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

{"title":"Right Ventricular Function and Pulmonary Arterial Coupling in Paediatric Obstructive Sleep Apnea.","authors":"Yumi Yuk-Ting Chan, Samuel Chung-Sum Ho, Chun-Ting Au, Dennis Lip-Yen Lee, Natalie Moon-Wah Leung, Ka-Li Kwok, Jacob Pak-Lam Ho, Hei-To Leung, Kwok-Lap Chan, Albert Martin Li, Kate Ching-Ching Chan, Yiu-Fai Cheung","doi":"10.1111/echo.70590","DOIUrl":"10.1111/echo.70590","url":null,"abstract":"<p><strong>Purpose: </strong>Right ventricular (RV) dysfunction and increased pulmonary arterial (PA) pressure may occur in children with obstructive sleep apnea (OSA). Long-term data on RV-PA coupling in children with OSA with or without adenotonsillectomy are absent.</p><p><strong>Methods: </strong>This prospective cohort study included children aged 5 to 12 years diagnosed with tonsillar hypertrophy and moderate-to-severe OSA. All subjects underwent echocardiographic assessment and sleep study at least 5 years since initial recruitment. Right atrial, RV function and indexed pulmonary artery acceleration time (PAATi) were evaluated. RV-PA coupling was assessed by tricuspid annular plane systolic excursion (TAPSE) / PAATi and RV global longitudinal strain (GLS) / PAATi.</p><p><strong>Results: </strong>We evaluated 160 subjects, including 38 with OSA who declined adenotonsillectomy (Group I), 80 with OSA post-adenotonsillectomy (Group II), and 42 controls (Group III). Baseline demographics were similar across groups. At a mean follow-up of 7.2 ± 2.5 years, the latest OAHI did not differ significantly between the two OSA groups. Echocardiographic assessment revealed small intergroup differences in RA total strain, peak tricuspid annular systolic velocity, RVGLS and PAATi, whereas TAPSE, RV fractional area change and systolic strain rate were comparable across groups. Importantly, RV-PA coupling indices did not differ significantly among the three groups. Furthermore, within the OSA cohort, neither follow-up duration nor current OAHI severity correlated significantly with RV function or RV-PA coupling indices.</p><p><strong>Conclusions: </strong>RV function and RV-PA coupling are preserved in adolescents and young adults with a childhood diagnosis of OSA, irrespective of prior adenotonsillectomy.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70590"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727112","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":"Atrial Fibrillation Burden and Early Mitral Valve Remodelling in Patients Without Significant Mitral Regurgitation: A 3D Transesophageal Echocardiographic Study.","authors":"Amr Yosry Emam, Mahmoud Shaaban, Ahmed Salah Elgendy, Karimeldeen Hafez, Amany Khaled Elagamy, Omnia Ibrahim, Abdelrahman Omar, Ahmed Mohy Zidan, Bakeer Mohamed Bakeer Saleh, Nagwa Thabet, Soha Hekal, Hani Mahmoud-Elsayed","doi":"10.1111/echo.70579","DOIUrl":"10.1111/echo.70579","url":null,"abstract":"<p><strong>Background: </strong>The progression of mitral valve (MV) remodelling in atrial fibrillation (AF) patients without significant mitral regurgitation (MR) remains poorly characterized. We aimed to determine whether AF burden-paroxysmal versus persistent-differentially affects MV annular geometry, leaflet morphology, and functional dynamics using three-dimensional transesophageal echocardiography (3D-TEE).</p><p><strong>Methods: </strong>In prospective cross-sectional observational study, 46 consecutive AF patients without significant MR (paroxysmal AF: n = 18; persistent AF: n = 28) underwent comprehensive 3D transesophageal echocardiography. Offline semi-automated quantitative analysis (4D MV Assessment, TomTec) was performed to assess mitral annular dimensions and geometry, leaflet morphology (area and angulation), and functional parameters including tenting volume, coaptation depth, and dynamic annular motion.</p><p><strong>Results: </strong>Despite comparable demographics, persistent AF patients had larger LA diameter (45.4 ± 7.1 vs. 40.3 ± 6.3 mm; p = 0.05), lower LVEF (45.5 ± 15.4 vs. 56.5% ± 15.2%; p = 0.042), and greater LV end-systolic dimension (41.3 ± 9.7 vs. 33.1 ± 9.4 mm; p = 0.018). 3D-TEE demonstrated significant annular enlargement in persistent AF: larger AP diameter (3.92 ± 0.53 vs. 3.60 ± 0.47 cm; p = 0.042), AL-PM diameter (3.74 ± 0.50 vs. 3.49 ± 0.34 cm; p = 0.048), 3D annular area (11.98 ± 3.19 vs. 10.34 ± 2.05 cm²; p = 0.038), and 2D annular area (9.78 ± 2.83 vs. 8.27 ± 1.87 cm²; p = 0.035). Anterior leaflet area was larger (8.93 ± 2.07 vs. 7.60 ± 2.02 cm²; p = 0.036) and distal anterior leaflet angle was reduced (16.97 ± 5.03 vs. 20.76 ± 6.40°; p = 0.042). Annular shape, tenting parameters, coaptation depth, and dynamic motion were preserved in both groups.</p><p><strong>Conclusion: </strong>Persistent AF was associated with early mitral annular enlargement, anterior leaflet remodelling, impaired LV function, and LA dilation, even in the absence of significant MR. However, the higher heart rate in persistent AF, unrecorded AF duration, and lack of data on prior rhythm-control therapy limit attribution of these changes to AF burden alone. These findings are hypothesis-generating and require confirmation in prospective studies accounting for these potential confounders.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":"e70579"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765942","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":"Impact of Left and Right Bundle Branch Block on Left Ventricular Systolic Function and Myocardial Mechanics Assessed by Speckle-Tracking Echocardiography and Cardiac Magnetic Resonance Feature Tracking: A Systematic Review and Meta-Analysis","authors":"Andrea Sonaglioni,&nbsp;Michele Lombardo,&nbsp;Giulio Francesco Gramaglia,&nbsp;Gian Luigi Nicolosi,&nbsp;Massimo Baravelli","doi":"10.1111/echo.70565","DOIUrl":"10.1111/echo.70565","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;Bundle branch conduction abnormalities are associated with ventricular dyssynchrony, impaired myocardial mechanics, and progressive systolic dysfunction. Advanced deformation imaging techniques, including speckle-tracking echocardiography (STE) and cardiac magnetic resonance feature tracking (CMR-FT), may identify subclinical ventricular dysfunction beyond conventional left ventricular ejection fraction (LVEF). We performed a systematic review and meta-analysis to evaluate conventional systolic function and myocardial deformation abnormalities associated with left bundle branch block (LBBB) and right bundle branch block (RBBB).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PubMed, Scopus, and EMBASE databases were systematically searched for observational studies evaluating ventricular systolic function and myocardial deformation parameters in patients with LBBB and/or RBBB using STE and/or CMR-FT. Comparative meta-analyses were performed using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Separate analyses were conducted for LVEF and left ventricular global longitudinal strain (LV-GLS).&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;Sixteen studies were included in the systematic review, whereas eight were eligible for quantitative meta-analysis. Compared with healthy controls, patients with LBBB demonstrated significantly reduced LVEF (SMD −0.404, 95% CI −0.553 to −0.255; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and impaired LV-GLS (SMD −0.345, 95% CI −0.535 to −0.156; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). In contrast, isolated RBBB was not associated with significant overall differences in either LVEF (SMD 0.051, 95% CI −0.146 to 0.247; &lt;i&gt;p&lt;/i&gt; = 0.613) or LV-GLS (SMD 0.064, 95% CI −0.134 to 0.262; &lt;i&gt;p&lt;/i&gt; = 0.527). Direct comparisons demonstrated significantly greater impairment of both LVEF (SMD −0.361, 95% CI −0.519 to −0.202; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and LV-GLS (SMD −0.436, 95% CI −0.595 to −0.276; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) in LBBB than in RBBB. STE-based studies generally demonstrated larger effect sizes and greater heterogeneity than CMR-FT investigations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Bundle branch conduction abnormalities, particularly LBBB, are closely associated with impaired left ventricular systolic performance and myocardial mechanics. LV-GLS abnormalities appeared consistently more pronounced than LVEF abnormalities across several comparisons, suggesting that myocardial deformation imaging may be more sensitive to the mechanical consequences of conduction abnormalities at a population level. Given the observational nature of the included studies, the substantial clinical","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632550","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":"Reply to “From Association to Action: Clarifying the Incremental Value of Machine-Reported RAD/RVH”","authors":"Yoshihiro Fuchigami","doi":"10.1111/echo.70580","DOIUrl":"10.1111/echo.70580","url":null,"abstract":"<p>\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":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632491","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":"Automated Echocardiographic Assessment of Left Atrial Remodeling in Atrial Fibrillation Using Dynamic HeartModel and AutoStrain LA","authors":"Xiaoyi Gong,&nbsp;Manying Xie,&nbsp;Jiabao Yin,&nbsp;Yuqi Liu,&nbsp;Yan Hua,&nbsp;Jiaqi Zhang","doi":"10.1111/echo.70568","DOIUrl":"https://doi.org/10.1111/echo.70568","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To compare left atrial (LA) size, emptying function, and strain among non-atrial fibrillation (AF) controls, patients with paroxysmal AF (PAF), and patients with persistent AF (PeAF) using automated 3D Dynamic HeartModel (DHM) and AutoStrain LA, and to examine their association with AF stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 210 participants: 70 non-AF controls, 70 patients with PAF, and 70 patients with PeAF. Controls and patients with PAF were examined during sinus rhythm; acquisition rhythm in PeAF was not uniformly documented. LA volumes and LA ejection fraction (LAEF) were measured using automated 3D DHM, and LA strain was assessed using AutoStrain LA. AF stage was coded as 0, 1, and 2. Multivariable regression analyses evaluated associations with LA volume index (LAVI), LAEF, and LA reservoir strain (LASr). Reproducibility was assessed using intraclass correlation coefficients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LAVI increased from 29.50 to 38.00 and 58.50 mL/m² across controls, PAF, and PeAF, whereas LAEF decreased from 65.37% ± 7.39% to 50.70% ± 8.28% and 23.34% ± 6.58%, and LASr decreased from 38.00% to 25.05% and 10.20%, respectively (all <i>p</i> &lt; 0.001). After adjustment, AF stage remained associated with higher LAVI (B = 16.43; 95% CI, 13.69–19.17), lower LAEF (B = −19.11; 95% CI, −20.58 to −17.64), and lower LASr (B = −12.37; 95% CI, −13.57 to −11.18; all <i>p</i> &lt; 0.001). Findings were similar after excluding participants with heart rate &gt;100 bpm. Intra-/inter-observer ICCs were 0.989/0.986 for LAVI, 0.975/0.964 for LAEF, and 0.983/0.977 for LASr.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Automated 3D DHM and AutoStrain LA demonstrated graded LA enlargement, reduced emptying function, and impaired reservoir strain across AF temporal patterns. These automated measurements showed favorable reproducibility and may help characterize LA structural and functional remodeling in patients with AF.</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":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616961","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 Coupling Indexes as New Mortality Predictors in Chronic Chagas Disease","authors":"Roberto M. Saraiva,&nbsp;Mauro Felippe F. Mediano,&nbsp;Henrique H. Veloso,&nbsp;Marcelo T. Holanda,&nbsp;Andréa R. Costa","doi":"10.1111/echo.70560","DOIUrl":"https://doi.org/10.1111/echo.70560","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the all-cause mortality predictive value of left atrioventricular coupling indexes in patients with chronic Chagas disease (CD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective longitudinal study included 382 patients with chronic CD. The left atrioventricular coupling index (LACI) was defined as the ratio of left atrial (LA) over left ventricular (LV) end-diastolic volumes. LA volumetric/mechanical coupling index (LAVI/A’) was the ratio of maximum LA volume index over late diastolic mitral annulus velocity. The endpoint was a composite of all-cause mortality or heart transplant. The associations between LACI or LAVI/A’ and the endpoint independent from clinical, electrocardiographic, and 2D echocardiographic parameters (Model I) or from Model I adjusting variables plus LV and LA strain parameters (Model II) were tested by multivariate Cox-proportional-hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After a mean follow-up of 6.6 ± 2.7 years, 80 patients died and two underwent a heart transplant. LACI was associated with the endpoint in Models I (HR 1.03, 95% CI 1.01–1.05, <i>p =</i> 0.01) and II (HR 1.03, 95% CI 1.01–1.05, <i>p =</i> 0.0008). LAVI/A’ was also associated with the endpoint in Models I (HR 1.08, 95% CI 1.05–1.12, <i>P &lt;</i> 0.0001) and II (HR 1.09, 95% CI 1.05–1.12, <i>P &lt;</i> 0.0001). The area under the ROC curve was larger for LAVI/A’ than LACI (0.87 vs. 0.65, <i>P &lt;</i> 0.0001). The optimal cutoff value for LAVI/A’ was 3.3 mL × s/cm⁻¹ per m² (sensitivity 81.7%, specificity 83.7%). Patients with LAVI/A’ ≥ 3.3 at baseline had a 19-fold higher risk for all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>New echocardiographic LA coupling indexes are promising predictors of dismal clinical outcomes in CD.</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":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616489","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":"Inferior Vena Cava Ultrasound Does Not Reliably Estimate Systemic Venous Pressure in Adults With a Fontan Circulation","authors":"Jef Van den Eynde,&nbsp;Hannah Van Belle,&nbsp;Jan Bogaert,&nbsp;Piet Claus,&nbsp;Els Troost,&nbsp;Pieter De Meester,&nbsp;Thibault Petit,&nbsp;Werner Budts,&nbsp;Alexander Van De Bruaene","doi":"10.1111/echo.70581","DOIUrl":"https://doi.org/10.1111/echo.70581","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Current ASE/EACVI echocardiography guidelines recommend estimating central venous pressure from inferior vena cava (IVC) diameter and collapsibility in biventricular circulations. Because altered blood volume, venous capacitance, and venous tone may weaken the relationship between IVC morphology and systemic venous pressure, it is uncertain whether these criteria apply in the Fontan circulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 101 adults with a Fontan circulation (median age 27.8 years), echocardiographic IVC and resting peripheral venous pressure (PVP) were measured simultaneously. ASE/EACVI guidelines were applied directly, estimating central venous pressure based on IVC diameter &gt; 21 mm and collapsibility &lt; 50%. Agreement with measured PVP categories was assessed using weighted κ. As a secondary post hoc analysis, IVC diameter and collapsibility thresholds were optimized within the same cohort to assess whether simple recalibration could materially improve agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median resting PVP was 10.6 (8.6–13.1) mmHg, and 21% had PVP ≥ 15 mmHg. IVC collapsibility was &lt; 50% in 99%, whereas only 17% had IVC diameter &gt; 21 mm. IVC diameter (<i>r</i> = 0.14, <i>p</i> = 0.163) and IVC collapsibility (<i>r</i> = −0.06, <i>p</i> = 0.527) did not correlate with PVP. Conventional criteria assigned no patient to the low pressure category and showed poor agreement with measured PVP (weighted κ 0.02, 95% confidence interval −0.12 to 0.16). Post hoc within-cohort recalibration (using IVC diameter ≥ 20 mm and collapsibility ≤ 10% as cut-offs) only modestly improved agreement (weighted κ 0.24, 95% confidence interval 0.05 to 0.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IVC-based pressure estimation is unreliable in adults with a Fontan circulation. Validated peripheral or invasive pressure measurements should be preferred for accurate Fontan pressure assessment.</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":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616433","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 Ventricular Mechanics and Myocardial Work in Competitive Sprinters","authors":"Esra Poyraz,&nbsp;Fatma Can","doi":"10.1111/echo.70571","DOIUrl":"https://doi.org/10.1111/echo.70571","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sprint exercise is characterized by repeated short-duration high-intensity anaerobic activity associated with distinct hemodynamic and autonomic adaptations. However, the effects of long-term sprint training on left ventricular (LV) mechanics and myocardial work (MW) parameters remain insufficiently investigated. This study aimed to evaluate LV global longitudinal strain (GLS) and MW indices in competitive sprinters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 65 competitive sprinters and 40 age- and sex-matched healthy sedentary controls were prospectively enrolled. All participants underwent comprehensive transthoracic echocardiography, including two-dimensional speckle-tracking echocardiography and non-invasive myocardial work analysis. GLS, global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global myocardial work efficiency (GWE) were quantified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Resting heart rate was significantly lower, whereas stroke volume was significantly higher in sprinters compared with controls. However, LV GLS and principal MW indices, including GWI, GCW, GWW, and GWE, were comparable between groups (all <i>p</i> &gt; 0.05). Intra- and interobserver reproducibility for MW measurements demonstrated good-to-excellent agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Long-term sprint training appears to be associated with preserved myocardial mechanics and myocardial work indices despite chronic exposure to high-intensity anaerobic exercise, supporting the presence of physiological rather than maladaptive cardiac adaptation in competitive sprinters.</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":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616492","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":"Quantitative Analysis of Pulmonary Right-to-Left Shunts and Patent Foramen Ovale via Agitated Saline Contrast Transesophageal Echocardiography: Associations With Migraine, Cryptogenic Stroke, and Transient Ischemic Attack","authors":"Jian Chen,&nbsp;Lang Wang,&nbsp;Yihua He,&nbsp;Zhengyi Li,&nbsp;Shanshan Huang,&nbsp;Hong Li","doi":"10.1111/echo.70576","DOIUrl":"https://doi.org/10.1111/echo.70576","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;Growing evidence associates patent foramen ovale right-to-left shunt (PFO-RLS) with conditions including migraine, cryptogenic stroke (CS), and transient ischemic attack (TIA). However, the potential role of pulmonary right-to-left shunt (P-RLS) remains unclear. This study aimed to characterize PFO-RLS and P-RLS using contrast transesophageal echocardiography (cTEE) and analyze their distinct features and intrinsic associations with migraine and CS/TIA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;302 patients with clinically suspected right-to-left shunt (RLS) contrast transesophageal echocardiography (cTEE) between October 2019 and January 2025 were retrospectively analyzed. Target Symptom Group included patients presenting with migraine, cryptogenic stroke (CS), and/or transient ischemic attack (TIA); all other patients comprised the Comparison Group. cTEE was performed to detect and quantitatively evaluate both patent foramen ovale right-to-left shunt (PFO-RLS) and pulmonary right-to-left shunt (P-RLS). We conducted stratified analyses to assess the relationships of PFO-RLS and P-RLS individually with the presence of target symptoms. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with the Target Symptom Group.&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;All 302 patients were successfully examined using TTE and cTEE. cTEE revealed 165 cases of PFO-RLS and 217 cases of P-RLS. Stratified analyses showed no statistical significance of P-RLS among patients with varying degrees of PFO-RLS between the positive symptom and other symptoms group. PFO-RLS was statistically significant between the two groups in patients with varying degrees of P-RLS. Pulmonary vein shunt and PFO shunt were significantly associated with positive symptoms (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) in the univariate analysis; however, only PFO shunt was an independent risk factor in the multivariate analysis (OR 1.363, &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Patients with moderate-to-severe dual shunts had the highest proportion(76.5%) of positive symptoms. Further analysis showed no significant interaction (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).&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;cTEE has a good diagnostic value for determining the source of RLS microvesicles. PFO-RLS causes migraine and CS/TIA; the more shunts there are, the more severe the symptoms. Current grading system for right-to-left shunt does not take microbubble size into consideration, although P-RLS is more common, it does not cause severe symptoms. A PFO shunt alone is an independent risk factor for migraine and CS/TIA.&lt;/p&gt;\u0000 ","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616490","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 the 2025 ASE Updated Recommendations on the Diagnosis of Left Ventricular Diastolic Dysfunction in Asymptomatic Elderly Inpatients With Preserved Ejection Fraction: A Multi-Center Retrospective Study","authors":"Wenwen Chen,&nbsp;Dian Zhang,&nbsp;Yunxiang Miao,&nbsp;Meifang Pan,&nbsp;Yuzhu Miao,&nbsp;Yuping Liao","doi":"10.1111/echo.70570","DOIUrl":"https://doi.org/10.1111/echo.70570","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiographic evaluation of left ventricular diastolic dysfunction (LVDD) remains ambiguous in asymptomatic elderly patients with preserved left ventricular ejection fraction (LVEF). This study aimed to assess the impact of the 2025 updated ASE guidelines on the diagnosis of LVDD in asymptomatic elderly inpatients with preserved ejection fraction, and to compare the diagnostic consistency of diastolic function grading between the 2016 and 2025 ASE guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multi-center retrospective study was conducted. A total of 2058 elderly patients who underwent hospitalization and surgery between January 2025 and December 2025 were enrolled. Patients with LVEF &lt;50% or cardiac symptoms were excluded. All subjects received a comprehensive transthoracic echocardiography. Left ventricular diastolic function was graded in accordance with the 2025 and 2016 ASE recommendations, respectively. The Kappa coefficient and overall agreement rate were calculated to analyze inter-guideline consistency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age was 70.8 ± 7.98 years, and 48.64% of patients were female. The prevalence of LVDD diagnosed according to the 2025 recommendations was higher than that diagnosed according to the 2016 guidelines (29.3% vs. 24%). Statistically significant inter-group differences were observed in core echocardiographic parameters across all diastolic function strata, including E/A ratio, e’ peak velocity, average E/e’ ratio, left atrial volume index (LAVi), and Tricuspid regurgitation peak velocity(TR) (<i>p</i> &lt; 0.001). Using the 2016 criteria, 12.8% of patients were classified as indeterminate diastolic function. The 2025 ASE algorithm eliminated all indeterminate cases, reclassifying them as normal diastolic function (<i>n</i> = 80), grade 1 diastolic dysfunction (<i>n</i> = 108), and grade 2 diastolic dysfunction (<i>n</i> = 76). Moderate diagnostic consistency was identified between the two guidelines (Kappa = 0.441), with an overall agreement rate of 75.3%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with the 2016 ASE guidelines, the 2025 updated ASE recommendations optimize the evaluation framework for left ventricular diastolic function in elderly patients, markedly reduce diagnostic indeterminacy, improve detection rates of LVDD, and demonstrate superior clinical applicability and risk stratification value.</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":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616491","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}