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

{"title":"Unmasking the Epicardial Adipose Tissue-Left Atrial Strain Nexus in HFpEF: A Potential Echocardiographic Signature of Cardiac Adaptation","authors":"Zhen Wang,&nbsp;KunDi Chen,&nbsp;Ting Wang,&nbsp;Fang Nie","doi":"10.1111/echo.70053","DOIUrl":"10.1111/echo.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to investigate the relationship between epicardial adipose tissue (EAT) and left atrial function in patients with preserved ejection fraction heart failure (HFpEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study involving 113 patients diagnosed with HFpEF and 48 control subjects without heart failure. Echocardiography was performed to assess EAT thickness and left atrial function was quantified using Autostrain left atrium (LA), including left atrial strain during reservoir phase (LASr), left atrial strain during conduit phase (LAScd), and left atrial strain during contraction phase (LASct). Clinical and biochemical parameters were correlated with EAT and LA strain using regression analyses and generating receiver operating characteristic (ROC) curves for left atrial strain parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EAT thickness was significantly greater in the HFpEF group (8.0 ± 1.0 mm) compared to the control group (5.0 ± 0.7 mm). HFpEF group exhibited poorer left ventricle diastolic function, indicated by lower e' velocity, E/A ratio, and higher E/e' values. Left atrial strain parameters, including LASr (22.4 ± 9.1%), LAScd (11.9 ± 6.9%), and LASct (10.5 ± 3.9%), were all lower in the HFpEF. EAT thickness was positively correlated with NT-proBNP, triglycerides, and fasting blood glucose. Multivariate analysis revealed significant associations between EAT and LA strain parameters even after adjusting for potential confounders. ROC curve analysis indicated that LASr had the highest diagnostic accuracy for HFpEF. Additionally, left atrial strain parameters were strongly correlated with left ventricular diastolic function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with HFpEF exhibit increased EAT thickness and reduced left atrial function. The thickening of EAT is associated with a decrease in left atrial strain. LA strain, particularly LASr, may serve as a sensitive indicator for early detection of left ventricular diastolic dysfunction in HFpEF.</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":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911054","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 Evaluation of Right Ventricular Synchrony by Two-Dimensional Speckle Tracking Echocardiography in Connective Tissue Disease-Associated Pulmonary Arterial Hypertension","authors":"Hong Ma,&nbsp;HongPing Wu,&nbsp;XiaoXuan Sun,&nbsp;Qiang Wang,&nbsp;YaGuo Zheng","doi":"10.1111/echo.70060","DOIUrl":"10.1111/echo.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Numerous studies have demonstrated impaired right ventricular (RV) synchronicity in pulmonary arterial hypertension (PAH). However, few studies have focused on connective tissue disease (CTD)-associated PAH. This study evaluates RV dyssynchrony and its prognostic value in CTD-associated PAH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred thirteen CTD patients and 32 healthy controls were consecutively recruited. The patients were further divided into two groups: the CTD-nonPAH group (sPAP ˂ 36 mmHg, <i>n</i> = 60) and the CTD-PAH group (sPAP ≥ 36 mm Hg, <i>n</i> = 53). RV dyssynchrony was evaluated by determining the standard deviation of the heart rate–corrected intervals from QRS onset to peak strain for the four segments (RV-SD4) using 2D speckle-tracking echocardiography (2D-STE). All patients were followed up, and the primary endpoint was clinical worsening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the health control, the CTD patients exhibited obviously prolonged RV-SD4 (13.3 ± 6.8 ms vs. 41.2 ± 36.5 ms, <i>p</i> &lt; 0.001). Among 113 CTD patients, the CTD-PAH patients had longer RV-SD4 than the CTD-nonPAH patients (20.8 ± 9.9 ms vs. 64.3 ± 41.6 ms, <i>p</i> &lt; 0.001). RV-SD4 was moderately positively correlated with RV longitudinal strain (<i>r</i> = 0.632, <i>p</i> &lt; 0.001), sPAP (<i>r</i> = 0.644, <i>p</i> &lt; 0.001), and were negatively correlated with TAPSE (<i>r</i> = –0.547, <i>p</i> &lt; 0.001), and FAC (<i>r</i> = –0.611, <i>p</i> &lt; 0.001). In the follow-up, 23 patients experienced clinical worsening. The ROC analysis suggested that RV-SD4 level &gt;60.6 ms predicted clinical worsening with 91.3% sensitivity and 66.7% specificity (AUC = 0.891, <i>p</i> &lt; 0.001). Multivariate Cox analysis showed that TAPSE (HR = 0.739; 95% CI 0.623–0.878; <i>p</i> = 0.001) and RV-SD4 (HR = 6.148; 95% CI 1.718–22.000; <i>p</i> = 0.005) were independent predictive parameters of clinical worsening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CTD patients exhibit impaired RV synchronicity, which is linked to RV function and pulmonary artery pressure. RV dyssynchrony could predict clinical worsening in CTD-PAH.</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":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911052","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":"Prognostic Value of Advanced Echocardiography in Patients with Ischemic Heart Disease: A Comprehensive Review","authors":"Shabnam Najaf Zadeh,&nbsp;Patrizia Malagutti,&nbsp;Luca Sartore,&nbsp;Raouf Madhkour,&nbsp;Martina Boscolo Berto,&nbsp;Christoph Gräni,&nbsp;Stefano De Marchi","doi":"10.1111/echo.70065","DOIUrl":"10.1111/echo.70065","url":null,"abstract":"<div>\u0000 \u0000 <p>Cardiovascular (CV) diseases caused 20.5 million deaths in 2021, making up nearly one-third of global mortality. This highlights the need for practical prognostic markers to better classify patients and guide treatment, especially in ischemic heart disease (IHD), which represents one of the leading causes of CV mortality. Transthoracic echocardiography (TTE) is a key, non-invasive imaging tool widely used in cardiology for diagnosing and managing a range of CV conditions. It is the first choice for diagnosing and monitoring patients with acute coronary syndrome (ACS). Alongside well-established echocardiographic measures, new techniques have proven useful for predicting adverse events in IHD patients, such as three-dimensional (3D) and tissue Doppler imaging (TDI), and speckle tracking technology. This review aims to explore the latest echocardiographic tools that could provide new prognostic markers for patients in the acute phase and during follow-up after an acute myocardial infarction (AMI). We focus on new imaging methods like TDI, myocardial work index (MWI), speckle-tracking strain, and 3D technologies using TTE, which are easy to use and widely available at all stages of coronary artery disease (CAD).</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911051","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 Between Lipoprotein(a) and Dilatation of Different Aortic Segments in Hypertensive Patients","authors":"Lin Wang,&nbsp;Chaoqun Ma,&nbsp;Xiaowei Liu,&nbsp;Wei Han","doi":"10.1111/echo.70061","DOIUrl":"10.1111/echo.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There are limited reports on the potential link between Lp(a) and ARDM. Thus, we examined the relationship between Lp(a) and ARDM among hypertensive patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used echocardiography to measure ARDM in 513 consecutively hospitalized patients. namely, the aortic valve annulus (Ava), sinuses of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) in 513 consecutive inpatients. We also examined the Lp(a), and other laboratory profiles of all participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lp(a) exhibited a positive and independent relationship with the SV diameter (coefficient [<i>β</i>] = 0.330, <i>p</i> = 0.002) and STJ (coefficient [<i>β</i>] = 0.253, <i>p</i> = 0.023), regardless of age, sex, height, or other clinical factors among hypertensive, but not nonhypertensive patients. We also demonstrated that a marked rise in Lp(a) levels was independently associated with SV dilatation (SVD) (OR: 1.006, 95% CI: 1.002–1.009, <i>p</i> = 0.002) and AA dilatation (AAD) (OR: 1.006, 95% CI: 1.000–1.011, <i>p</i> = 0.035) in patients with hypertension. In the subgroup analysis, elevated Lp(a) levels were significantly associated with SV dilatation in all subgroups, and with AAD in males and patients aged 65 years or younger (<i>p</i> &lt; 0.05). The restricted cubic spline analysis indicated a linear association between Lp(a) levels and the risk of both SV and AAD (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Herein, we were the first to report that among hypertensive patients, elevated Lp(a) concentrations were intricately linked to the ARDMs at SV and STJ. Moreover, we revealed that the Lp(a) level was a stand-alone indicator of SVD and AAD.</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":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911049","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 Regurgitation Evaluation in Modern Echocardiography: Bridging Standard Techniques and Advanced Tools for Enhanced Assessment","authors":"Laura Anna Leo,&nbsp;Giacomo Viani,&nbsp;Susanne Schlossbauer,&nbsp;Sebastiano Bertola,&nbsp;Amabile Valotta,&nbsp;Stephanie Crosio,&nbsp;Matteo Pasini,&nbsp;Alessandro Caretta","doi":"10.1111/echo.70052","DOIUrl":"https://doi.org/10.1111/echo.70052","url":null,"abstract":"<div>\u0000 \u0000 <p>Mitral regurgitation (MR) is one of the most common valvular heart diseases worldwide. Echocardiography remains the first line and most effective imaging modality for the diagnosis of mitral valve (MV) pathology and quantitative assessment of MR. The advent of three-dimensional echocardiography has significantly enhanced the evaluation of MV anatomy and function. Furthermore, recent advancements in cardiovascular imaging software have emerged as step-forward tools, providing a powerful support for acquisition, analysis, and interpretation of cardiac ultrasound images in the context of MR. This review aims to provide an overview of the contemporary workflow for echocardiographic assessment of MR, encompassing standard echocardiographic techniques and the integration of semiautomated and automated ultrasound solutions. These novel approaches include advancements in segmentation, phenotyping, morphological quantification, functional grading, and chamber quantification.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868789","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":"Navigating the Spectrum of Double-İnlet Left Ventricle Presentations: Contemporary Retrospective Cohort Study","authors":"Aydın Ocal,&nbsp;Oya Demirci,&nbsp;Gizem Elif Dizdarogulları,&nbsp;Nurdan Erol,&nbsp;Ilker Kemal Yucel","doi":"10.1111/echo.70054","DOIUrl":"10.1111/echo.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We presented the experience of a tertiary care center for maternal and fetal diseases and assessed the findings fetuses with double-inlet left ventricle (DILV) regarding fetal echocardiography, prenatal course including fetal growth and death, and postnatal outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, patients diagnosed with DILV via prenatal ultrasound in the maternal–fetal medicine department between 2015 and 2023 were included to evaluate important aspects of prenatal diagnosis and course, as well as postnatal management and outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 33 DILV cases prenatally diagnosed and postnatally confirmed. Genetic abnormality was detected in two (8%) of 25 fetuses that had undergone genetic tests. Pulmonary artery obstruction was observed in 10 (30.3%) fetuses; pulmonary stenosis was found in nine, and pulmonary atresia in one. Aortic arc abnormalities were found in 11 (33.3%) fetuses. The great arteries were malpositioned in the 29 (87.8%) fetuses. The median duration of follow-up for the infants was 12 (2–96) months, and 22 (66.6%) of 33 cases survived. Among the 27 (81.8%) live births, 24 infants required univentricular palliation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Remarkable implications of this study were that unless extra-cardiac and genetic anomalies accompany DILV, the probability of a chromosomal anomaly is low; that univentricular repair could be performed in almost all cases; and that the major causes of poor prognosis may be related to the restrictive bulboventricular foramen and severe aortic obstruction. Although long-term survival rates after univentricular repair appear to be high, these patients require long-term follow-up and repeated surgical procedures.</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":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848019","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":"Speckle Tracking Echocardiography-Based Correlation Between Left Atrial Strain and Functional Capacity in Patients With Hypertrophic Cardiomyopathy","authors":"Mohit D. Gupta,&nbsp;Rupesh Agrawal,&nbsp;Shekhar Kunal,&nbsp;Girish Meenahalli Palleda,&nbsp;Brijesh Kumar,&nbsp;Dixit Goyal,&nbsp;Ankit Bansal,&nbsp;Vishal Batra,&nbsp;Rajeev Kumar Malhotra,&nbsp;Jamal Yusuf","doi":"10.1111/echo.70051","DOIUrl":"10.1111/echo.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The left atrium (LA) dilates and its function decreases as a chronic secondary change in hypertrophic cardiomyopathy (HCM). LA strain is a more sensitive measure of LV filling pressure than LA volume and can be used to predict the functional capacity in HCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyze LA strain in patients with HCM and its correlation with exercise tolerance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 113 patients with HCM were enrolled. All patients underwent detailed clinical evaluation, 24-h Holter monitoring, exercise stress testing, two-dimensional echocardiography with LA strain analysis using speckle tracking imaging. Assessment of functional capacity was done in terms of metabolic equivalents (METs). HCM patients with METS &gt;6.0 were included in Group A while those with METS ≤ 6.0 were included Group B. Correlation of various parameters of LA strain (left atrial reservoir strain [LASr], left atrial conduit strain [LAScd], and left atrial contraction strain [LASct]) was done with functional capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the study population was 47 ± 10.77 years with the majority of them being males (71.9%). Group B patients had significantly lower LASr (12.95% ± 8.61% vs. 22.16% ± 16%; <i>p</i> &lt; 0.001), LAScd (−7.28% ± 6.29% vs. −12.74% ± 8.40%; <i>p</i> &lt; 0.001), and LASct (−7.44 ± 4.46 vs. −11.19 ± 6.53; <i>p</i> &lt; 0.001). Multivariable linear regression analysis reported LASr to be an independent predictor of METs and had a quadratic relationship with log-odds with negative linear and positive quadratic coefficients. LASr was the strongest echocardiographic predictor of reduced METS with an AUC of 0.78 (95% confidence interval [CI]: 0.68–0.88), sensitivity of 71.8%, and specificity of 82.9%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LA strain parameters are associated with functional capacity in patients with HCM with lower LA strain values being associated with poor functional capacity.</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":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848031","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":"Single Coronary Origin From Right Coronary Sinus With Intraseptal Course: How to Make Diagnosis by Echocardiography","authors":"Massimiliano Cantinotti,&nbsp;Alberto Clemente,&nbsp;Guglielmo Capponi,&nbsp;Nadia Assanta","doi":"10.1111/echo.70050","DOIUrl":"10.1111/echo.70050","url":null,"abstract":"<div>\u0000 \u0000 <p>We describe a rare case of a male adolescent with anomalous aortic origin of the left coronary artery from the right sinus with intraseptal course (L-ACAO-IS), which was diagnosed at transthoracic echocardiography. The case we presented confirms how echocardiography is accurate in the diagnosis of even challenging coronary artery origin anomalies such as L-ACO-IS. Coronary artery origin evaluation should be an integral part of echocardiography examinations in infants, children, and young adults, especially those undergoing physical activity. We also remark the importance of using multiple views including short axis, long axis, and modified (anteriorized) 4-chamber view which is very helpful for a better evaluation of coronary artery origin and their proximal course.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848023","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 Diabetes Mellitus on Left Ventricular Mechanics and Long-Term Outcome in Patients with Hypertrophic Cardiomyopathy","authors":"Hala Mahfouz Badran,&nbsp;John Anis Helmy,&nbsp;Nagalaa Fahem Ahmed,&nbsp;Magdi Yacoub","doi":"10.1111/echo.70048","DOIUrl":"10.1111/echo.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) intensifies the clinical symptoms of heart diseases and leads to a worse prognosis in heart failure patients. Although hypertrophic cardiomyopathy (HCM) and DM rarely co-occur, particularly in older individuals, the impact of DM on cardiac function and outcomes in individuals with HCM remains insufficiently understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 421 HCM patients were included and followed up in a prospective cohort study (mean 68.7 months). In the diabetic HCM group (<i>n</i> = 47), patients had a mean age of 47 ± 17 years, and 31 (66%) were male, while the non-diabetic HCM group (<i>n</i> = 374) had a mean age of 44 ± 14 years, and 246 (65%) were male. At study entry, all patients underwent echocardiographic evaluation, encompassing left ventricular (LV) regional and global longitudinal strain (GLS), as well as strain rate (SR) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In diabetic HCM, there was a greater prevalence of hypertension (<i>p</i> &lt; 0.0001), while the ratio of septal to posterior wall thickness (PWT) (<i>p</i> &lt; 0.003) and E' value were lower (<i>p</i> &lt; 0.009) compared to non-diabetic HCM. No significant difference between groups in NYHA class or cardiac phenotype. Diabetic HCM exhibited notable reductions in GLS (<i>p</i> &lt; 0.02), systolic SR (SRsys) (<i>p</i> &lt; 0.04), and early diastolic SR (SRe) <i>p</i> &lt; 0.006. Additionally, there was a significant inverse correlation between LVGLS and HbA1c levels (<i>r</i> = −0.58, <i>p</i> &lt; 0.0001), and the duration of diabetes (<i>r</i> = −0.39, <i>p</i> &lt; 0.006). Hospitalization rates were greater in the diabetic HCM than in the non-diabetic group (44.7% vs.19.5%, <i>p</i> &lt; 0.001). Among all demographic characteristics, phenotypic data, conventional echocardiographic measurements, and LV mechanics, diabetes emerged as the sole determinant of hospitalization among HCM patients. The presence of diabetes nearly tripled the odds of hospitalization (odds ratio: 2.813 [1.448–5.465], <i>p</i> &lt; 0.002). However, diabetes did not negatively affect long-term survival, and age remained the only independent predictor of all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In HCM, T2DM is linked to more deterioration of cardiac mechanics and contributes to unfavorable consequences by frequent hospitalization on its own, independent of age, comorbidities, or phenotype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 12","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808484","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 False Tendons: A Morphological Study by Echocardiography","authors":"Aizhuo Chen,&nbsp;Jinqing Chen","doi":"10.1111/echo.70049","DOIUrl":"10.1111/echo.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This is a prospective study aimed to investigate the morphology of left ventricular false tendons (LVFTs) using echocardiography and explore its associations with age, sex, body mass index (BMI), congenital heart structural abnormalities, and premature ventricular contractions (PVCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We analyzed data from 889 individuals who underwent consecutive echocardiograms at our ultrasound department between December 2023 and February 2024. Routine echocardiograms were performed to detect congenital structural abnormalities, with a focus on identifying LVFT. We examined the prevalence, number, and distribution of LVFTs, as well as their correlation with age, sex, BMI, and congenital heart structural abnormalities. LVFTs were detected in 460 of 889 cases (51.74%), totaling 672 LVFTs. LVFT prevalence significantly differed not only between sexes but also between ages. LVFT prevalence was higher in individuals with lower BMI. There was no significant difference in congenital heart structural abnormalities between the groups, but the composition of distinct types of structural abnormalities differed between the groups. The incidence of PVCs in the LVFT-positive group was significantly higher than in the LVFT-negative group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of LVFTs is notably higher in males than females and tends to decrease with advancing age and increasing BMI. LVFTs display diverse morphological features and may interact synergistically with certain congenital heart structural abnormalities. LVFTs can easily lead to PVCs in healthy people, but the risk of leading to malignant PVCs does not seem to be high. Correctly recognizing the morphological characteristics of LVFTs helps to distinguish similar ultrasonic images of different diseases, thus avoiding missed diagnoses and misdiagnoses in ultrasound work and clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 12","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803276","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}