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

{"title":"Clinical Relevance of Senior-Supervised Transthoracic Echocardiography in Clinical Practice and Research: An Editorial Commentary and Systematic Review","authors":"Daniel A. Morris","doi":"10.1111/echo.70085","DOIUrl":"10.1111/echo.70085","url":null,"abstract":"<p>In clinical practice, senior cardiologists in echocardiography laboratories frequently find clinically significant findings during supervised transthoracic echocardiography (TTE) that less experienced colleagues had not identified [<span>1</span>]. These findings, which are exclusively uncovered during senior-supervised TTE, encompass a wide range of abnormalities, from apical left ventricular (LV) thrombus to subtle changes in LV wall thickness [<span>1</span>]. However, the most commonly affected parameters or evaluations are the LV ejection fraction (LVEF) and the severity of valvular heart disease [<span>1-3</span>].</p><p>Several studies have highlighted the clinical importance of senior-supervised TTE in determining the final value of LVEF that should be reported [<span>2</span>]. In effect, as demonstrated in the present systematic review (see Table 1), the absolute mean difference in LVEF between evaluations conducted by senior cardiologists and those by non-senior practitioners is approximately 3% absolute LVEF units, with a range of 0%–8% (95% confidence interval: 1.8%–4.4%) (see Table 1). These discrepancies have significant clinical implications. For instance, a senior-supervised evaluation might classify a patient's LVEF as < 35% rather than > 40% (see Table 1). This change in LVEF value would indicate the initiation of specific heart failure therapies or consideration of advanced interventions such as cardiac resynchronization therapy or implantable cardioverter–defibrillators, decisions that might not have been made without senior supervision.</p><p>The evaluation of valvular heart disease severity is another critical area where senior-supervised TTE plays a pivotal role [<span>3</span>]. It is not uncommon for senior-supervised TTE to identify severe aortic stenosis (AS), severe mitral regurgitation, or severe tricuspid regurgitation, whereas less experienced colleagues reported only moderate severity [<span>1, 3</span>]. In cases of AS, discrepancies often arise from differences in the measurement of the LV outflow tract (LVOT) diameter and the peak aortic valve velocity obtained via continuous-wave Doppler [<span>3, 18</span>]. In this issue of the journal, Velders et al. demonstrated significant and clinically relevant differences in LVOT diameter measurements between evaluations conducted by senior cardiologists in an academic echocardiography core laboratory and routine or screening measurements from study centers [<span>19</span>]. Similar findings have been corroborated by other studies comparing LVOT diameter and peak aortic valve velocity measurements in patients with AS and bioprosthetic aortic valves between academic echocardiography core laboratories or senior cardiologists and study centers [<span>20, 21</span>].</p><p>Based on the above-mentioned evidence, the evidence shown in the current systematic review and current expert consensus recommendations [<span>1-26</span>], senior supervision of TTE is clinica","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034639","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":"Two- and Three-dimensional Transthoracic Echocardiographic Identification of Esophageal Stent","authors":"John LaForge,&nbsp;Donovon Allen,&nbsp;Regina Dickey,&nbsp;Navin Nanda","doi":"10.1111/echo.70080","DOIUrl":"10.1111/echo.70080","url":null,"abstract":"<p>First echocardiographic detection of esophageal stent.\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 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014871","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 Transvalvular Flow Rate in Aortic Stenosis: Implications for Risk Stratification","authors":"Elad M. Bar Gil,&nbsp;Ruslan Sergienko,&nbsp;Nir Roguin,&nbsp;Shoham Birman,&nbsp;Sergio L. Kobal","doi":"10.1111/echo.70077","DOIUrl":"10.1111/echo.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Timing of treatment of aortic stenosis (AS) is of key importance. AS severity is currently determined by transthoracic echocardiography (TTE) with a main focus on mean trans-aortic gradients. However, echocardiography has its limitations. The transvalvular flow rate (<i>Q</i>), is defined as the ratio of stroke volume (SV) to ejection time (ET): <i>Q</i> = SV/ET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To examine the prognostic value of aortic transvalvular flow rate (<i>Q</i>), in patients with moderate or severe AS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 824 patients diagnosed with AS between 2017 and 2020, and followed up until 2022 for four clinical outcomes: mortality, congestive heart failure (CHF), transcatheter aortic valve implantation (TAVI), and surgical aortic valve replacement (SAVR) was used for this retrospective study. Univariate and multivariate regression analyses were performed for the whole cohort and for the moderate AS subgroup, to identify prognostic markers. Kaplan-Meier survival analysis was conducted for different transvalvular flow rates and AS severities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings demonstrate that lower <i>Q</i> is a significant risk factor for all-cause mortality even when adjusted for other echocardiographic and clinical variables. Survival analysis for the composite outcome occurrence (TAVI, SAVR, CHF, or mortality) and mortality showed significant differences between groups stratified by AS severity and <i>Q</i> (<i>p</i> value &lt;0.0001). Specifically, <i>Q</i> was more substantial in the moderate AS group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transvalvular flow rate (<i>Q</i>) is independently prognostic for all-cause mortality. Furthermore, patients with moderate AS and lower <i>Q</i> should be closely monitored. Flow rate assessment should be integrated into the diagnosis, classification, and prognosis framework for AS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014271","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":"Left Atrial Mechanics and Atrioventricular Coupling in Hypertension With Supra-Normal Left Ventricular Ejection Fraction","authors":"Chong Liu,&nbsp;Wen-Jun Xu,&nbsp;Jia-Wei Tian","doi":"10.1111/echo.70079","DOIUrl":"10.1111/echo.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Supra-normal left ventricular ejection fraction (snLVEF) represents a heterogeneous group with distinct prognoses. Left atrial (LA) strain, measured by speckle tracking echocardiography (STE), is a validated prognostic indicator. This study aimed to evaluate LA and left ventricular (LV) mechanical strains in hypertensive patients with snLVEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 101 patients (mean age 59.7 ± 8.4 years; 61.4% men) with primary arterial hypertension and preserved LVEF (≥50%). Patients were categorized into low-normal LVEF (lnLVEF; 50%–59%), mid-normal LVEF (mnLVEF; 60%–69%), and snLVEF (≥70%). LV global longitudinal strain (LVGLS) and LA strains during reservoir (LASr), conduit (LAScd), and contraction (LASct) phases were measured using STE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative wall thickness was significantly higher in snLVEF patients compared to mnLVEF (<i>p</i> &lt; 0.01), with no difference in LVGLS (<i>p</i> = 0.933). Compared to mnLVEF, snLVEF patients had reduced LASr and LAScd (both <i>p</i> &lt; 0.01) but preserved LASct (<i>p</i> = 0.057). In contrast, lnLVEF patients showed greater reductions in all phasic LA strains (all <i>p</i> &lt; 0.01). Loess regression revealed an inverted U-shaped relationship between LASr and LVEF, peaking at LVEF 65%–70%. The mitral E/e′_mean ratio and LVGLS correlated moderately to strongly with LASr (<i>r</i> = −0.39 and <i>r</i> = −0.65, respectively; both <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hypertensive patients with snLVEF exhibit impaired LA reservoir and conduit functions while maintaining pump function, suggesting snLVEF may be an intermediate stage between mnLVEF and lnLVEF as hypertension progresses. Further studies are needed to explore the prognostic potential of LA strain in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015721","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 Application of the Fetal HQ Technique in the Evaluation of Normal Fetal Cardiac Function at Different Gestational Weeks","authors":"Xiao-rong Su,&nbsp;Ai-lin Wang,&nbsp;Hong-xia Tie,&nbsp;Wen-rui Wu,&nbsp;Wen-dong Zhang,&nbsp;Ke-xiong Niu,&nbsp;Tian-gang Li","doi":"10.1111/echo.70078","DOIUrl":"10.1111/echo.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the clinical value of fetal heart quantification (fetal HQ) in the evaluation of normal fetal heart size, morphology, and cardiac function at different gestational weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 101 pregnant women diagnosed with a healthy fetus by fetal echocardiography from September 2021 to December 2023 were selected and classified into four different periods of gestational weeks: 20–28 weeks (25 cases), 29–32 weeks (26 cases), 33–36 weeks (26 cases), and 37–40 weeks (24 cases). Quantitative analyses were performed by automatically tracking the endocardium using fetal HQ software that comes with the Voluson E10 from GE. To investigate the correlation between four-chambered vesicle length end-diastolic (4CV LED), four-chambered vesicle transverse width end-diastolic (4CV TWED), global sphericity index (GSI), ejection fraction (EF), stroke volume (SV), cardiac output (CO), and gestation age (GA), and the variability of normal fetal cardiac morphology and cardiac function at different gestational weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A statistically significant difference was observed between 4CV LED and 4CV TWED in normal fetuses at different gestational weeks (<i>p</i> &lt; 0.05), which exhibited a positive correlation with gestational week. Conversely, no significant correlation was identified between GSI and gestational week (<i>p</i> &gt; 0.05). The mean GSI of 101 normal fetuses was found to be 1.25 ± 0.09. A comparative analysis of EF, SV, and CO in normal fetuses at different gestational weeks revealed statistically significant differences in SV and CO (<i>p</i> &lt; 0.05), which gradually increased with gestational weeks, whereas there was no statistically significant difference in EF (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fetal HQ represents a straightforward and dependable method for evaluating GSI and 24-segment SI of the left and right ventricles, which can provide a certain theoretical basis for the clinical quantitative evaluation of fetal cardiac geometry and cardiac function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015718","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":"Utility of Cardiovascular CT in Ischemic Heart Disease","authors":"Davide Marchetti,&nbsp;Michele Gallazzi,&nbsp;Giulia Nemola,&nbsp;Marco Stracqualursi,&nbsp;Blanca Prestini,&nbsp;Alessandro Masini,&nbsp;Maria Clara Alessandrello,&nbsp;Sara Belleggia,&nbsp;Pasquale Paolisso,&nbsp;Daniele Andreini,&nbsp;Edoardo Conte","doi":"10.1111/echo.70032","DOIUrl":"10.1111/echo.70032","url":null,"abstract":"<p>Cardiac computed tomography angiography (CCTA) has acquired a pivotal role in modern cardiology. It represents the gold standard for noninvasive coronary imaging. Moreover, CCTA permits a comprehensive evaluation of atheromatic burden and plaque composition. This study aims to review the impact of CCTA across the different presentations of ischemic heart disease, from primary prevention to the evaluation of patients requiring revascularization.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015042","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":"Is Myocardial Work a Surrogate Marker for Functional Coronary Artery Stenosis or a Marker of Coronary Atherosclerosis?","authors":"Rita Pavasini","doi":"10.1111/echo.70073","DOIUrl":"10.1111/echo.70073","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985478","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":"Association of Epicardial Adipose Tissue With Left Atrial Function in Heart Failure With Preserved Ejection Fraction","authors":"Hidekazu Tanaka","doi":"10.1111/echo.70072","DOIUrl":"10.1111/echo.70072","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985436","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":"Understanding the Link Between Lipoprotein (A) and Thoracic Aortic Damage: A Step Toward to Improve Prevention","authors":"Elisa Gherbesi,&nbsp;Andrea Faggiano,&nbsp;Cesare Cuspidi","doi":"10.1111/echo.70074","DOIUrl":"10.1111/echo.70074","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985481","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 Quadruple Valve Infective Endocarditis Combined With Ventricular Septal Defect","authors":"Qiuyu Xiao,&nbsp;Shuzhen Wang,&nbsp;Feng Xiong","doi":"10.1111/echo.70076","DOIUrl":"10.1111/echo.70076","url":null,"abstract":"<p>Quadruple valve infective endocarditis is very rare and is often combined with congenital heart disease or other risk factors. The prognosis of this disease is poor and echocardiography is an important method of diagnosing this disease.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962635","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}