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

{"title":"Non-Invasive Myocardial Work Indices (GWI, GCW, GWW, and GWE) as Predictors of Clinical Outcomes Across Cardiac Diseases: A Systematic Review and Meta-Analysis","authors":"Jeevarathinam Thirumalai, Mohamed Sahal, Priyanka Bai","doi":"10.1111/echo.70544","DOIUrl":"10.1111/echo.70544","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Non-invasive myocardial work (MW) indices derived from pressure-strain loop analysis, including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), have emerged as novel predictors of clinical outcomes across a broad spectrum of cardiac diseases. The purpose of this systematic review and meta-analysis was to comprehensively synthesize published evidence examining the prognostic value of MW indices for predicting clinical outcomes and their diagnostic performance for identifying disease-specific abnormalities across cardiac conditions, including heart failure, acute coronary syndrome, valvular heart disease, cardiomyopathy, cardiotoxicity in oncology, and cardiac resynchronization therapy response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science (up to May 2026) identified 24 eligible studies encompassing 4,710 participants. Random-effects inverse-variance models with restricted maximum likelihood (REML) estimation and Hartung-Knapp confidence interval correction were applied. Direction-harmonized hazard ratios (HR), odds ratios (OR), and standardized odds ratios (sOR) were pooled as an exploratory summary of ratio-based effects, such that values exceeding 1.0 consistently indicated higher clinical risk with an adverse MW profile, while the HR-only model was retained as the principal prognostic sensitivity analysis. Quality was assessed using the Newcastle-Ottawa Scale and the GRADE framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The primary pooled analysis yielded a random-effects estimate of 1.12 (95% CI: 0.99–1.27); however, substantial heterogeneity was observed (<i>I</i><sup>2</sup> = 82.1%), reflecting important differences across cardiac disease populations. The all-estimates sensitivity analysis (18 estimates; <i>n</i> = 3,536) achieved statistical significance (RE: 1.19; 95% CI: 1.04–1.35). The HR-only sensitivity analysis yielded a similar effect estimate (RE: 1.18; 95% CI: 0.99–1.41) and represented the most clinically interpretable prognostic analysis. Disease-specific analyses demonstrated heterogeneous effect sizes: the cardiomyopathy subgroup showed the largest associations (HR up to 5.46 for GWI in dilated cardiomyopathy), while heart failure and valvular disease demonstrated consistent moderate associations. Prognostic analyses primarily evaluated mortality, MACE, hospitalization, and other time-to-event outcomes, whereas diagnostic analyses assessed the ability of MW indices to identify disease-specific abnormalities such as CTRCD and impaired microvascular perfusion. GCW demonstrated the highest diagnostic accu","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609694","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 Electrocardiogram and Pulmonary Hypertension: When Occam'S Razor Fails","authors":"Elisa Gherbesi, Andrea Faggiano, Cesare Cuspidi","doi":"10.1111/echo.70577","DOIUrl":"10.1111/echo.70577","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609637","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":"Transient Ischemic Stunning Visualized by Echocardiography Preceding a Wellens Pattern","authors":"Takakazu Kinugawa,&nbsp;Hiroki Matsuzoe,&nbsp;Sachiyo Iwata,&nbsp;Hidekazu Tanaka,&nbsp;Gaku Nakazawa","doi":"10.1111/echo.70572","DOIUrl":"10.1111/echo.70572","url":null,"abstract":"<div>\u0000 \u0000 <p>Continuous echocardiography captured transient myocardial stunning before the appearance of a type-A Wellens ECG pattern. This case highlights the value of echocardiography for detecting transient myocardial ischemia before characteristic electrocardiographic changes become apparent.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609639","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":"Beyond Conventional Echocardiography: The Emerging Role of Left Atrioventricular Coupling Indexes in Chronic Chagas Disease","authors":"Stefano Sforna,&nbsp;Erberto Carluccio,&nbsp;Federico Fortuni","doi":"10.1111/echo.70578","DOIUrl":"10.1111/echo.70578","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609649","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":"Cardiac Myxoma Originating From the Septal Papillary Muscle of the Right Ventricle in a Second-Trimester Patient","authors":"Jing-jing Zhou,&nbsp;Qi-wei Dong,&nbsp;Yan-ting Song,&nbsp;Rong-juan Li,&nbsp;Hong-kai Zhang,&nbsp;Xiao-yan Gu,&nbsp;Yi-hua He","doi":"10.1111/echo.70573","DOIUrl":"10.1111/echo.70573","url":null,"abstract":"<p>This case illustrates a large right ventricular myxoma causing severe right ventricular outflow tract obstruction. Multimodality imaging, including echocardiography and CT, guided the diagnosis. The patient underwent successful surgical resection, with histopathology confirming the benign tumor, leading to hemodynamic relief.\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":"43 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609657","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":"Four-Chamber Deformation Remodeling and Atrial Fibrillation After Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy","authors":"Olga N. Kislitsina,&nbsp;Lubna Choudhury,&nbsp;Kifah Hussain,&nbsp;James D. Thomas,&nbsp;Seokyung An,&nbsp;Abigail S. Baldridge,&nbsp;Daniel J. Romary,&nbsp;Beth Whippo,&nbsp;James L. Cox,&nbsp;Patrick M. McCarthy,&nbsp;Douglas R. Johnston","doi":"10.1111/echo.70567","DOIUrl":"10.1111/echo.70567","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Septal myectomy treats hypertrophic obstructive cardiomyopathy (HOCM), but its effect on myocardial deformation across cardiac chambers is incompletely defined. We evaluated chamber-specific strain remodeling 1 year after septal myectomy and examined whether atrial strain was associated with atrial fibrillation (AF) during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 187 consecutive patients undergoing surgical septal myectomy for HOCM. Conventional echocardiography and speckle-tracking strain analysis were used to assess left ventricular (LV), right ventricular (RV), left atrial (LA), and right atrial (RA) deformation preoperatively and at 1-year follow-up. Paired analyses compared preoperative and postoperative strain values. Multivariable logistic regression evaluated associations between baseline strain measures, AF, and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 187 patients, 85 had analyzable 1-year strain studies. At 1 year, LA contractile strain (CS) improved from 10.4±5.9% to 13.6±7.1% (<i>p</i> = 0.005), whereas LA reservoir strain (RS) did not significantly change. In contrast, RA-RS decreased from 36.0±10.6% to 28.0±11.6% (<i>p</i> = 0.001), RV free-wall strain worsened from −26.3±7.0% to −21.1±6.8% (<i>p</i> = 0.001), and RV global longitudinal strain (GLS) worsened from −21.3±5.1% to −17.3±5.5% (<i>p</i> = 0.001). LV-GLS was unchanged. Higher LA-CS was associated with lower odds of AF after adjustment (aOR 0.92, 95% CI 0.85–0.99; <i>p</i> = 0.018), as was higher LA-RS (aOR 0.95, 95% CI 0.91–0.99; <i>p</i> = 0.035). LA-RS was associated with mortality in unadjusted analysis but not after multivariable adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Septal myectomy is followed by nonuniform, chamber-specific deformation remodeling. LA-CS improves, LA-RS and CS identify patients at higher AF risk, LV-GLS remains unchanged, and right-sided longitudinal deformation worsens at 1 year. Four-chamber strain analysis may augment post-myectomy surveillance.</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":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609675","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":"Disease-Phase Myocardial Dysfunction by Strain Imaging in Kawasaki Disease: A Systematic Review and Meta-Analysis","authors":"Kwadwo Danso,&nbsp;Susana Mayer,&nbsp;Kangwa Mulenga,&nbsp;Aluisio Gomes,&nbsp;Natanael Portilho","doi":"10.1111/echo.70554","DOIUrl":"10.1111/echo.70554","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Global longitudinal strain (GLS) can detect subclinical dysfunction missed by left ventricular ejection fraction (LVEF). We aim to quantify the magnitude of myocardial dysfunction using GLS across the phases of Kawasaki disease (KD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We systematically searched for studies comparing GLS measurements between children with KD and age-matched controls. Effect sizes were pooled using a random-effects model and reported as standardized mean differences (SMD) for the acute and chronic disease phases. SMDs were re-expressed as mean differences (MDs) using pooled weighted standard deviations (SDs) of 2.75% and 1.89% for the control groups in the acute and chronic phases, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 18 observational studies comprising 907 KD patients and 764 controls. KD patients demonstrated significant GLS depression compared with controls in both the acute (SMD: 1.34, 95% CI: 0.73, 1.95, <i>p</i> &lt; 0.0001, <i>I</i>² = 93%; MD: 3.6%) and chronic (SMD: 0.72, 95% CI: 0.20, 1.25, <i>p</i> = 0.007, <i>I</i>² = 92%; MD: 1.9%) phases. LVEF was reduced in the acute phase (MD: −1.09%, 95% CI: −1.57, −0.61, <i>I</i>² = 0%), and normalized in the chronic phase (MD: −0.27%, 95% CI: −1.18, 0.64, <i>I</i>² = 36%). Multivariable meta-regression in the acute phase identified CRP (<i>β</i> = 0.02, <i>p</i> = 0.024) plus CAA patient proportion (<i>β</i> = −1.13, <i>p</i> = 0.069) explaining 49.28% of heterogeneity, whereas vendor platform (GE vs. Philips) (<i>β</i> = −1.02, <i>p</i> = 0.007) plus age at follow-up (<i>β</i> = 0.02, <i>p</i> = 0.019) explained 56.34% of heterogeneity in the chronic phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite LVEF normalization in the chronic phase of KD, myocardial dysfunction persists. This could be essential for long-term monitoring algorithms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537116","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":"Mavacamten's Dose-Time Dynamics and Predictive Factors in Hypertrophic Obstructive Cardiomyopathy Cardiac Remodeling","authors":"Binbin Cao,&nbsp;Yuanhong Li,&nbsp;Xiaomin Chen","doi":"10.1111/echo.70540","DOIUrl":"https://doi.org/10.1111/echo.70540","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypertrophic obstructive cardiomyopathy (HOCM) causes dynamic left ventricular outflow tract (LVOT) obstruction and disabling symptoms; many patients do not respond to conventional agents. Mavacamten, a selective cardiac myosin inhibitor, improves gradients, but the dose–time response in routine practice remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate longitudinal echocardiographic, biomarker, and safety changes associated with clinically guided mavacamten therapy compared with conventional pharmacotherapy in symptomatic HOCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center prospective comparative cohort study, 95 symptomatic HOCM patients were included, of whom 48 received mavacamten and 47 received conventional pharmacotherapy. Mavacamten was initiated at 2.5 mg daily and titrated (2.5–10 mg) based on resting LVOT gradient (LVOTG) and ejection fraction (LVEF). Follow-up assessments were performed at baseline and at scheduled visits at 3, 6, and 9 months. Longitudinal echocardiographic trajectories were analyzed using observed mean changes with 95% confidence intervals (CIs), and baseline imbalance was assessed using inverse probability weighting. The predefined LVOTG response endpoint was defined as a reduction in resting LVOTG of ≥ 30 mmHg from baseline at the last available follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mavacamten was associated with a downward trajectory in resting LVOTG during follow-up, whereas the control group remained relatively stable. BNP decreased significantly in the mavacamten group, whereas no significant paired change was observed in the control group. The predefined LVOTG response endpoint was achieved by 9 of 48 patients (18.8%) in the mavacamten group and 1 of 42 patients (2.4%) in the control group (Fisher exact <i>p</i> = 0.0175; OR = 9.46, 95% CI 1.14–78.20). No patient experienced LVEF &lt; 50%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In symptomatic HOCM, clinically guided mavacamten therapy was associated with reductions in resting LVOT gradient and BNP, while LVEF remained preserved during short-term follow-up. These findings support individualized dose titration with echocardiographic monitoring, while dose-stratified and response analyses should be interpreted cautiously because of limited subgroup sizes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467111","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":"Cardiac Shear Wave Elastography: Principles, Clinical Applications, and Practical Considerations for Interpretation","authors":"Fan Wu,&nbsp;Qiyao Xu","doi":"10.1111/echo.70551","DOIUrl":"10.1111/echo.70551","url":null,"abstract":"<div>\u0000 \u0000 <p>Cardiac shear wave elastography (SWE) is an emerging ultrasound-based technique that enables noninvasive assessment of myocardial mechanical properties beyond conventional motion- and deformation-based indices. By tracking the propagation of shear waves within the myocardium using ultrafast imaging, SWE provides stiffness-related information that may complement standard echocardiographic parameters in selected clinical settings. In this narrative review, we summarize the methodological principles of cardiac SWE, including acoustic radiation force-induced techniques, natural shear wave imaging approaches, and emerging three-dimensional SWE. We discuss current clinical evidence in key disease states characterized by altered myocardial stiffness, such as hypertrophic cardiomyopathy, cardiac amyloidosis, heart failure with preserved ejection fraction, and post-transplant or diffuse myocardial injury. Importantly, SWE measurements are highly context-dependent and influenced by cardiac phase, loading conditions, myocardial anisotropy, imaging plane, and acquisition methodology. Therefore, reported values should be interpreted as reflecting stiffness-related myocardial behavior rather than direct measures of fibrosis or specific histopathologic substrates. At present, cardiac SWE remains primarily a research-stage technique, with potential roles in phenotypic characterization, disease burden assessment in selected populations, longitudinal monitoring, and future integration into multiparametric echocardiographic and artificial intelligence–assisted workflows. Further standardization, definition of normal reference ranges, technical validation, and multicenter clinical studies are required before broader clinical adoption. In conclusion, cardiac SWE represents a promising extension of echocardiographic assessment of myocardial mechanics, but its clinical interpretation requires careful consideration of methodological, physiological, and disease-specific determinants.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431452","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":"Machine-Reported Electrocardiographic Right Axis Deviation or Right Ventricular Hypertrophy and Echocardiographic Pulmonary Hypertension Phenotypes and Right-Heart Abnormalities","authors":"Yoshihiro Fuchigami","doi":"10.1111/echo.70539","DOIUrl":"10.1111/echo.70539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Machine-reported electrocardiographic findings suggesting right-heart strain are routinely generated during electrocardiogram (ECG) acquisition, but their relationship to echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities remains incompletely defined. This study evaluated whether machine-reported right axis deviation (RAD) or right ventricular hypertrophy (RVH) is associated with echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities in hospitalized patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study used linked MIMIC-IV-ECG and MIMIC-IV-ECHO data. Echocardiograms were linked to the closest ECG obtained from 7 days before echocardiography through the time of echocardiography. The primary exposure was machine-reported RAD or RVH. The primary outcome was Echo-PH specific, a composite echo-derived phenotype including tricuspid regurgitation velocity greater than 3.4 m/s, moderate or severe pulmonary hypertension text, or right ventricular pressure overload. Logistic regression adjusted for demographics, comorbidities, and ICU status, with patient-level cluster-robust standard errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 68 905 ECG–echocardiography pairs from 42 078 patients; 2815 pairs were RAD/RVH-positive. For Echo-PH specific, RAD/RVH had sensitivity 7.5%, specificity 96.7%, positive predictive value 35.5%, and negative predictive value 81.4%. RAD/RVH remained associated with Echo-PH specific after full adjustment using cluster-robust standard errors (odds ratio, 2.04; 95% confidence interval, 1.84–2.26). The adjusted probability of Echo-PH specific was 18.8% without RAD/RVH and 30.0% with RAD/RVH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Machine-reported ECG RAD/RVH was highly specific but insensitive for echocardiographic pulmonary hypertension phenotypes and right-heart abnormalities. These routine ECG findings may serve as supportive clues to echocardiographic right-heart disease but should not be used to exclude it.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"43 7","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431490","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}