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

{"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}

{"title":"The Role of Right Ventricular Embryology in Echocardiographic Assessment of RV Function","authors":"Ghassan Alnaami","doi":"10.1111/echo.70255","DOIUrl":"https://doi.org/10.1111/echo.70255","url":null,"abstract":"<p>The right ventricle (RV) possesses a complex geometry and unique functional characteristics stemming from its embryologic development. Unlike the left ventricle (LV), which arises primarily from the primary heart field, the RV originates predominantly from the anterior or secondary heart field, influencing its structural organization, myocardial fiber orientation, and contractile patterns. This embryologic origin is not only essential for understanding congenital anomalies but also profoundly impacts the interpretation and accuracy of echocardiographic modalities used to assess RV function. This review explores how knowledge of RV embryology enhances the clinical application of echocardiographic methods, including tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging (TDI), RV fractional area change (FAC), 3D echocardiography, and RV longitudinal strain. Incorporating embryologic insights provides a more anatomically and physiologically grounded approach to evaluating RV performance, especially in congenital heart disease and right heart failure.</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":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773906","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":"Exercise Stress Echocardiography for Detection of Concealed Apical Pouch in Hypertrophic Cardiomyopathy","authors":"Sakiko Honda,&nbsp;Michiyo Yamano,&nbsp;Tomoko Sakaguchi,&nbsp;Tatsuya Kawasaki","doi":"10.1111/echo.70257","DOIUrl":"https://doi.org/10.1111/echo.70257","url":null,"abstract":"<p>An early diastolic flow from the apex toward the base of the left ventricle—known as diastolic paradoxical jet flow—is associated with adverse cardiovascular events in patients with hypertrophic cardiomyopathy. This subtle flow, indicative of a concealed apical pouch, can be unmasked by exercise stress echocardiography even when no pouch is visualized on cardiac magnetic resonance imaging.</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":"144767277","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":"Assessing the Use of Left Atrial Strain Before and After Treadmill Exercise Stress Echocardiography","authors":"Benjamin T. Fitzgerald,&nbsp;Jonathan Chan,&nbsp;Alfred K. Lam,&nbsp;Gregory M. Scalia","doi":"10.1111/echo.70253","DOIUrl":"https://doi.org/10.1111/echo.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Left atrial strain (LAS) is a novel speckle-tracking technique used in the assessment of left atrial function. It has been shown to be a marker for adverse cardiac events (heart failure, myocardial ischemia, and atrial fibrillation). This study aimed to assess the role of LAS in assessing risk for diastolic dysfunction and myocardial ischemia in stress echocardiography (SE) before and after treadmill exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Patients undergoing routine Bruce protocol SE had LAS measurements (reservoir, conduit, and contractile strain) assessed before and after maximal treadmill exertion. Changes in LAS were measured and compared based on the result of the SE. Consecutive SE (<i>n</i> = 420) were analyzed (mean age 62 ± 5 years, 37% female). LAS was able to be estimated before and after stress in 367 patients, including 313 <i>Normal SE</i>, 32 <i>Ischemic SE</i>, and 22 <i>Abnormal DST</i>. All LAS measurements (reservoir, conduit, and contractile strain) increased significantly in <i>Normal SE</i>. The LAS measurements did not significantly change for patients with <i>Ischemic SE</i> and <i>Abnormal DST</i>. Using a receiver operator curve analysis and linear regression, apical 4-chamber reservoir LAS was found to be the best differentiator between <i>Normal SE</i> and abnormal tests (<i>Ischemic SE</i> and <i>Abnormal DST)</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Change in LAS before and after treadmill exercise differentiated Normal SE and abnormal SE (Ischemic SE and Abnormal DST). It may represent a novel non-invasive assessment for diastolic stress echocardiography.</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":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751447","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":"Mitral Stenosis and Subaortic Membrane in Hypertrophic Cardiomyopathy: A Rare Multimodality Imaging-Based Diagnosis.","authors":"Aditi Parimoo, Dhiraj Kumar, Ajay Mahajan","doi":"10.1111/echo.70258","DOIUrl":"10.1111/echo.70258","url":null,"abstract":"<p><p>This case demonstrates the importance of multi-modality imaging for diagnosing rare entities. Echocardiographic diagnosis of hypertrophic cardiomyopathy with both fixed and dynamic LVOTO and mitral valve abnormalities raised the suspicion of abnormal mitral valve apparatus and coexistent subaortic membrane. This was confirmed on cardiac MR and CT images subsequently .</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":"e70258"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805223","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 Strain in the Prognostic Assessment of Severe Tricuspid Regurgitation and Heart Failure: A Review.","authors":"Zuzanna Sachajko, Marcin Jakiel, Julia Krupa-Zabiegała, Gabriela Bajor, Monika Komar, Piotr Podolec","doi":"10.1111/echo.70259","DOIUrl":"https://doi.org/10.1111/echo.70259","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid regurgitation (TR) is becoming more commonly recognized as an important contributor to adverse cardiovascular outcomes. Right ventricular (RV) dysfunction influences TR progression and prognosis. RV free wall longitudinal strain (FWLS) is a valuable marker of RV function, though its prognostic significance in TR requires further study.</p><p><strong>Methods: </strong>We conducted a comprehensive search of studies assessing the role of RV strain in patients with severe TR, heart failure (HF), and those undergoing tricuspid valve interventions, using MEDLINE, EMBASE, and Cochrane databases to identify relevant studies. Retrospective and prospective clinical studies were included, while case reports, case series, and animal studies were excluded.</p><p><strong>Results: </strong>A decrease in RVFWLS was consistently associated with mortality, HF-related hospitalizations, adverse clinical outcomes in severe TR and in TR valve repair. Several studies have demonstrated that reduced RVFWLS may be an independent predictive factor for poor prognosis, proving to have a superior prognostic value than conventional RV function parameters such as TAPSE and FAC. A number of studies show that assessing RV strain appears critical for optimizing the strategy for percutaneous and surgical treatment of TR. Implementing this parameter in routine echocardiographic evaluation could contribute to more precise timing of interventional treatment, thus improving long-term outcomes and prognosis.</p><p><strong>Conclusions: </strong>RV strain assessment, particularly RVFWLS, may provide valuable prognostic information in patients with severe TR and help optimize treatment strategies. Implementing RVFWLS into routine echocardiographic evaluation could improve patient selection and timing of interventions.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":"e70259"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805224","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":"Evaluating the Correlation and Reliability of a New Left Ventricular Segmental Wall Motion Score With Conventional Left Ventricular Ejection Fraction Measures in Echocardiography and Cardiac Magnetic Resonance Imaging.","authors":"Ehab F Jaradat, Sadeq Tabatabai, Saeed Alseiari, Arif Al-Mulla","doi":"10.1111/echo.70264","DOIUrl":"https://doi.org/10.1111/echo.70264","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular ejection fraction (LVEF) remains essential for evaluating systolic function. Although three-dimensional (3D) echocardiography and cardiac magnetic resonance (CMR) offer precise measurements, they are limited by cost, accessibility, and patient cooperation. In contrast, wall motion score (WMS) analysis is a simpler, faster alternative requiring no specialized equipment. This study compared LVEF-derived WMS by transthoracic echocardiography (TTE) with values obtained via CMR and standard echocardiography.</p><p><strong>Methods: </strong>The study analyzed 78 participants who underwent both TTE and cardiac CMR and 118 who had comprehensive TTE with 3D echocardiography, 2D biplane Simpson's method, and visual LVEF assessment. Each of the 16 LV segments was weighted equally in calculating global LVEF. Dividing the normal LVEF range by 16 gives the average segmental contribution: 3.25%-4.625% for normokinetic, 1.62%-2.31% for hypokinetic, and 0% for akinetic or dyskinetic segments. Global LVEF was the sum of these values.</p><p><strong>Results: </strong>WMS-LVEF correlates positively with CMR-LVEF (r = 0.98), 3D echocardiography (r = 0.98), the 2D biplane Simpson's (r = 0.96), and visual assessment of LVEF (r = 0.97) with p < 0.001. In general, WMS-LVEF provided a good agreement with a relatively small mean bias and narrow standard deviation (SD) of LVEF compared to CMR-LVEF (bias: 0.83%, SD: 2.8), 3D-echocardiography (bias: 0.43%, SD: 1.96), the 2D biplane Simpson's (bias: 0.74%, SD: 2.39%), and visual assessment of LVEF (bias: 0.20%, SD: 2.39%).</p><p><strong>Conclusions: </strong>The segmental WMS-LVEF technique correlated well with CMR and conventional echocardiography, establishing its reliability for estimating left ventricular function.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":"e70264"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805222","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":"Calcific Aortic Valve Disease Assessment: Strengths and Challenges.","authors":"Diana-Elena Floria, Mariana Floria, Daniela Maria Tanase","doi":"10.1111/echo.70261","DOIUrl":"10.1111/echo.70261","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":"e70261"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805219","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":"Comparative Reproducibility of Myocardial Work and Left Ventricular Ejection Fraction in Patients After an Acute Coronary Syndrome.","authors":"Ruxandra Copciag, Vladimir Bratu, Roxana Rimbas, Elena Stamate, Tudor Lixandru, Alexandru Corlan, Dragos Vinereanu","doi":"10.1111/echo.70215","DOIUrl":"10.1111/echo.70215","url":null,"abstract":"<p><strong>Purpose: </strong>To assess reproducibility (interobserver variability and agreement) of global work efficiency (GWE) and left ventricular ejection fraction (LVEF), assessed by 2D-echocardiography (2-DE) and 3D-echocardiography (3-DE), in patients with acute coronary syndrome (ACS), through measurements performed by operators with different levels of experience.</p><p><strong>Methods: </strong>Echocardiographers with three levels of experience were involved in offline processing: advanced, who performed image acquisition-Reader 1 (5 years of training in 2-DE, 3 years in 3-DE); intermediate-Reader 2 (3 years of training in 2-DE, 1 year in 3-DE); and beginner-Reader 3 (1 year of training in 2-DE, 3 months in 3-DE). Measurements of GWE and LVEF were performed independently. Intraobserver and interobserver variability and agreement between readers were compared using Bland-Altman plots, as bias and limits of agreement (LOA), and Pearson correlations.</p><p><strong>Results: </strong>90 patients (54 ± 9 years, 75 males) with ACS were analyzed. Comparing measurements of GWE, the following bias and LOA were obtained: R1 versus R2: bias -0.6, LOA -3-2 (r = 0.98, p < 0.001); R2 versus R3: bias -0.3, LOA -3-5 (r = 0.96, p < 0.001); R1 versus R3: bias -1, LOA -5-4 (r = 0.94, p < 0.001). Interobserver variability and agreement of GWE were comparable with LVEF by 3-DE: R1 versus R2: bias 0.6, -2, and -1.4; LOA -3-4, -7-4, and -6-4, respectively (r = 0.96, 0.91, and 0.94, respectively, all p < 0.001); however, for LVEF by 2-DE, interobserver variability was higher, while agreement was lower.</p><p><strong>Conclusion: </strong>Reproducibility of GWE in patients after an ACS is independent of the experience of the operator and similar to the reproducibility of LVEF by 3-DE.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 8","pages":"e70215"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805220","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}