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

{"title":"Left Ventricular Pseudoaneurysm With Acquired Gerbode-Type Defect After Mitral Bioprosthetic Valve Replacement.","authors":"Wei Yan, Wenjun Deng","doi":"10.1111/echo.70606","DOIUrl":"https://doi.org/10.1111/echo.70606","url":null,"abstract":"<p><p>We present a 61-year-old woman with progressive dyspnea 20 days after mitral bioprosthetic valve replacement. Multimodality imaging revealed a left ventricular pseudoaneurysm rupturing into the right atrium-an acquired Gerbode-type defect with significant left-to-right shunt-most likely caused by perioperative atrioventricular annular injury. Emergency surgery using a skirted conduit technique successfully repaired the rupture while preserving the functioning bioprosthesis. This case highlights the critical role of multimodality imaging in diagnosing and surgically managing this uncommon but life-threatening complication.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70606"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801149","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":"From Association to Action: Clarifying the Incremental Value of Machine-Reported RAD/RVH.","authors":"Shuhui Zhou, Zhengyi Zhang","doi":"10.1111/echo.70575","DOIUrl":"https://doi.org/10.1111/echo.70575","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70575"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801189","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":"From Snapshot to Trajectory: The RV-3 Check for Pulmonary Arterial Hypertension Follow-up.","authors":"Arif Albulushi, Ahmed Shams, Hatem Farhan","doi":"10.1111/echo.70600","DOIUrl":"10.1111/echo.70600","url":null,"abstract":"<p><p>Pulmonary arterial hypertension follow-up relies on composite clinical risk assessment, yet symptoms and functional markers may not always reflect right ventricular (RV) adaptation. We propose the RV-3 Check, a practical framework for serial RV assessment using three complementary domains: remodeling, systolic performance, and RV-pulmonary arterial coupling. Each domain is classified as improving, stable, worsening, or indeterminate, with overall RV direction assigned when at least two domains change concordantly. The framework is intended to identify clinically important discordance, particularly symptomatic improvement despite progressive RV deterioration, or persistent symptoms despite objective RV recovery. The RV-3 Check does not replace ESC/ERS risk stratification or invasive hemodynamics; rather, it serves as a structured confirmation tool that may prompt repeat imaging, cardiac magnetic resonance, or right-heart catheterization when findings are uncertain or management-changing. Prospective validation is needed before it can be used as an independent treatment algorithm.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70600"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801170","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":"Multimodality Imaging of Unrepaired Adult Interrupted Aortic Arch With Pulmonary Artery Aneurysm.","authors":"José Martín Alanís-Naranjo, Edgar Alejandro Sáenz-Ordóñez, Gabriela Melendez-Ramírez, Ana María Rosas-Vázquez, María Eugenia Ruiz-Esparza Dueñas, Daniel Campuzano-González","doi":"10.1111/echo.70599","DOIUrl":"10.1111/echo.70599","url":null,"abstract":"<p><p>A 25-year-old woman with progressive dyspnea underwent multimodality cardiovascular imaging, establishing the diagnosis of interrupted aortic arch with a giant pulmonary artery aneurysm. The combined strengths of echocardiography, cardiac computed tomography, cardiovascular magnetic resonance, and 4D flow imaging guided therapeutic decision-making in complex congenital heart disease.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70599"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801151","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":"Non-Invasive Assessment of Left Ventricular Myocardial Work in Conditions Associated With Increased Left Ventricular Wall Thickness.","authors":"Sapna Nagvanshi, Ravi R Kasliwal, Manish Bansal","doi":"10.1111/echo.70604","DOIUrl":"https://doi.org/10.1111/echo.70604","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) myocardial work (MW) assessment is a novel non-invasive tool for relatively load-independent assessment of LV myocardial contractile function. In this study, we compared LVMW characteristics across three conditions- aortic stenosis (AS), chronic kidney disease (CKD), and cardiac amyloidosis (CA)- that share increased LV wall thickness but arise from fundamentally different pathophysiological mechanisms.</p><p><strong>Methods: </strong>The study included 25 consecutive patients in each of the following groups: severe AS scheduled for aortic valve replacement, CKD on maintenance hemodialysis, and light-chain CA. An additional group of twenty-five apparently healthy individuals served as controls. LV global longitudinal strain (GLS) and MW were quantified using speckle tracking echocardiography.</p><p><strong>Results: </strong>LV mass was significantly increased in all three disease groups compared with controls. LV ejection fraction was mildly reduced but similar in all the three disease groups. LVGLS was impaired in all patient groups, with the greatest reduction observed in CA. Global work index and global constructive work were highest in patients with AS [1815 mmHg% (interquartile range or IQR 1271, 2061) and 2094 mmHg% (IQR 1815, 2521), respectively] and lowest in patients with CA [804 mmHg% (IQR 596, 1091) and 1117 mmHg% (IQR 810, 1256)], while CKD patients demonstrated intermediate values. Multivariable analyses adjusting for demographic and hemodynamic variables confirmed these findings.</p><p><strong>Conclusion: </strong>Our study demonstrates distinct patterns of MW across conditions associated with increased LV wall thickness. These findings support the complementary role of MW assessment in the comprehensive evaluation of LV function and myocardial dysfunction. Larger prospective studies are required to establish its diagnostic and prognostic utility.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70604"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801211","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":"Contemporary Imaging Modalities for Transcatheter Interatrial Communication Closure: A Comparative Meta-Analysis of Intracardiac and Transesophageal Echocardiography.","authors":"Dyah Wulan Anggrahini, Bernadus Bernardino Bramantyo, Arditya Damarkusuma, Ariana Safitri Putri, Bayu Yudha Pratama, Real Kusumanjaya Marsam","doi":"10.1111/echo.70598","DOIUrl":"10.1111/echo.70598","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac echocardiography (ICE) is increasingly used to guide cardiovascular interventions. This study compared the performance of ICE with transesophageal echocardiography (TEE) in device closures of interatrial communications.</p><p><strong>Methods: </strong>A systematic search through PubMed, Scopus, Cochrane Library, and Europe PMC identified clinical studies directly comparing ICE and TEE as imaging guidance modalities for percutaneous closure of ASD or PFO in pediatric and adult populations. The key outcomes encompassed procedural time, fluoroscopy time, procedural success, complete closure at the latest follow-up, and major and minor complications. Pooled mean differences (MD) and risk ratios (RR) with corresponding 95% confidence intervals (CI) were measured by applying the random-effects model.</p><p><strong>Results: </strong>Twelve studies comprising 5054 participants (ICE = 2480; TEE = 2574) were included in the quantitative analysis. Meta-analysis demonstrated a numerically shorter procedural time (MD -20.80 min; 95% CI -29.84 to -11.75; p < 0.00001), but not fluoroscopy time (MD -1.17 min; 95% CI -2.64 to 0.30; p = 0.12), in the ICE group compared with the TEE group. Procedural success rates and complete closure at the latest follow-up were comparable between both imaging strategies. In safety analyses, ICE was associated with a meaningful reduction of risk of major complications compared to TEE (RR 0.77; 95% CI 0.64 to 0.92; p = 0.004). Comparable findings were observed in the incidence of minor complications.</p><p><strong>Conclusion: </strong>ICE represents a promising alternative imaging modality for guiding transcatheter closure of ASD and PFO. Compared with TEE, ICE is associated with a numerically reduced procedural duration and a lower incidence of major complications, while maintaining comparable procedural success and long-term closure rates.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70598"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760229","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":"Research Tool or Clinical Parameter?","authors":"Jens-Uwe Voigt","doi":"10.1111/echo.70574","DOIUrl":"10.1111/echo.70574","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70574"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702336","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":"Multimodal Echocardiographic Assessment in Intravenous Immunoglobulin-Resistant Kawasaki Disease: From Prediction to Long-Term Surveillance.","authors":"Xin Xu, Tingting Wu, Kexiang Wei","doi":"10.1111/echo.70589","DOIUrl":"https://doi.org/10.1111/echo.70589","url":null,"abstract":"<p><p>Kawasaki disease (KD) with intravenous immunoglobulin (IVIG) non-response is a high-risk state in which fever response, coronary evolution, and myocardial dysfunction may diverge. This narrative review, appraised against SANRA after drafting, examines echocardiography across the disease-management lifecycle, from pre-treatment risk enrichment to long-term surveillance. PubMed/MEDLINE searches were supplemented by cross-source discovery and metadata verification. Standardized serial coronary measurement with consistent use of one Z-score system remains the management core. Initial composite echocardiographic abnormalities, myocardial deformation, and tissue-Doppler indices may enrich risk assessment, but current discrimination is moderate and thresholds lack external validation. IVIG non-response and coronary aneurysm are related but non-interchangeable; defervescence does not establish coronary safety, whereas definite baseline coronary artery aneurysm is a treatment-relevant high-risk phenotype. Deformation, myocardial work, right-heart indices, coronary flow reserve, and complementary imaging can refine selected clinical questions but should not trigger treatment in isolation. Echocardiography can therefore structure coronary and myocardial surveillance, but cannot yet independently determine treatment resistance or support a universal multimodal treatment score. Prospective multicenter standardization, external validation, and clinical-utility testing are required before multimodal imaging-guided treatment decisions are adopted.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70589"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801134","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":"Novel Insights from Blood Speckle Imaging for the Assessment of Left Ventricular Flow Dynamics in Adult Patients: A Three-Patient Proof-of-Concept Case Series in the Context of Current Evidence.","authors":"Francesco Mangini, Massimo Grimaldi, Nicola Vitulano, Federica Troisi, Antonio Di Monaco, Luca Sgarra, Francesco Spinelli, Roberto Calbi","doi":"10.1111/echo.70593","DOIUrl":"10.1111/echo.70593","url":null,"abstract":"<p><p>Transthoracic echocardiography is the cornerstone of cardiac imaging, yet conventional volumetric and Doppler indices may fail to detect clinically meaningful changes in ventricular performance. Patients often improve symptomatically and biochemically after device-based or medical therapies without parallel changes in standard echocardiographic measures, reflecting that the left ventricle functions not only as a pressure-volume pump but as a complex fluid-dynamic system in which myocardial mechanics and intracavitary blood flow are tightly coupled. Blood speckle imaging (BSI) tracks red blood cell speckle patterns, enabling angle-independent, contrast-free, real-time visualization and qualitative assessment of intraventricular vortex organization. We present a three-patient proof-of-concept case series including non-ischemic dilated cardiomyopathy treated with cardiac contractility modulation, ischemic cardiomyopathy managed by conduction-system pacing (CSP), and heart failure with preserved ejection fraction treated with medical optimization. BSI was performed before and after therapy and interpreted alongside a review of the intracardiac flow-dynamics literature. In all patients, symptoms and N-terminal pro-B-type natriuretic peptide levels improved despite minimal changes in left ventricular volumes and conventional systolic indices, whereas BSI revealed reorganization of intraventricular flow, characterized by fewer competing vortices, reduced late-diastolic persistence, and more physiological vortex positioning. These observations support the hypothesis that flow reorganization may represent an early marker of ventricular recovery preceding detectable structural remodeling. To our knowledge, this is among the first adult reports of therapy-associated left ventricular flow reorganization assessed by BSI across distinct heart failure phenotypes. These findings are hypothesis-generating and require prospective validation against quantitative four-dimensional flow cardiovascular magnetic resonance.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70593"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801218","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":"Beyond Left Ventricular and Left Atrial Strain: The Need for Comprehensive Four-Chamber Mechanical Assessment during the Preclinical Phase of Cardiovascular Disease.","authors":"Andrea Sonaglioni, Gian Luigi Nicolosi","doi":"10.1111/echo.70592","DOIUrl":"10.1111/echo.70592","url":null,"abstract":"<p><p>The combined assessment of left ventricular global longitudinal strain and left atrial reservoir strain has recently demonstrated significant incremental prognostic value in patients with heart failure with reduced ejection fraction, reinforcing the concept that ventricular and atrial mechanics provide complementary information beyond conventional echocardiographic parameters. However, the implications of these findings extend beyond risk stratification in established heart failure. Growing evidence indicates that myocardial deformation abnormalities frequently involve all four cardiac chambers and develop during the preclinical stages of cardiovascular disease, when left ventricular ejection fraction and conventional echocardiographic indices remain preserved. Across diverse clinical settings-including metabolic disorders, inflammatory diseases, cardio-oncology, pregnancy-related cardiovascular conditions, and chronic pulmonary diseases-comprehensive multichambered speckle-tracking echocardiography has consistently identified early mechanical remodeling before overt structural or functional abnormalities become evident. This evolving evidence supports a paradigm shift from isolated chamber-specific strain analysis toward integrated whole-heart mechanical phenotyping. At the same time, the remarkable sensitivity of strain imaging requires careful interpretation, as myocardial deformation is influenced not only by intrinsic myocardial function but also by loading conditions, technical factors, and extrinsic mechanical determinants such as thoracic anatomy. Future research should therefore focus on comprehensive four-chamber mechanical assessment as a physiological and clinically meaningful approach for the early identification, characterization, and risk stratification of cardiovascular disease.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70592"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702326","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}