage of heart failure (HF) with preserved ejection fraction (EF) and affects exercise tolerance and prognosis. Left atrial (LA) reservoir strain, which reflects the left ventricular filling pressure, is an associated factor with HF. This study aimed to investigate the association between the LA reservoir strain at rest and EIPH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis included 188 participants with a left ventricular EF ≥ 50% who underwent ESE. EIPH was defined as a peak tricuspid regurgitation (TR) pressure gradient &gt;50 mm Hg. HF events (HF hospitalization or diuretic use with brain natriuretic peptide ≥100 pg/mL) were evaluated in patients with ≥3 months follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four (18.1%) patients were diagnosed with EIPH. LA reservoir strain at rest with an optimal cutoff value of 21% identified patients, with 73% sensitivity and 59% specificity. The multivariate logistic regression analysis indicated that LA reservoir strain was independently associated with EIPH. Furthermore, adding LA reservoir strain to the TR-velocity significantly improved EIPH discrimination. During a median follow-up period of 336 days, 29 patients (21.6%) experienced HF events. The hazard ratio for HF events in patients with LA reservoir strain ≤21% was 4.04 after adjusting for age and HFA-PEFF score (95% confidence interval, 1.29–12.7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LA reservoir strain at rest was associated with EIPH and HF events in patients with preserved EF, suggesting that impaired LA reservoir strain could increase the risk of HF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665206","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}